Daoud Shadi, Zoabi Adeeb, Kasem Adi, Totry Amir, Oren Daniel, Redenski Idan, Srouji Samer, Kablan Fares
Department of Oral and Maxillofacial Surgery, Galilee College of Dental Sciences, Galilee Medical Center, Nahariya 2210001, Israel.
The Azrieli Faculty of Medicine, Bar-Ilan University, Safed 1311502, Israel.
Diagnostics (Basel). 2024 Feb 27;14(5):504. doi: 10.3390/diagnostics14050504.
Bone augmentation prior to dental implant placement is a common scenario in the dental implantology field. Among the important intraoral harvesting sites to obtain bone blocks is the ramus/retromolar region that has a high success rate and long-lasting alveolar ridge augmentation. Preserving the bone volume and quality at the donor site is crucial for preventing further complications or to serve as a site for re-harvesting. Healing of the intraoral donor sites has been described in the maxillofacial field. This study aimed to evaluate the spontaneous healing of the mandibular retromolar donor site utilizing computer-assisted quantification 6 and 12 months after bone harvesting.
The study was conducted on patients who underwent an alveolar ridge augmentation using an intraoral retromolar bone graft. Three CBCT scans were performed-intraoperative, and at six months and one year after the surgical procedure. By using the Materialise Mimics Innovation Suite software 26.0 features segmentation by thresholding, Hounsfield unit averaging, and superimposition of the tomographies, we could precisely quantify the healing process utilizing spatial and characteristic measures.
In all cases, the computer-aided quantification showed that six months following surgery, the donor site had recovered up to 64.5% ± 4.24 of its initial volume, and this recovery increased to 89.2% ± 2.6 after one year. Moreover, the Hounsfield unit averaging confirmed dynamic bone quality healing, starting at 690.3 ± 81 HU for the bone block, decreasing to 102 ± 27.8 HU at six months postoperatively, and improving to 453.9 ± 91.4 HU at the donor site after a year.
This study demonstrates that there is no need for additional replanting at the donor site following retromolar bone block harvesting, whether autogenous or allograft, since spontaneous healing occurs 12 months following the surgery.
在种植牙植入前进行骨增量是牙种植领域的常见情况。获取骨块的重要口腔内取材部位之一是升支/磨牙后区,该部位骨增量成功率高且效果持久。在供区保留骨体积和质量对于预防进一步并发症或作为再次取材部位至关重要。口腔内供区的愈合情况在颌面领域已有描述。本研究旨在利用计算机辅助定量评估骨采集后6个月和12个月下颌磨牙后供区的自然愈合情况。
本研究针对接受口腔内磨牙后骨移植进行牙槽嵴增量的患者。在手术中、手术后6个月和1年进行了三次CBCT扫描。通过使用Materialise Mimics Innovation Suite软件26.0的阈值分割、亨氏单位平均和断层扫描叠加功能,我们能够利用空间和特征测量精确量化愈合过程。
在所有病例中,计算机辅助定量显示,术后6个月,供区已恢复至初始体积的64.5%±4.24%,1年后这一恢复率增至89.2%±2.6%。此外,亨氏单位平均证实了骨质量的动态愈合,骨块起始为690.3±81 HU,术后6个月降至102±27.8 HU,1年后供区改善至453.9±91.4 HU。
本研究表明,在磨牙后骨块采集后,无论自体骨还是同种异体骨,供区无需额外再植,因为手术后12个月会发生自然愈合。