Pistilli Roberto, Karaban Maryia, Bonifazi Lorenzo, Barausse Carlo, Ferri Agnese, Felice Pietro
Int J Periodontics Restorative Dent. 2023 Sep-Oct;43(5):588-595. doi: 10.11607/prd.5779.
The management of horizontally fully edentulous atrophic ridges is a common problem in dental implantology. This case report describes an alternative modified two-stage presplitting technique. The patient was referred for an implant-supported rehabilitation of their edentulous mandible. CBCT scans showed a mean available bone width of about 3 mm. At the first stage, four linear corticotomies were performed using a piezoelectric surgical device. At the second surgical stage 4 weeks later, bone expansion was performed, and four implants were placed in the interforaminal area. The healing process was uneventful. No fractures of the buccal wall and no neurologic lesions were observed. Postoperative CBCT scans showed a mean bone width gain of about 3.7 mm. Implants were uncovered 6 months after the second surgery, and 1 month later, a fixed provisional screw-retained prosthesis was delivered. This approach could be used as a reconstructive technique that avoids using grafts and reduces treatment times, possible complications, postsurgical morbidity, and costs by exploiting the patient's native bone as much as possible. Considering the limitations of a case report, randomized controlled clinical trials are needed to confirm the results and validate this technique.
水平向全牙列缺失萎缩牙槽嵴的处理是牙种植学中的常见问题。本病例报告描述了一种改良的两阶段预劈开替代技术。该患者因下颌无牙颌的种植支持修复前来就诊。锥形束计算机断层扫描(CBCT)显示平均可用骨宽度约为3毫米。在第一阶段,使用压电手术器械进行了四次线性皮质切开术。4周后的第二手术阶段,进行了骨扩张,并在孔间区域植入了4枚种植体。愈合过程顺利。未观察到颊壁骨折和神经损伤。术后CBCT扫描显示平均骨宽度增加约3.7毫米。在第二次手术后6个月暴露种植体,1个月后,交付了固定的临时螺丝固位假体。该方法可作为一种重建技术,通过尽可能利用患者的自体骨,避免使用骨移植,减少治疗时间、可能的并发症、术后发病率和成本。考虑到病例报告的局限性,需要进行随机对照临床试验来证实结果并验证该技术。