Hsu Cheng-Hsiang, Chen Zhaozhao, Urban Istvan A, Wang Hom-Lay
Private Practice, Taipei, Taiwan.
Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA.
J Esthet Restor Dent. 2025 Jan;37(1):178-186. doi: 10.1111/jerd.13333. Epub 2024 Oct 9.
To propose a new difficulty classification for vertical bone augmentation (VBA) based on different defect morphologies.
VBA procedures for dental implant placement present significant biological and technical challenges. Among the various techniques, guided bone regeneration (GBR) provides an optimal balance between the anticipated bone gain and the likelihood of postoperative complications. Understanding the specific configuration of defects and adjacent bone peaks is essential for tailoring treatment strategies and improving outcomes. The proposed Simple-Challenging-Difficult (SCD) difficulty classification was based on defect morphology (V-shaped, U-shaped, VV-shaped), including defect size (Height: < 5 mm, 5-8 mm, and > 8 mm), proximity of neighboring bony walls (Width: < 10 mm, 10-20 mm, and > 20 mm), as well as predictability of treatment outcomes.
The proposed difficulty classification for VBA serves as a guide for selecting the most appropriate GBR treatment modality and sequence for safe and predictable management of VBA in implant therapy. In addition, when determining the preferred treatment, it is again essential to consider site-specific and patient-related factors alongside the clinician's surgical experience and skill.
Identifying defect patterns and bone peak structures is crucial, and the proposed classification assists in decision-making in VBA treatment.
基于不同的缺损形态，提出一种用于垂直骨增量（VBA）的新难度分类方法。
用于牙种植体植入的VBA手术面临重大的生物学和技术挑战。在各种技术中，引导骨再生（GBR）在预期的骨增量和术后并发症的可能性之间提供了最佳平衡。了解缺损的具体形态和相邻骨嵴对于制定治疗策略和改善治疗效果至关重要。所提出的简单-具有挑战性-困难（SCD）难度分类基于缺损形态（V形、U形、VV形），包括缺损大小（高度：<5mm、5-8mm和>8mm）、相邻骨壁的接近程度（宽度：<10mm、10-20mm和>20mm）以及治疗结果的可预测性。
所提出的VBA难度分类为选择最合适的GBR治疗方式和顺序提供了指导，以便在种植治疗中对VBA进行安全且可预测的管理。此外，在确定首选治疗方法时，除了临床医生的手术经验和技能外，考虑特定部位和患者相关因素同样至关重要。
识别缺损模式和骨嵴结构至关重要，所提出的分类有助于VBA治疗中的决策制定。
