Khoury Fouad, Hanser Thomas
Int J Oral Implantol (Berl). 2022 May 13;15(2):111-126.
To evaluate the short- and long-term outcomes of vertical 3D bone augmentation in the posterior mandible, performed using the split bone block technique with a tunnel technique.
Patients were treated for vertical and horizontal alveolar bone defects without simultaneous implant placement and followed up for at least 10 years postoperatively. Autogenous bone blocks were harvested from the mandibular retromolar area following the MicroSaw protocol (Dentsply Sirona, Charlotte, NC, USA). The harvested bone blocks were split longitudinally according to the split bone block technique and grafted in 3D form using a tunnel technique. Implants were inserted and exposed after 3 months and prosthetic restoration was performed.
A total of 117 consecutively treated patients with 128 grafted sites in 3D form were enrolled in the present study and followed up over a period of up to 17 years. The 10-year results were collected with a total patient dropout rate of 24.13%. Minimal late graft exposure was documented postoperatively for 4 to 8 weeks on the lingual site in two cases but did not influence the outcome. Infection of the grafted area occurred in one other case, leading to loss of the grafted bone. The postoperative mean vertical bone gain was 7.6 ± 3.1 mm and the mean bone width achieved after surgery was 8.1 ± 1.6 mm. A total of 287 implants were inserted 3 months after the augmentation procedure. The maximum vertical bone resorption, which was calculated around implants, was 0.66 ± 0.38 mm after 1 year, 0.72 ± 0.31 mm after 5 years and 0.75 ± 0.43 mm after 10 years. Furthermore, five implants were lost during this time, due to peri-implantitis and chronic pain. After 10 years, the mean vertical bone gain was stable at 6.72 ± 2.26 mm and the resorption rate was 11.4%.
The short- and long-term results of the present study confirm the predictability of using mandibular bone blocks according to the split bone block technique for 3D bone reconstruction in the posterior mandible.
评估采用劈开骨块技术结合隧道技术在下颌后部进行垂直三维骨增量的短期和长期效果。
对存在垂直和水平牙槽骨缺损且未同期植入种植体的患者进行治疗，并在术后至少随访10年。按照MicroSaw方案（美国北卡罗来纳州夏洛特市登士柏西诺德公司）从下颌磨牙后区获取自体骨块。将获取的骨块按照劈开骨块技术纵向劈开，并采用隧道技术以三维形式植入。3个月后植入种植体并暴露，然后进行修复。
本研究共纳入117例连续接受治疗的患者，共128个以三维形式植入的部位，随访时间长达17年。收集了10年的结果，患者总失访率为24.13%。术后有两例在舌侧部位记录到最少的晚期植骨暴露，持续4至8周，但未影响结果。另一例发生植骨区感染，导致植骨丢失。术后平均垂直骨增量为7.6±3.1毫米，术后平均骨宽度为8.1±1.6毫米。在增量手术后3个月共植入287枚种植体。种植体周围计算得出的最大垂直骨吸收在1年后为0.66±0.38毫米，5年后为0.72±0.31毫米，10年后为0.75±0.43毫米。此外，在此期间有5枚种植体因种植体周围炎和慢性疼痛而丢失。10年后，平均垂直骨增量稳定在6.72±2.26毫米，吸收率为11.4%。
本研究的短期和长期结果证实了根据劈开骨块技术使用下颌骨块在下颌后部进行三维骨重建的可预测性。
