Mertens Christian, Büsch Christopher, Goldenbaum Konrad, Ristow Oliver, Hoffmann Jürgen, Wang Hom-Lay, Hoffmann Korbinian Jochen
Department of Oral and Cranio-Maxillofacial Surgery, Heidelberg University Hospital, Heidelberg, Germany.
Institute of Medical Biometry, University of Heidelberg, Heidelberg, Germany.
Clin Implant Dent Relat Res. 2023 Dec;25(6):1149-1163. doi: 10.1111/cid.13263. Epub 2023 Aug 16.
To evaluate radiographic bone gain after alveolar ridge augmentation with two different designs of autogenous block graft harvested from the mandible.
Alveolar ridge defects were evaluated by preoperative cone beam computed tomography (CBCT) and grafted in a staged approach using intraoral block grafts. The ridge augmentation was either performed using the full-block technique (group 1) or the split-block technique (cortical plate with autogenous bone chips) (group 2). After 4 months of bone healing, a further CBCT scan was performed before implant placement. Horizontal and vertical bone gain were measured.
In this retrospective study, 91 patients were grafted with block grafts (36 patients with full-block grafts; 55 patients with split-block grafts) resulting in 171 block grafts in total. The mean horizontal bone gain was 3.37 ± 0.71 mm in group 1 and 5.79 ± 2.20 mm in group 2. A linear mixed-effect model also showed a statistically significant group difference (p < 0.001, estimate: 3.455, 95% CI: [2.082-4.829]). The mean vertical bone gain was 2.85 ± 0.73 mm in group 1 and 7.60 ± 1.87 mm in group 2. A linear mixed-effect model also showed a statistically significant group difference (p: 0.029, estimate: 3.126, 95% CI: [0.718-5.557]). Mean marginal bone level was 0.33 ± 0.37 mm (group 1) and 0.17 ± 0.29 mm (group 2).
The split-block technique resulted in a greater bone gain than the full-block technique. This effect was observed in both the vertical and the horizontal dimensions.
评估采用两种不同设计的取自下颌骨的自体块状骨移植进行牙槽嵴增高术后的影像学骨增量。
术前通过锥形束计算机断层扫描（CBCT）评估牙槽嵴缺损情况，并采用分期方式使用口内块状骨移植进行植骨。牙槽嵴增高术采用整块骨技术（第1组）或劈开骨技术（皮质骨板加自体骨碎块）（第2组）。在骨愈合4个月后，植入种植体前再次进行CBCT扫描。测量水平和垂直方向的骨增量。
在这项回顾性研究中，91例患者接受了块状骨移植（36例接受整块骨移植；55例接受劈开骨移植），共植入171块块状骨。第1组平均水平骨增量为3.37±0.71mm，第2组为5.79±2.20mm。线性混合效应模型也显示两组间存在统计学显著差异（p<0.001，估计值：3.455，95%可信区间：[2.082 - 4.829]）。第1组平均垂直骨增量为2.85±0.73mm，第2组为7.60±1.87mm。线性混合效应模型也显示两组间存在统计学显著差异（p：0.029，估计值：3.126，95%可信区间：[0.718 - 5.557]）。平均边缘骨水平在第1组为0.33±0.37mm，在第2组为0.17±0.29mm。
劈开骨技术比整块骨技术导致更大的骨增量。在垂直和水平维度均观察到这种效果。
