Takahara Namiaki, Shibata Mari, Iwasaki Takuya, Marukawa Eriko, Yoda Tetsuya
Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, Tokyo, Japan.
Department of Regenerative and Reconstructive Dental Medicine, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, Tokyo, Japan.
J Oral Implantol. 2025 Feb 1;51(1):60-66. doi: 10.1563/aaid-joi-D-24-00102.
This study evaluated the efficacy of poly(lactic-co-glycolic acid) (PLGA) mesh sheets for alveolar bone reconstruction in the anterior maxilla with significant bone defects. This prospective case series included 4 male patients (mean age, 34.5 years; range, 20-49 years) with anterior maxillary bone defects. Bone augmentation was performed using a staged guided bone regeneration technique with PLGA mesh sheets as barrier membranes and a 1:1 mixture of autogenous and xenogeneic bone as grafting material. The effectiveness of bone augmentation was evaluated using preoperative and postoperative computerized tomography data at 1 and 6 months. Secondary outcomes included complications such as wound infection and dehiscence. The treatment of the 4 patients required 7 PLGA mesh sheets and particulate bone, followed by 9 implant placements. Wound healing was uneventful except for 1, wherein wound dehiscence and graft loss were observed. One patient had an exposed PLGA mesh sheet during healing, necessitating its removal. The mean vertical bone gain was 2.3 ± 0.5 mm, and the mean horizontal gain was 3.7 ± 1.3 mm at 1 month postoperatively. Sites without wound dehiscence exhibited a bone decrease rate of 6.5%-21.1%, whereas successful bone height and width increases were observed across treated sites. Bone augmentation using PLGA mesh sheets proved effective in reconstructing horizontal and vertical alveolar bone dimensions. This technique provides adequate support for implant placement, demonstrating its potential utility in cases of substantial alveolar bone deficiency.
本研究评估了聚乳酸-乙醇酸共聚物(PLGA)网片在前上颌骨存在明显骨缺损时用于牙槽骨重建的疗效。该前瞻性病例系列纳入了4例前上颌骨缺损的男性患者(平均年龄34.5岁;范围20 - 49岁)。采用分期引导骨再生技术进行骨增量,使用PLGA网片作为屏障膜,并用自体骨与异种骨1:1混合作为移植材料。利用术前及术后1个月和6个月的计算机断层扫描数据评估骨增量的效果。次要结局包括伤口感染和裂开等并发症。4例患者的治疗共需要7张PLGA网片和颗粒骨,随后进行了9次种植体植入。除1例观察到伤口裂开和移植骨丢失外,其余伤口愈合均顺利。1例患者在愈合过程中网片暴露,需将其取出。术后1个月时,平均垂直骨增量为2.3±0.5 mm,平均水平骨增量为3.7±1.3 mm。未发生伤口裂开的部位骨量减少率为6.5% - 21.1%,而各治疗部位均观察到骨高度和宽度成功增加。使用PLGA网片进行骨增量被证明在重建水平和垂直牙槽骨尺寸方面是有效的。该技术为种植体植入提供了足够的支持,表明其在严重牙槽骨缺损病例中的潜在应用价值。