Rossi Roberto, Bambini Fabrizio, Dellavia Claudia, Henin Dolaji, Memè Lucia
Private Practice Genoa, 16121 Genova, Italy.
Department of Clinical Sciences and Stomatology (DISCO), Polytechnic University of Marche, 60121 Ancona, Italy.
Medicina (Kaunas). 2025 Apr 8;61(4):683. doi: 10.3390/medicina61040683.
Guided bone regeneration (GBR) has represented a challenge for clinicians in the past 30 years, and the literature has well described many different surgical options such as d-PTFE membranes, titanium grids, or autogenous bone harvested from the posterior mandible. All of the previously mentioned techniques have shown a high rate of complications but, in the last decade, a new membrane made of xenogenic bone was introduced. Most of the publications regarding its application report very few and mild complications. In this article we will suggest a new application using segmented xenogenic bone sheets instead of autogenous bone to correct severe ridge deformity. : Xenogenic bone sheets have been studied extensively over the past decade and have proven effective, with a very low rate of complications when used to reconstruct bone atrophies. The technique presented in this paper aims to reduce morbidity, avoid the need for intra-oral graft harvesting, and minimize both surgical time and post-operative discomfort. : Xenogenic bone sheets of equine origin were used to reconstruct severe 3D bone defects in five patients requiring dental implants. The segmentation of the sheet allowed the operator to rebuild the missing bone walls and achieve optimal anatomy without compromise. Furthermore, using different sizes and thicknesses of the bone sheets allowed safe procedures preventing early exposure of the membranes. CBCT of the defects before and after 8 months of healing were measured with Exocad software to assess the volumetric gain. Histological analysis performed on one site showed integration of the bone lamina and live bone underneath. : In all five cases evaluated the ridge deformities were successfully corrected and all patients' implants have functioned for more than two years to date. The average horizontal bone gain in these five cases was 6.18 mm (±1.19 mm) while the vertical gain was 9.70 mm (±2.39 mm). : This new application of flex cortical sheets simplifies the surgical procedure for both operator and patient, reduces morbidity and post-operative complications, and shows promising signs for resolving complex 3D bone reconstructions.
在过去30年里，引导骨再生（GBR）一直是临床医生面临的一项挑战，文献中已经详细描述了许多不同的手术选择，如双层聚四氟乙烯（d-PTFE）膜、钛网或从下颌后部获取的自体骨。上述所有技术都显示出较高的并发症发生率，但在过去十年中，一种由异种骨制成的新型膜被引入。关于其应用的大多数出版物报告的并发症很少且很轻微。在本文中，我们将提出一种使用分段异种骨片代替自体骨来矫正严重牙槽嵴畸形的新应用。：在过去十年中，异种骨片已被广泛研究，并已被证明是有效的，用于重建骨萎缩时并发症发生率非常低。本文介绍的技术旨在降低发病率，避免口内取骨的需要，并将手术时间和术后不适降至最低。：使用马源异种骨片为五名需要种植牙的患者重建严重的三维骨缺损。骨片的分段使手术者能够重建缺失的骨壁并实现最佳解剖结构而不受影响。此外，使用不同尺寸和厚度的骨片可进行安全操作，防止膜过早暴露。使用Exocad软件测量愈合8个月前后缺损的锥形束计算机断层扫描（CBCT），以评估体积增加情况。对一个部位进行的组织学分析显示骨板与下方活骨的整合。：在评估的所有五例病例中，牙槽嵴畸形均得到成功矫正，所有患者的种植体至今已正常使用两年多。这五例病例的平均水平骨增量为6.18毫米（±1.19毫米），而垂直增量为9.70毫米（±2.39毫米）。：这种柔性皮质骨片的新应用简化了手术者和患者的手术过程，降低了发病率和术后并发症，并显示出解决复杂三维骨重建问题的良好前景。
