Pabst Andreas, Wiegner Jörg, Schneider Matthias, Weyer Nils, Bartella Alexander, Heiland Max, Becker Philipp, Zeller Alexander-N
Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany.
Department of Oral and Maxillofacial Surgery, German Armed Forces Central Hospital, Rübenacherstr. 170, 56072, Koblenz, Germany.
Int J Implant Dent. 2025 Apr 16;11(1):31. doi: 10.1186/s40729-025-00619-5.
This study identifies current practices, patient management concepts and innovations in alveolar ridge augmentation (ARA) in Oral and Maxillofacial Surgery (OMFS) in Germany.
A survey with a dynamic online questionnaire with up to 40 questions was designed to collect general and specific data on ARA, such as case numbers, imaging, surgical techniques, (bio-)materials, and case management in OMFS. After internal and external validation, 1863 OMF surgeons within the German Association for Oral and Maxillofacial Surgery (DGMKG) were invited via email to participate. Data management was anonymized and descriptively.
324 OMF surgeons participated in the study (response rate 17.39%). Most participants (60.8%) work in private practices without inpatient care. 62.03% of participants insert > 200 implants, and 28.70% perform > 200 ARA annually. About 30.86% also provide implant-based prosthetic restorations. Cone-beam computed tomography (CBCT) is the imaging method most preferred by 87.74% of participants. The most common ARA techniques are external and internal sinus lift (SL) and bone block augmentation (97.31%, 90.57%, and 73.4%, respectively). Intraoral harvested autogenous bone grafts (ABG) are most commonly used for ARA (96.63%). The oblique line is the participants' preferred donor site for ABG (93.27%). ABG and xenogeneic bone substitutes are the most frequently used graft combinations (72.73%). Platelet-rich fibrin (PRF) is used by 58.59% of participants for ARA, mostly in SL procedures (76.44%). PRF is the most common substitute used to biofunctionalize biomaterials (48.16%). Oral antibiotics are used by 86.40% pre-/intraoperatively and by 88.97% postoperatively for ARA. Most participants believe the surgical technique (94.49%) and the surgeon's experience (92.28%) are the most critical factors for ARA success. 46.32% of participants aim to perform ARA within the skeletal envelope.
The findings highlight current practices, patient management, and innovations in ARA in OMFS in Germany. They show standard practices and numerous variations in several aspects.
Surgical technique, experience, patient health and compliance are relevant ARA success factors. This underlies the importance of extended surgical training and careful patient selection.
本研究确定了德国口腔颌面外科（OMFS）中牙槽嵴增高术（ARA）的当前实践、患者管理理念及创新方法。
设计了一份包含多达40个问题的动态在线调查问卷，以收集关于ARA的一般和具体数据，如病例数量、影像学检查、手术技术、（生物）材料以及口腔颌面外科中的病例管理。在进行内部和外部验证后，通过电子邮件邀请了德国口腔颌面外科学会（DGMKG）的1863名口腔颌面外科医生参与。数据管理采用匿名和描述性方式。
324名口腔颌面外科医生参与了该研究（回复率为17.39%）。大多数参与者（60.8%）在没有住院护理的私人诊所工作。62.03%的参与者植入超过200颗种植体，28.70%的参与者每年进行超过200例牙槽嵴增高术。约30.86%的参与者还提供基于种植体的修复体。锥形束计算机断层扫描（CBCT）是87.74%的参与者最青睐的影像学检查方法。最常见的牙槽嵴增高术技术是外、内窦提升术（SL）和骨块植入术（分别为97.31%、90.57%和73.4%）。口腔内采集的自体骨移植（ABG）最常用于牙槽嵴增高术（96.63%）。斜线是参与者用于自体骨移植的首选供区（93.27%）。自体骨移植和异种骨替代物是最常用的移植组合（72.73%）。58.59%的参与者在牙槽嵴增高术中使用富血小板纤维蛋白（PRF），主要用于窦提升术（76.44%）。PRF是用于生物功能化生物材料的最常见替代物（48.16%）。86.40%的参与者在牙槽嵴增高术前/术中使用口服抗生素，术后使用的比例为88.97%。大多数参与者认为手术技术（94.49%）和外科医生的经验（92.28%）是牙槽嵴增高术成功的最关键因素。46.32%的参与者旨在在骨轮廓范围内进行牙槽嵴增高术。
研究结果突出了德国口腔颌面外科中牙槽嵴增高术的当前实践、患者管理及创新方法。结果显示在多个方面既有标准做法，也存在诸多差异。
手术技术、经验、患者健康状况和依从性是牙槽嵴增高术成功的相关因素。这凸显了强化外科培训和谨慎选择患者的重要性。
