Urban Istvan, Sanz-Sánchez Ignacio, Monje Alberto, Montero Eduardo
Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA.
Department of Periodontology and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA.
Periodontol 2000. 2023 Jun;92(1):278-298. doi: 10.1111/prd.12472. Epub 2023 Apr 4.
Bone augmentation procedures aim to regenerate the deficient alveolar ridge to properly place dental implants that are completely surrounded by bone. However, these are invasive and technically demanding surgeries that are not free of either complications or treatment errors. Careful patient selection and preparation is a mandatory process to reduce the rate of complications in bone regeneration procedures, irrespective of the technique used. It is important to assess the cost benefit of the intervention and to evaluate the potential impact on the patient's quality of life, especially in the elderly and medically compromised patients. Most common postoperative complications are wound dehiscences, which may be reduced, at least partially, by proper knowledge of the surgical technique and the craniofacial anatomy. Other complications that may appear are postoperative infections or nerve injuries. The aim of this narrative review is to summarize the best available scientific evidence on the incidence of complications, as well as the ideal strategies for their prevention and management. Depending on the severity of the complication, treatment approaches may vary and can include drug prescription or even surgical re-entries to remove exposed barrier membranes or contaminated bone grafts. Adequate prevention and proper management of complications associated with bone augmentation interventions are a requirement for clinicians carrying out these demanding procedures. A series of cases illustrating proper management of complications in different clinical scenarios is presented.
骨增量手术旨在使不足的牙槽嵴再生，以便正确植入完全被骨组织包围的牙种植体。然而，这些手术具有侵入性，技术要求高，且并非没有并发症或治疗失误。无论采用何种技术，仔细的患者选择和准备是降低骨再生手术并发症发生率的必要过程。评估干预措施的成本效益并评估其对患者生活质量的潜在影响非常重要，尤其是对于老年患者和有医疗问题的患者。最常见的术后并发症是伤口裂开，通过正确掌握手术技术和颅面解剖知识，至少可以部分减少这种情况。可能出现的其他并发症包括术后感染或神经损伤。本叙述性综述的目的是总结关于并发症发生率的最佳现有科学证据，以及预防和管理并发症的理想策略。根据并发症的严重程度，治疗方法可能会有所不同，包括药物处方，甚至再次手术以取出暴露的屏障膜或受污染的骨移植材料。对于实施这些高要求手术的临床医生来说，充分预防和妥善管理与骨增量干预相关的并发症是必要的。本文展示了一系列在不同临床场景中正确处理并发症的病例。
