Dental Academy for Continuing Professional Development, Karlsruhe, Lorenzstrasse 7, 76135 Karlsruhe, Germany.
Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital, Saarland University, Building 73, 66421 Homburg, Germany.
Int J Environ Res Public Health. 2021 Mar 19;18(6):3174. doi: 10.3390/ijerph18063174.
In the literature, autogenous dentin is considered a possible alternative to bone substitute materials and autologous bone for certain indications. The aim of this proof-of-concept study was to use autogenous dentin for lateral ridge augmentation. In the present retrospective study, autogenous dentin slices were obtained from teeth and used for the reconstruction of lateral ridge defects (tooth-shell technique (TST): 28 patients (15 females, 13 males) with 34 regions and 38 implants). The bone-shell technique (BST) according to Khoury (31 patients (16 females, 15 males) with 32 regions and 41 implants) on autogenous bone served as the control. Implants were placed simultaneously in both cases. Follow-up was made 3 months after implantation. Target parameters during this period were clinical complications, horizontal hard tissue loss, osseointegration, and integrity of the buccal lamella. The prosthetic restoration with a fixed denture was carried out after 5 months. The total observation period was 5 months. A total of seven complications occurred. Of these, three implants were affected by wound dehiscences (TST: 1, BST: 2) and four by inflammations (TST: 0, BST: 4). There were no significant differences between the two groups in terms of the total number of complications. One implant with TST exhibited a horizontal hard tissue loss of 1 mm and one with BST of 0.5 mm. Other implants were not affected by hard tissue loss. There were no significant differences between the two groups. Integrity of the buccal lamella was preserved in all implants. All implants were completely osseointegrated in TST and BST. All implants could be prosthetically restored with a fixed denture 5 months after augmentation. TST showed results comparable to those of the BST. Dentin can therefore serve as an alternative material to avoid bone harvesting procedures and thus reduce postoperative discomfort of patients.
在文献中,自体牙本质被认为是某些适应症下替代骨替代材料和自体骨的可能选择。本概念验证研究的目的是使用自体牙本质进行侧壁骨增量。在本回顾性研究中,从牙齿中获取自体牙本质薄片,并用于重建侧壁骨缺损(牙壳技术(TST):28 名患者(15 名女性,13 名男性),34 个区域和 38 个种植体)。根据 Khoury 的骨壳技术(BST)(16 名女性,15 名男性),32 个区域和 41 个种植体,自体骨作为对照。两种情况下均同时植入种植体。植入后 3 个月进行随访。在此期间的目标参数为临床并发症、水平硬组织损失、骨整合和颊侧板的完整性。5 个月后用固定义齿进行修复。总观察期为 5 个月。共发生 7 例并发症。其中,TST 中有 3 个种植体受创口裂开影响(1 个),BST 中有 4 个受炎症影响(4 个)。两组总并发症数无显著差异。TST 中有 1 个种植体发生 1mm 的水平硬组织损失,BST 中有 1 个种植体发生 0.5mm 的水平硬组织损失。其他种植体不受硬组织损失影响。两组间无显著差异。颊侧板完整性在所有种植体中均得到保留。所有种植体在 TST 和 BST 中均完全骨整合。TST 和 BST 组均在增强后 5 个月进行了固定义齿修复。TST 结果与 BST 相当。因此,牙本质可以作为替代材料,避免取骨手术,从而减轻患者术后不适。