Schwarz Frank, Obreja Karina, Mayer Stephanie, Ramanauskaite Ausra, Sader Robert, Parvini Puria
Department of Oral Surgery and Implantology, Goethe University, Carolinum, Frankfurt, Germany.
Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of the Goethe University Frankfurt, Frankfurt am Main, Germany.
J Clin Periodontol. 2022 May;49(5):496-505. doi: 10.1111/jcpe.13609. Epub 2022 Mar 8.
To assess and compare the efficacy and safety of autogenous tooth roots (TRs) and autogenous bone blocks (ABs) for combined vertical and horizontal alveolar ridge augmentation and two-stage implant placement.
A total of 28 patients in need of implant therapy and vertical ridge augmentation were allocated to parallel groups receiving either healthy autogenous tooth roots (e.g., retained wisdom teeth) (n = 14, n = 15 defects) or cortical autogenous bone blocks harvested from the retromolar area (n = 14, n = 17 defects). After 26 weeks of submerged healing, the clinical reduction in ridge height (RH) deficiency was defined as the primary outcome.
Both surgical procedures were associated with a similar mean reduction in RH deficiency values, amounting to 4.48 ± 2.42 mm (median: 4.25; 95% CI: 3.08-5.88) in the TR group and 4.46 ± 3.31 mm (median: 3.00; 95% CI: 2.54-6.38) in the AB group (p = .60, Mann-Whitney U-test). In all patients investigated, the reduction in RH deficiency values allowed for an adequate implant placement at the respective sites. The frequency of complications (e.g., soft tissue dehiscences) was low (TR: n = 4; AB: n = 0).
Up to staged-implant placement, both TR and AB grafts appeared to be associated with comparable efficacy and safety for combined vertical and horizontal alveolar ridge augmentation.
评估并比较自体牙根（TRs）和自体骨块（ABs）用于垂直和水平牙槽嵴联合增高及二期种植体植入的疗效和安全性。
共有28例需要种植治疗和垂直牙槽嵴增高的患者被分配到平行组，分别接受健康自体牙根（如保留的智齿）（n = 14，n = 15处缺损）或从磨牙后区获取的皮质自体骨块（n = 14，n = 17处缺损）。经过26周的潜行愈合后，将牙槽嵴高度（RH）缺损的临床减少量定义为主要观察指标。
两种手术方法导致的RH缺损值平均减少量相似，TR组为4.48±2.42mm（中位数：4.25；95%可信区间：3.08 - 5.88），AB组为4.46±3.31mm（中位数：3.00；95%可信区间：2.54 - 6.38）（p = 0.60，Mann-Whitney U检验）。在所有接受调查的患者中，RH缺损值的减少使得在相应部位能够进行合适的种植体植入。并发症（如软组织裂开）的发生率较低（TR组：n = 4；AB组：n = 0）。
在二期种植体植入前，TR和AB移植物在垂直和水平牙槽嵴联合增高方面的疗效和安全性似乎相当。
