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新型早期垂直牙槽嵴增高技术。

Novel early vertical ridge augmentation technique.

作者信息

Lin Jerry Chin-Yi, Bahammam Shaima O, Kim David M, Chang Wei-Jen

机构信息

School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.

Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA.

出版信息

J Dent Sci. 2025 Jan;20(1):20-27. doi: 10.1016/j.jds.2024.10.025. Epub 2024 Nov 6.

DOI:10.1016/j.jds.2024.10.025
PMID:39873038
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11763238/
Abstract

BACKGROUND/PURPOSE: Multiple augmentation protocols are documented in the literature to rebuild the deficient alveolar ridge after tooth extraction; however, achieving adequate vertical augmentation remains the most challenging goal. This study demonstrated a novel surgical technique of early vertical ridge augmentation for post-dental extraction. This technique offers several biological and technical advantages regarding the timing of the procedure and its relative simplicity compared to other complex techniques.

MATERIALS AND METHODS

This retrospective study consisted of 50 extraction sites from 44 participants who had received early vertical ridge augmentation (VRA) procedures (6-16 weeks post-extraction in either the maxilla or the mandible). The procedures were carried out using titanium tenting screws, freeze-dried bone allografts (FDBA), and xenografts (bovine). Pre- and post-operative cone-beam computed tomography (CBCT) images were taken for all participants 6-9 months after the augmentation surgery to measure the vertical bone gained.

RESULTS

A total of 44 patients were treated with early VRA 6-16 weeks post-dental extraction. The total mean vertical bone gain measured after 6-9 months of augmentation for all cases was 4.64 ± 1.76 mm with no complications encountered. About 80 % of augmented sites met or exceeded the expected vertical bone gain (EVBG). Delaying vertical ridge augmentation until after eight weeks post-extraction, particularly beyond twelve weeks, results in higher rates of EVBG and more consistent average bone gain.

CONCLUSION

This study indicates that VRA can be achieved predictably by utilizing the early VRA technique, which is relatively straightforward and is associated with a minimal complication.

摘要

背景/目的:文献中记载了多种用于拔牙后重建牙槽嵴缺损的增量方案;然而,实现足够的垂直增量仍然是最具挑战性的目标。本研究展示了一种用于拔牙后早期垂直牙槽嵴增量的新型手术技术。与其他复杂技术相比,该技术在手术时机及其相对简单性方面具有若干生物学和技术优势。

材料与方法

这项回顾性研究纳入了44名接受早期垂直牙槽嵴增量(VRA)手术(上颌或下颌拔牙后6 - 16周)的参与者的50个拔牙位点。手术使用钛钉、冻干异体骨(FDBA)和异种移植物(牛源)进行。在增量手术后6 - 9个月为所有参与者拍摄术前和术后锥形束计算机断层扫描(CBCT)图像,以测量获得的垂直骨量。

结果

共有44例患者在拔牙后6 - 16周接受了早期VRA治疗。所有病例在增量6 - 9个月后测量的总平均垂直骨增量为4.64 ± 1.76毫米,未出现并发症。约80%的增量位点达到或超过预期垂直骨增量(EVBG)。将垂直牙槽嵴增量推迟到拔牙后八周之后,尤其是超过十二周,会导致更高的EVBG发生率和更一致的平均骨增量。

结论

本研究表明,通过采用早期VRA技术可以可预测地实现VRA,该技术相对简单,且并发症极少。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5bc9/11763238/d9eac629751c/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5bc9/11763238/04d6bf6fa07a/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5bc9/11763238/442ccab890ae/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5bc9/11763238/fbe6c4983ff1/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5bc9/11763238/f9e4ab8cd9fe/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5bc9/11763238/36ff280d2e08/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5bc9/11763238/d9eac629751c/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5bc9/11763238/04d6bf6fa07a/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5bc9/11763238/442ccab890ae/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5bc9/11763238/fbe6c4983ff1/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5bc9/11763238/f9e4ab8cd9fe/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5bc9/11763238/36ff280d2e08/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5bc9/11763238/d9eac629751c/gr6.jpg

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本文引用的文献

1
Alveolar ridge preservation: Complications and cost-effectiveness.牙槽嵴保存:并发症与成本效益
Periodontol 2000. 2023 Jun;92(1):235-262. doi: 10.1111/prd.12469. Epub 2022 Dec 29.
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Selection of Collagen Membranes for Bone Regeneration: A Literature Review.用于骨再生的胶原膜的选择:文献综述
Materials (Basel). 2020 Feb 9;13(3):786. doi: 10.3390/ma13030786.
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Effectiveness of vertical ridge augmentation interventions: A systematic review and meta-analysis.垂直骨嵴增高干预措施的有效性:系统评价和荟萃分析。
J Clin Periodontol. 2019 Jun;46 Suppl 21:319-339. doi: 10.1111/jcpe.13061.
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Effect of alveolar ridge preservation interventions following tooth extraction: A systematic review and meta-analysis.拔牙后牙槽嵴保存干预的效果:系统评价和荟萃分析。
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The Fate of Lateral Ridge Augmentation: A Systematic Review and Meta-Analysis.侧方骨嵴增高术的预后:一项系统评价与荟萃分析
Int J Oral Maxillofac Implants. 2018 May/Jun;33(3):622-635. doi: 10.11607/jomi.6290.
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Tentpole technique for bone regeneration in vertically deficient alveolar ridges: A prospective study.垂直骨量不足的牙槽嵴骨再生的支柱技术:一项前瞻性研究。
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Implant placement post extraction in esthetic single tooth sites: when immediate, when early, when late?拔牙后即刻、早期和晚期在美学单牙位点植入的位置:何时进行?
Periodontol 2000. 2017 Feb;73(1):84-102. doi: 10.1111/prd.12170.
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A Titanium Mesh and Particulate Allograft for Vertical Ridge Augmentation in the Posterior Mandible: A Pilot Study.钛网与颗粒状同种异体骨用于下颌后牙区垂直骨增量的初步研究
Int J Periodontics Restorative Dent. 2015 Jul-Aug;35(4):515-22. doi: 10.11607/prd.1980.
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