Ji Jung-Gu, Yu Jung-A, Choi Seong-Ho, Lee Dong-Woon
Department of Periodontology, Dental Hospital, Veterans Health Service Medical Center, Seoul 05368, Korea.
Department of Periodontology, College of Dentistry and Research Institute for Periodontal Regeneration, Yonsei University, Seoul 03722, Korea.
Materials (Basel). 2021 Jul 8;14(14):3828. doi: 10.3390/ma14143828.
Vertical ridge augmentation for long-term implant stability is difficult in severely resorbed areas. We examined the clinical, radiological, and histological outcomes of guided-bone regeneration using novel titanium-reinforced microporous expanded polytetrafluoroethylene (MP-ePTFE) membranes. Eighteen patients who underwent implant placement using a staged approach were enrolled (period: 2018-2019). Vertical ridge augmentation was performed in areas with vertical bone defects ≥4 mm. Twenty-six implant fixtures were placed in 14 patients. At implant placement six fixtures had relatively low stability. On cone-beam computed tomography, the average vertical changes were 4.2 ± 1.9 (buccal), 5.9 ± 2.7 (central), and 4.4 ± 2.8 mm (lingual) at six months after vertical ridge augmentation. Histomorphometric analyses revealed that the average proportions of new bone, residual bone substitute material, and soft tissue were 34.91 ± 11.61%, 7.16 ± 2.74%, and 57.93 ± 11.09%, respectively. Stable marginal bone levels were observed at 1-year post-loading. The residual bone graft material area was significantly lower in the exposed group ( = 0.003). There was no significant difference in the vertical height change in the buccal side between immediately after the augmentation procedure and the implant placement reentry time ( = 0.371). However, all implants functioned well regardless of the exposure during the observation period. Thus, vertical ridge augmentation around implants using titanium-reinforced MP-ePTFE membranes can be successful.
在骨严重吸收区域,进行垂直骨嵴增量以实现长期种植体稳定性具有挑战性。我们研究了使用新型钛增强微孔聚四氟乙烯(MP-ePTFE)膜引导骨再生的临床、影像学和组织学结果。纳入18例采用分期方法植入种植体的患者(时间:2018 - 2019年)。在垂直骨缺损≥4 mm的区域进行垂直骨嵴增量。14例患者共植入26枚种植体。植入时,6枚种植体稳定性相对较低。在锥形束计算机断层扫描上,垂直骨嵴增量6个月后,平均垂直变化为:颊侧4.2±1.9 mm、中央5.9±2.7 mm、舌侧4.4±2.8 mm。组织形态计量学分析显示,新骨、残留骨替代材料和软组织的平均比例分别为34.91±11.61%、7.16±2.74%和57.93±11.09%。加载后1年观察到边缘骨水平稳定。暴露组的残留骨移植材料面积显著更低(P = 0.003)。骨增量手术刚结束时与种植体植入再进入时相比,颊侧垂直高度变化无显著差异(P = 0.371)。然而,在观察期内,无论是否暴露,所有种植体功能良好。因此,使用钛增强MP-ePTFE膜进行种植体周围垂直骨嵴增量可以成功。