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通过预制钛网对裂开型种植体周围缺损进行同期牙槽嵴增量的临床和影像学评估:一项前瞻性初步研究

Clinical and Radiographic Evaluation of Simultaneous Alveolar Ridge Augmentation by Means of Preformed Titanium Meshes at Dehiscence-Type Peri-Implant Defects: A Prospective Pilot Study.

作者信息

Maiorana Carlo, Manfredini Mattia, Beretta Mario, Signorino Fabrizio, Bovio Andrea, Poli Pier Paolo

机构信息

Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Odontostomatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Via della Commenda 10, 20122 Milan, Italy.

出版信息

Materials (Basel). 2020 May 22;13(10):2389. doi: 10.3390/ma13102389.

Abstract

BACKGROUND

bone augmentation by means of manually shaped titanium mesh is an established procedure to regenerate atrophic alveolar ridges and recreate a proper contour of the peri-implant bone anatomy. Conversely, current literature on the use of preformed titanium meshes instead of traditional grids remains lacking. Therefore, the aim of the present prospective study was to evaluate the use of preformed titanium mesh to support bone regeneration simultaneously to implant placement at dehiscence-type defects from clinical, radiological, and patient-related outcomes.

METHODS

8 implants showing buccal dehiscence defects were treated with preformed titanium mesh directly fixed to flat abutments screwed to the implant. Intrasurgical clinical measurements and radiographic evaluations by means of cone-beam computed tomography scans were performed to assess the horizontal bone gain after 8 months from the augmentation surgery. Biological and patient-centered outcomes were also evaluated.; Results: clinically, a mean horizontal bone gain of 4.95 ± 0.96 mm, and a mean horizontal thickness of the buccal plate of 3.25 ± 0.46 mm were found. A mean horizontal bone gain of 5.06 ± 0.88 mm associated with a mean horizontal thickness of the buccal plate of 3.45 ± 0.68 mm were observed radiographically. From a macroscopic aspect, the remodeled graft appeared well integrated with the host bone. Well vascularized newly formed bone-like tissue was observed in intimate contact with the implants.

CONCLUSIONS

preformed titanium mesh may be effective in supporting simultaneous horizontal bone regeneration at dehiscence-type peri-implant defects. Titanium mesh exposure still remain an issue in this type of surgery.

摘要

背景

通过手工塑形钛网进行骨增量是一种成熟的方法,用于修复萎缩性牙槽嵴并重建种植体周围骨解剖结构的合适轮廓。相反,目前关于使用预制钛网而非传统网格的文献仍然缺乏。因此,本前瞻性研究的目的是从临床、影像学和患者相关结局方面评估在种植体植入时使用预制钛网来支持裂开型缺损处骨再生的效果。

方法

对8颗出现颊侧裂开缺损的种植体,使用直接固定在拧入种植体的平面基台上的预制钛网进行治疗。通过锥形束计算机断层扫描进行术中临床测量和影像学评估,以评估骨增量手术后8个月的水平骨增量。还评估了生物学和以患者为中心的结局。结果:临床上,平均水平骨增量为4.95±0.96mm,颊侧骨板平均水平厚度为3.25±0.46mm。影像学观察到平均水平骨增量为5.06±0.88mm,颊侧骨板平均水平厚度为3.45±0.68mm。从宏观角度看,重塑的移植物与宿主骨融合良好。观察到血管化良好的新形成的类骨组织与种植体紧密接触。

结论

预制钛网可能有效地支持裂开型种植体周围缺损处的同步水平骨再生。在这类手术中,钛网暴露仍然是一个问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c76d/7287986/598f0b0648a6/materials-13-02389-g001.jpg

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