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评价下颌下牙槽神经侧向分离与植骨对神经功能及种植体稳定性的影响。(随机临床试验)

Evaluation of the effect of the lateralized inferior alveolar nerve isolation and bone grafting on the nerve function and implant stability. (Randomized Clinical Trial).

作者信息

Garoushi Ibrahim H, Elbeialy Ramy R, Gibaly Amr, Atef Mohammed

机构信息

Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Libyan International Medical University, Benghazi, Libya.

Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Cairo University, Cairo, Egypt.

出版信息

Clin Implant Dent Relat Res. 2021 Jun;23(3):423-431. doi: 10.1111/cid.13003. Epub 2021 Apr 18.

DOI:10.1111/cid.13003
PMID:33870587
Abstract

BACKGROUND

The inferior alveolar nerve lateralization (IANL), although allows for an implant full-length mandibular height engagement, coincides with depleting the buccal bone support and sensory deficits.

PURPOSE

This study aims to assess whether interposing a bone graft coupled with securing a collagen membrane separation between the inferior alveolar nerve (IAN) and the underlying dental implants would preserve the nerve function, enhance the implant stability, and minimize the radiographic marginal bone loss.

MATERIAL AND METHODS

Eighteen patients with 30 atrophic mandibular edentulous ridges were subjected to IANL after being randomly assigned to two treatment modalities which consisted of 15 patients each. The (control group) utilized conventional IANL in direct contact with 20 implants. The (test group) implemented the IAN collagen-membrane wrapping and interposing bone graft to overlay 23 implants. The neural function, the radiographic marginal bone loss, and the implant stability quotient were assessed and compared 6 months postoperatively.

RESULTS

All the patients regained their full neurosensory function after 6 months, with statistically nonsignificant differences between both groups throughout the follow-up period. The mean marginal bone loss in the test group was (0.42 ± 0.09) mm versus (0.38 ± 0.14) mm for the control group, which was statistically similar (P = 0.401). The 6-month postoperative mean implant stability quotient values of the test group recorded (74.73 ± 2.68) versus (74.73 ± 1.79) for the control group, which was statistically nonsignificant with a value of P = 0.626.

CONCLUSION

The interposed bone graft, coupled with the collagen membrane isolation, neither subsided the neural disturbances nor enhanced the secondary implant stability and marginal bone loss.

摘要

背景

下牙槽神经侧方移位(IANL)虽然能使种植体全长植入下颌骨高度,但会导致颊侧骨支持减少和感觉功能障碍。

目的

本研究旨在评估在下牙槽神经(IAN)与下方牙种植体之间植入骨移植材料并使用胶原膜隔开,是否能保留神经功能、增强种植体稳定性并使影像学上的边缘骨丢失最小化。

材料与方法

18例患者共30个萎缩性下颌无牙颌骨嵴,随机分为两组,每组15例,均接受IANL治疗。(对照组)采用常规IANL,使20枚种植体直接接触。(试验组)采用IAN胶原膜包裹并植入骨移植材料覆盖23枚种植体。术后6个月评估并比较神经功能、影像学边缘骨丢失和种植体稳定性商数。

结果

所有患者术后6个月均恢复了完全神经感觉功能,随访期间两组间差异无统计学意义。试验组平均边缘骨丢失为(0.42±0.09)mm,对照组为(0.38±0.14)mm,差异无统计学意义(P = 0.401)。试验组术后6个月平均种植体稳定性商数为(74.73±2.68),对照组为(74.73±1.79),差异无统计学意义,P值为0.626。

结论

植入骨移植材料并结合胶原膜隔离,既不能减轻神经干扰,也不能增强种植体的继发稳定性和边缘骨丢失。

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