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上颌窦提升和侧壁骨增量术后完全无牙颌的容积性骨变化:系统评价。

Volumetric osseous changes in the completely edentulous maxilla after sinus grafting and lateral bone augmentation: a systematic review.

机构信息

Department of Oral and Maxillofacial Surgery, Rijnstate Hospital, Arnhem, Netherlands; Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.

Department of Oral and Maxillofacial Surgery, Rijnstate Hospital, Arnhem, Netherlands.

出版信息

Int J Oral Maxillofac Surg. 2020 Nov;49(11):1470-1480. doi: 10.1016/j.ijom.2020.03.001. Epub 2020 Mar 30.

Abstract

The aim of this systematic review was to evaluate the volumetric changes associated with different bone grafting techniques in the completely edentulous atrophic maxilla before dental implant placement. A search was performed according to the PRISMA guidelines. A PICO question was formed, and the PubMed, Scopus, Embase, and Cochrane Library databases were searched, covering the period 2000-2018. Relevant data were extracted from the results regarding study population, surgical details, technical information on volumetric data acquirement, and volumetric outcome after bone augmentation procedures before implant placement. Six articles with a combined population of 84 patients were included. All patients had a completely edentulous maxilla, with a crestal horizontal width of <3-4mm or a crestal vertical height of <6-7mm. The iliac bone and ascending ramus were most frequently used as grafts. Five of the six studies reported volumes of sinus inlay graft (SIG) and four reported volumes of lateral bone augmentation (LBA). Radiographic analyses of the augmented areas differed among the studies. Volume loss after bone augmentation procedures ranged from 5% to 50% for SIG and from 5% to 47% for LBA. All surgical augmentation techniques for the edentulous maxilla are prone to resorption; no procedure seemed to be superior, but some interesting observations were made.

摘要

本系统评价的目的是评估在牙种植体植入前,完全无牙的萎缩上颌骨中不同植骨技术相关的体积变化。按照 PRISMA 指南进行了检索。提出了一个 PICO 问题,并对 PubMed、Scopus、Embase 和 Cochrane Library 数据库进行了检索,涵盖了 2000 年至 2018 年的时间段。关于研究人群、手术细节、关于体积数据获取的技术信息以及植入前骨增量手术后的体积结果,从结果中提取了相关数据。纳入了 6 篇文章,共 84 例患者。所有患者均为完全无牙的上颌骨,牙槽嵴水平宽度<3-4mm 或牙槽嵴垂直高度<6-7mm。髂骨和升支最常被用作移植物。6 项研究中的 5 项报告了窦内植骨(SIG)的体积,4 项报告了外侧骨增量(LBA)的体积。研究中对增强区域的影像学分析存在差异。SIG 的骨增量手术后的体积损失范围为 5%-50%,LBA 的体积损失范围为 5%-47%。无牙上颌骨的所有外科增强技术都容易被吸收;没有一种方法似乎更优越,但也有一些有趣的观察结果。

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