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三维打印个体化钛网在不同 Terheyden 分类牙槽骨缺损中的应用:一项回顾性病例系列研究。

Application of three-dimensional printing individualized titanium mesh in alveolar bone defects with different Terheyden classifications: A retrospective case series study.

机构信息

Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Stomatological Hospital of Chongqing Medical University, Chongqing, China.

Key Laboratory of Biomechanics and Mechanobiology, Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, School of Engineering Medicine, Beihang University, No.37, Xueyuan Road, Beijing, 100083, China.

出版信息

Clin Oral Implants Res. 2023 Jun;34(6):639-650. doi: 10.1111/clr.14062. Epub 2023 Mar 31.

Abstract

OBJECTIVE

To present the results of guided bone regeneration (GBR) with three-dimensional printing individualized titanium mesh (3D-PITM) applied to alveolar bone defects with different Terheyden classifications and the factors affecting the osteogenic outcome.

MATERIALS AND METHODS

Fifty-nine patients, presenting with 61 defect sites, were enrolled between 2018 and 2021. GBR+3D-PITM was obtained with simultaneous or second stage implant placement. The complication rate, the success rate of the bone grafting procedure and the survival rate of the implant were documented. Bone gain, thickness of pseudo-periosteum and peri-implant marginal bone loss (MBL) were measured through digital methods by imaging data (CBCT and X-ray).

RESULTS

Out of 61 sites, 20 were exposed (exposure rate: 32.8%). The width, height, and volume bone gain at P (mesh removal) were 5.22 ± 3.19 mm, 5.01 ± 2.83 mm, and 588.91 ± 361.23 mm , respectively. From P (3D-PITM+GBR) to P , changes in bone gain were not statistically different in the different Terheyden classifications, the occurrence of exposure (p < .001 for all dimensions) and the different type of pseudo-periosteum (p = .030 for width and p = .002 for height) were significantly correlated with the reduction of bone gain. Terheyden classification of the defect sites was significantly associated with the occurrence of exposure (p = .014) and types of the pseudo-periosteum (p = .015).

CONCLUSION

The 3D-PITM can be used in alveolar bone defects with different Terheyden classification, but cases with severe vertical bone defects have a greater chance of the 3D-PITM exposure and the exposure can affect the outcome of bone augmentation.

摘要

目的

介绍应用三维打印个体化钛网(3D-PITM)进行不同 Terheyden 分类牙槽骨缺损引导骨再生(GBR)的结果,以及影响成骨效果的因素。

材料与方法

2018 年至 2021 年间,共纳入 59 例患者(61 个缺损部位)。同期或二期植入时采用 GBR+3D-PITM。记录并发症发生率、植骨成功率和种植体存活率。通过数字方法(CBCT 和 X 线)对影像学数据进行测量,得出骨增量、假性骨膜厚度和种植体边缘骨吸收(MBL)。

结果

61 个部位中有 20 个暴露(暴露率:32.8%)。P(去除网片)时的宽度、高度和体积骨增量分别为 5.22±3.19mm、5.01±2.83mm 和 588.91±361.23mm。从 P(3D-PITM+GBR)到 P,不同 Terheyden 分类之间的骨增量变化无统计学差异,暴露的发生(各维度 p<0.001)和不同类型的假性骨膜(宽度 p=0.030,高度 p=0.002)与骨增量减少显著相关。缺损部位的 Terheyden 分类与暴露的发生(p=0.014)和假性骨膜类型(p=0.015)显著相关。

结论

3D-PITM 可应用于不同 Terheyden 分类的牙槽骨缺损,但严重垂直骨缺损的病例发生 3D-PITM 暴露的几率更大,暴露会影响骨增量的效果。

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