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使用口腔内定制牵张装置在四周与八周时进行扁平牙槽嵴修复的评估及其对牙种植体疗效的影响:一项比较研究。

Evaluation of flat ridge rehabilitation using an intraoral custom-made distraction device at four weeks versus eight weeks and its impact on dental implant efficacy: A comparative study.

作者信息

Hassan Sherif S, Shuman Mohamed A, Makke Alaa Z, AlQutub Alaa W, Bamaga Ibraheem K, Nofal Reda A, Al-Kabany Mohammed H

机构信息

Department of Basic and Clinical Oral Sciences, Faculty of Dental Medicine, Umm Al-Qura University, Makkah, Saudi Arabia.

Department of Oral Biology and Dental Anatomy, Faculty of Dentistry, Al-Azhar University, Egypt.

出版信息

Saudi Dent J. 2024 Sep;36(9):1241-1247. doi: 10.1016/j.sdentj.2024.07.007. Epub 2024 Jul 6.

Abstract

BACKGROUND

This study aimed to evaluate alveolar bone height enhancement using a custom-made distractor to evaluate its ability to support dental implants.

METHOD

The left mandibular premolars of nine dogs were extracted, followed by alveoloplasty to simulate an atrophic ridge. The dogs were divided into three groups: groups I and II received distractors followed by dental implants, while group III received implants alone. Distractors remained in place for 4 weeks in group I and 8 weeks in group II for consolidation. Subsequently, the distractors were removed, and a titanium dental implant was immediately inserted during the same visit. In the third group, implants were placed in the same area as noted. The implant was left in position for 8 weeks, after which the left hemimandible underwent dual-energy X-ray absorptiometry and histological analysis, focusing on the region of interest (ROI) mesial and distal to the dental implant.

RESULTS

Densitometric analysis revealed notable osseointegration between the regenerated bone adjacent to the dental implant. Notably, there were significant differences in osseointegration between groups I and II. Moreover, osseointegration levels were similar between groups II and III, where no distraction device was employed. Histological findings showed the formation of new bone in the distraction gap, with more advanced maturation noted in the 8-week group. It is worth noting that the integration between bone and implants in the third group surpasses that of the distraction groups.

CONCLUSION

Using the distraction device for only 4 weeks is acceptable to meet the criteria for implant placement. The small size of the distraction device reduces tissue reaction after surgery because it eliminates the necessity of complex surgeries that may require bone grafting. Density measurements and histological observations indicate that the distractor promotes the generation of enough bone for prosthetic rehabilitation with dental implants.

摘要

背景

本研究旨在使用定制牵张器评估牙槽骨高度增加情况,以评估其支持牙种植体的能力。

方法

拔除9只犬的左下颌前磨牙,随后进行牙槽骨成形术以模拟萎缩牙槽嵴。将犬分为三组:第一组和第二组先使用牵张器,然后植入牙种植体,而第三组仅植入种植体。牵张器在第一组放置4周,在第二组放置8周以促进愈合。随后,取出牵张器,并在同一次就诊时立即植入钛牙种植体。在第三组中,在相同区域植入种植体。种植体在位8周后,对左半侧下颌骨进行双能X线吸收测定和组织学分析,重点关注牙种植体近中和远中的感兴趣区域(ROI)。

结果

密度测定分析显示牙种植体相邻的再生骨之间有明显的骨整合。值得注意的是,第一组和第二组之间的骨整合存在显著差异。此外,在未使用牵张装置的第二组和第三组之间,骨整合水平相似。组织学结果显示在牵张间隙中有新骨形成,8周组的成熟度更高。值得注意的是,第三组中骨与种植体之间的整合超过了牵张组。

结论

仅使用牵张装置4周就可满足种植体植入标准。牵张装置体积小,减少了术后组织反应,因为它消除了可能需要骨移植的复杂手术的必要性。密度测量和组织学观察表明,牵张器可促进生成足够的骨用于牙种植体的修复康复。

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