Kelly J F, Friedlaender G E
J Oral Surg. 1977 Apr;35(4):268-75.
Allogeneic bone biologically interacts with host tissues at a graft site. Addition of autogenous cancellous bone and marrow to allogeneic bone enhances the osteogenic activity of the graft. These observations have been confirmed by noninvasive, quantitative radionuclide methods. The process of freeze-drying greatly reduces and, from the standpoint of clinical significance, essentially eliminates the antigenicity of allogeneic bone. Judged by the results of 14 cases that are under continuous follow-up, allogeneic bone graft augmentation of the denture-bearing area is a possible alternative to autogenous grafting. The process of obtaining and preparing the blanked bone for surgery is reasonable although some questions remain, such as the desirable length of time for tissue reconstitution and the need for culturing or adding antibiotics to the reconstitution solution, or both. It appears that the addition of autogenous cancellous bone and marrow is desirable in most instances unless the dimension of the area to be augmented is quite small or an iliac osteotomy is precluded for medical reasons. The occurrence of complications such as infection and dehiscence during the postoperative course is similar to that in patients with autogenous grafts. Dehiscence can be expected although it appears that if the graft has been supplemented with autogenous cancellous marrow the incidence and extent are dminished. It should be emphasized that dehiscence does not signify failure of the graft-allogeneic bone is not sloughed in toto after being exposed to the oral cavity. Secondary soft tissue procedures can be used in patients with allogeneic grafts; additional cases with long-term follow-up are still needed to establish this method.
异体骨在移植部位与宿主组织发生生物学相互作用。将自体松质骨和骨髓添加到异体骨中可增强移植骨的成骨活性。这些观察结果已通过非侵入性定量放射性核素方法得到证实。冷冻干燥过程极大地降低了异体骨的抗原性，从临床意义的角度来看，基本上消除了其抗原性。根据14例持续随访的结果判断，在义齿承托区进行异体骨移植增强术是自体移植的一种可能替代方法。获取和准备手术用块状骨的过程是合理的，尽管仍存在一些问题，例如组织重建所需的理想时间长度以及是否需要在重建溶液中培养或添加抗生素，或两者皆需。在大多数情况下，添加自体松质骨和骨髓似乎是可取的，除非待增强区域的尺寸非常小，或者由于医学原因无法进行髂骨截骨术。术后过程中感染和裂开等并发症的发生率与自体移植患者相似。尽管似乎如果移植骨已补充自体松质骨髓，裂开的发生率和程度会降低，但仍可能发生裂开。应该强调的是，裂开并不意味着移植失败——异体骨暴露于口腔后不会整块脱落。对于异体移植患者可采用二次软组织手术；仍需要更多长期随访的病例来确立这种方法。
