State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
Clin Oral Implants Res. 2024 Sep;35(9):1091-1100. doi: 10.1111/clr.14299. Epub 2024 May 24.
To analyze changes in bone dimensions and their modulating factor in bone dimensions 6 months after horizontal ridge augmentation using autogenous bone grafts.
Thirty-eight patients with horizontally atrophic alveolar ridges of a single edentulous tooth at the maxillary anterior site were divided into two groups based on the fixation position of the bone block during ridge augmentation surgery (H, vertical distance from the upper edge of the bone block to the alveolar crest). Patients were classified into a crestal level (CL) group if H ≤ 1 mm and a sub-crestal level (SCL) group if H > 1 mm. The width and height of the alveolar ridge were recorded using CBCT both before and 6 months after the augmentation procedure.
The CL group comprised 20 patients with 23 implants, whereas the SCL group comprised 18 patients with 22 implants. All the augmentation sites exhibited vertical bone resorption. Vertical bone resorption in the SCL group (1.94 ± 2.11 mm) was significantly higher than that of the CL group (0.61 ± 0.64 mm). The SCL group showed significantly lower horizontal bone gain than the CL group (SCL: 1.02 ± 2.30 mm; CL: 3.19 ± 3.17 mm) at the cervical level. Peri-implant marginal bone loss increased significantly in the SCL group (1.00 ± 2.71 mm) compared to the CL group (0.64 ± 0.40 mm).
The bone height decreased after horizontal ridge augmentation using autogenous onlay grafting. The fixation position of the bone block was a modulating factor. The SCL group showed more vertical bone loss, less horizontal bone gain 6 months after surgery, and more marginal bone loss after restoration.
分析自体骨移植水平牙槽嵴增量 6 个月后骨量的变化及其调节因素。
将 38 例上颌前牙单个缺牙区水平牙槽嵴萎缩的患者,根据骨块在牙槽嵴顶上方的固定位置(H 值,即骨块上缘到牙槽嵴顶的垂直距离)分为两组。H 值≤1mm 为牙槽嵴顶水平组(CL 组),H 值>1mm 为牙槽嵴顶下水平组(SCL 组)。在骨增量术前和术后 6 个月,使用 CBCT 分别记录牙槽嵴的宽度和高度。
CL 组 20 例患者 23 枚种植体,SCL 组 18 例患者 22 枚种植体。所有的骨增量部位均出现垂直向骨吸收。SCL 组的垂直向骨吸收(1.94±2.11mm)明显高于 CL 组(0.61±0.64mm)。SCL 组水平向骨获得量明显低于 CL 组(SCL 组:1.02±2.30mm;CL 组:3.19±3.17mm),差异有统计学意义。SCL 组种植体周边缘骨吸收量(1.00±2.71mm)明显高于 CL 组(0.64±0.40mm),差异有统计学意义。
自体骨块水平骨增量后牙槽嵴高度降低,骨块固定位置是影响因素之一。SCL 组术后 6 个月垂直骨吸收较多,水平骨获得量较少,修复后边缘骨吸收较多。