Unit of Oral Surgery, Department of Biomedical, Surgical, and Dental Sciences, Dental Clinic, St. Paolo and St. Carlo Hospitals, University of Milan, Milan, Italy.
Private Practice Milan, Milan, Italy.
Clin Oral Implants Res. 2021 Apr;32(4):498-510. doi: 10.1111/clr.13720. Epub 2021 Mar 1.
To present the results of guided bone regeneration (GBR) of atrophic edentulous ridges with customized CAD/CAM titanium meshes.
Forty-one patients, presenting with 53 atrophic sites, were enrolled between 2018 and 2019. GBR was obtained with titanium meshes filled with autogenous bone chips and bovine bone mineral (BBM). After a mean of 7 months (range: 5-12 months), meshes were removed and 106 implants placed. After a mean of 3.5 months (range: 2-5 months), implants were uncovered and prosthetic restorations started. The outcomes were vertical and horizontal bone augmentation changes, biological complications and implant survival.
Out of 53 sites, 11 underwent mesh exposure: eight of them were followed by uneventful integration of the graft, while three by partial bone loss. The mean vertical and horizontal bone gain after reconstruction was 4.78 ± 1.88 mm (range 1.00-8.90 mm) and 6.35 ± 2.10 mm (range 2.14-11.48 mm), respectively. At the time of implant placement, mean changes of initial bone gain were -0.39 ± 0.64 mm (range -3.1 to + 0.80 mm) and -0.49 ± 0.83 mm (range -3.7 to +0.4 mm), in the vertical and horizontal dimensions, respectively. Reduction of bone volume was significantly higher (p < .001 for both dimensions) in the exposed sites. The mean follow-up of implants after loading was 10.6 ± 6.5 months (range: 2-26 months). The survival rate of implants was 100%.
Customized titanium meshes can represent a reliable tool for GBR of severely atrophic sites, with simplification of the surgical phases.
介绍使用定制 CAD/CAM 钛网进行萎缩性无牙颌骨再生(GBR)的结果。
2018 年至 2019 年间,共纳入 41 名患者(53 个部位)。使用填充自体骨屑和牛骨矿物质(BBM)的钛网进行 GBR。平均 7 个月(范围:5-12 个月)后,去除网格并植入 106 个种植体。平均 3.5 个月(范围:2-5 个月)后,暴露种植体并开始修复体。评估指标为垂直和水平骨增量变化、生物并发症和种植体存活率。
53 个部位中有 11 个发生了网片暴露,其中 8 例无并发症,植骨完全整合,3 例发生部分骨丢失。重建后平均垂直和水平骨增量分别为 4.78 ± 1.88mm(范围 1.00-8.90mm)和 6.35 ± 2.10mm(范围 2.14-11.48mm)。植入时,初始骨增量的平均变化分别为-0.39 ± 0.64mm(范围-3.1 至+0.80mm)和-0.49 ± 0.83mm(范围-3.7 至+0.4mm),在垂直和水平方向上。暴露部位的骨量减少明显更高(两个维度均 p <.001)。种植体加载后平均随访时间为 10.6 ± 6.5 个月(范围:2-26 个月)。种植体的存活率为 100%。
定制钛网可作为严重萎缩性部位 GBR 的可靠工具,简化手术阶段。