Department of Periodontology, Nangjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China.
Central laboratory of Stomatology, Nangjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China.
J Oral Rehabil. 2019 Aug;46(8):756-764. doi: 10.1111/joor.12800. Epub 2019 May 9.
The purpose of this study was to investigate whether a novel in situ interdental bone elevation method could achieve vertical bone augmentation around natural teeth.
Horizontal periodontal bone defects were created at nine quadrants of mandibles in five dogs. Six weeks later, one of the nine quadrants was randomly chosen as the model control. The remaining mandibles were allocated into two experimental groups: cortical bone removing (CBR) or interdental bone elevation (IBE). For the IBE group, four millimetres of interdental bone blocks were separated and elevated from the base of alveolar bone. Then bone xenografts were implanted beneath the elevated alveolar blocks. Animals were euthanised 12 weeks post-operation. Cone beam computed tomography (CBCT) examination and histological analysis were performed to evaluate the surgical outcomes.
Enhanced soft tissue profiles were observed in the two experimental groups as compared to the model control group. CBCT images showed that the height of alveolar bone was significantly higher in the IBE group with bone blocks seated near the cementoenamel junction. Significantly larger area of bone tissues with the highest coronal level of new bone was observed in the IBE group. New bone was observed around the elevated bone blocks with bone remodelling and neovascularisation inside the elevated blocks.
Vertical bone augmentation at interdental sites may be performed through in situ interdental bone elevation for patients with horizontal alveolar bone resorption.
本研究旨在探讨一种新型的牙间骨内提升方法是否可实现天然牙周围的垂直骨增量。
在 5 只犬的下颌骨 9 个象限中创建水平牙周骨缺损。6 周后,随机选择其中的 9 个象限作为模型对照组。其余下颌骨分为皮质骨去除(CBR)或牙间骨提升(IBE)两组。对于 IBE 组,从牙槽骨底部分离并提升 4 毫米的牙间骨块。然后在提升的牙槽骨块下方植入骨异种移植物。动物在术后 12 周被安乐死。通过锥形束 CT(CBCT)检查和组织学分析评估手术结果。
与模型对照组相比,两个实验组观察到软组织轮廓增强。CBCT 图像显示,在有骨块位于牙骨质-釉质交界处附近的 IBE 组中,牙槽骨高度显著增加。IBE 组观察到具有最高新骨冠方水平的骨组织面积显著增大。在提升的骨块周围观察到新骨,提升块内有骨重塑和新生血管形成。
对于水平牙槽骨吸收的患者,通过牙间骨内提升可实现牙间部位的垂直骨增量。