Abtahi Jahan, Klintström Benjamin, Klintström Eva
Department of Oral & Maxillofacial Surgery and Department of Biomedical and Clinical Sciences Linköping University Linköping Sweden.
Center for Medical Image Science and Visualization (CMIV) Linköping University Linköping Sweden.
JBMR Plus. 2021 Feb 10;5(3):e10468. doi: 10.1002/jbm4.10468. eCollection 2021 Mar.
Autologous bone grafts are considered the gold standard for reconstruction of the edentulous alveolar ridges. However, this procedure is associated with unpredictable bone loss caused by physiological bone resorption. Bisphosphonates are antiresorptive drugs that act specifically on osteoclasts, thereby maintaining bone density, volume, and strength. It was hypothesized that the resorption of bone grafts treated with an ibandronate solution would be less advanced than bone grafts treated with saline. Ten patients who underwent bilateral sagittal split osteotomy were included in a randomized double-blind trial with internal controls. Each patient received a bone graft treated with a solution of ibandronate on one side and a graft treated with saline (controls) contralaterally. Radiographs for the measurement of bone volume were obtained at 2 weeks and at 6 months after surgery. The primary endpoint was the difference in the change of bone volume between the control and the ibandronate bone grafts 6 months after surgery. All of the bone grafts healed without complications. One patient was excluded because of reoperation. In eight of the nine patients, the ibandronate bone grafts showed an increase in bone volume compared with baseline, with an average gain of 126 mm (40% more than baseline) with a range of +27 to +218 mm. Only one ibandronate-treated graft had a decrease in bone volume (8%). In the controls, an average bone volume loss of -146 mm (58% of baseline) with a range of -29 to -301 mm was seen. In the maxillofacial field, the reconstructions of atrophic alveolar ridges, especially in the esthetical zones, are challenging. These results show that bone grafts locally treated with ibandronate solution increases the remaining bone volume. This might lead to new possibilities for the maxillofacial surgeons in the preservation of bone graft volumes and for dental implant installations. © 2021 The Authors. published by Wiley Periodicals LLC. on behalf of American Society for Bone and Mineral Research.
自体骨移植被认为是无牙牙槽嵴重建的金标准。然而，该手术会因生理性骨吸收导致不可预测的骨丢失。双膦酸盐是一类特异性作用于破骨细胞的抗吸收药物，可维持骨密度、骨体积和骨强度。有研究假设，用伊班膦酸钠溶液处理的骨移植的吸收程度会低于用生理盐水处理的骨移植。10例接受双侧矢状劈开截骨术的患者被纳入一项有自身对照的随机双盲试验。每位患者一侧接受用伊班膦酸钠溶液处理的骨移植，对侧接受用生理盐水处理的移植（对照）。术后2周和6个月时拍摄X线片以测量骨体积。主要终点是术后6个月时对照骨移植和伊班膦酸钠骨移植之间骨体积变化的差异。所有骨移植均愈合且无并发症。1例患者因再次手术被排除。在9例患者中的8例中，与基线相比，伊班膦酸钠骨移植的骨体积增加，平均增加126 mm（比基线多40%），范围为+27至+218 mm。仅1例经伊班膦酸钠处理的移植骨骨体积减少（8%）。在对照组中，平均骨体积减少-146 mm（占基线的58%），范围为-29至-301 mm。在颌面领域，萎缩性牙槽嵴的重建，尤其是在美学区域，具有挑战性。这些结果表明，用伊班膦酸钠溶液局部处理的骨移植可增加剩余骨体积。这可能为颌面外科医生在保留骨移植体积和进行牙种植方面带来新的可能性。© 2021作者。由Wiley Periodicals LLC代表美国骨与矿物质研究学会出版。
