Franke Thomas, Korzinskas Tadas
Privatärztliches Zentrum für biologische Mund-, Kiefer-, Gesichtschirurgie und Zahnmedizin, Stuttgarter Platz 1, Charlottenburg 10627, Berlin, Germany.
Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorder, Charité-Universitätsmedizin Berlin, Aßmannshauser Straße 4-6 14197, Berlin, Germany.
Case Rep Dent. 2024 Dec 13;2024:2659893. doi: 10.1155/crid/2659893. eCollection 2024.
Due to bone loss, implant placement in the posterior mandible is often impossible without prior augentative procedures. The reconstruction of bone defects with horizontal and vertical components using particulated bone grafts requires the placement of a mechanically stable structure for stabilization of the grafting material. Although titanium-reinforced membranes and titanium meshes have been shown to be effective in this indication, the necessity of their removal, often in a separate surgical procedure, is seen as a disadvantage. Since the introduction of a new resorbable magnesium metal membrane and fixation screw, a mechanically stable and resorbable system might provide an alternative option for guided bone regeneration (GBR) in the posterior mandible. A 61-year-old patient was presented with large edentulous areas in all posterior regions and requested fixed dentures in Areas 34-36. Tooth 33 was extracted and treated with an immediate implantation of a ceramic implant, whereas Positions 34-36 were treated with a two-stage approach. The site was augmented horizontally, with a slight vertical component using autologous and allogenic bone and a new completely resorbable magnesium metal membrane and fixation screw. During the initial healing period, the patient reported a tingling sensation at the site of the augmentation. This is an observation that is specific to the magnesium products and is potentially caused by the release of hydrogen gas as the metal degrades and is resorbed. Upon re-entry at 3 months, it was clinically observed that there was a very dense and vascularized bone that was sufficient for placing two 5.5 × 10 mm ceramic dental implants. A completely resorbable magnesium membrane and fixation screw were able to support the bony regeneration in a large GBR situation in the posterior mandible. Due to the use of a new material for GBR, different clinical observations were made compared to the standard material choices.
由于骨质流失,若不预先进行增量手术,往往无法在下颌后部植入种植体。使用颗粒状骨移植物重建具有水平和垂直成分的骨缺损需要放置一个机械稳定的结构来稳定移植材料。尽管钛增强膜和钛网已被证明在此适应症中有效,但通常需要在单独的手术中取出它们,这被视为一个缺点。自从引入一种新型可吸收镁金属膜和固定螺钉以来,一种机械稳定且可吸收的系统可能为下颌后部的引导骨再生(GBR)提供另一种选择。一名61岁的患者下颌所有后部区域均有大面积无牙区,并要求在34 - 36区安装固定义齿。拔除了33号牙并立即植入了陶瓷种植体,而34 - 36位则采用两阶段方法治疗。使用自体骨和异体骨以及一种新型完全可吸收镁金属膜和固定螺钉对该部位进行水平增量,并伴有轻微的垂直成分。在初始愈合期,患者报告在增量部位有刺痛感。这是镁产品特有的一种观察结果,可能是由于金属降解和吸收时释放氢气所致。在3个月时再次切开时,临床观察到有非常致密且血管化的骨,足以植入两颗5.5×10毫米的陶瓷牙种植体。一种完全可吸收的镁膜和固定螺钉能够在下颌后部大GBR情况下支持骨再生。由于在GBR中使用了新材料,与标准材料选择相比出现了不同的临床观察结果。