Jiang Zhaoxia, Kong Dejing, Zhou Chuanqing, Liang Yixin, Liu Mingli, Qu Zhe
Department of Implantology, Dalian Stomatological Hospital, NO.935,Changjiang Road, Shahekou District, Dalian, Liaoning Province, China.
Department of Stomatology, the Second Hospital of Dalian Medical University, Liaoning Province, China.
BMC Oral Health. 2025 May 1;25(1):673. doi: 10.1186/s12903-025-06025-y.
This retrospective comparative study aimed to evaluate the effects of guided bone regeneration(GBR) on horizontal bone augmentation of the alveolar ridge in the mandibular posterior region and bone stability after loading for 1-2 years. We measured and analyzed the changes in alveolar ridge bone width to observe the clinical effect of bone grafting. The RANK/RANKL/OPG concentration in gingival crevicular fluid around the implant was quantitatively analyzed and compared with that of healthy natural teeth to assess the bone condition.
Fifty-two patients admitted to the Department of Implantology of Dalian Stomatological Hospital were selected. 22 implanted dentures of 22 patients that were repaired with soft tissue-level implants after horizontal bone grafting (experimental group). Thirty patients had 30 implanted dentures with the same system of implants without bone grafting (control group). The gingival crevicular fluid around the implant and healthy control natural teeth were collected via the same filter paper strip after loading for 1-2 years. The concentrations and ratios of RANKL and OPG were quantitatively detected via ELISA. The CBCT images taken before bone grafting, on the day after surgery, 6 months after surgery, and after loading were superimposed to measure the horizontal width of the alveolar ridge. Measurements were taken 2 mm apical from the top of the crest at the center of the implant.
The average alveolar crest width in the experimental group was 3.72 ± 0.94 mm before surgery, 11.57 ± 1.44 mm on the day after surgery, 8.86 ± 1.37 mm at 6 months after surgery, and 7.62 ± 1.08 mm after 1-2 years of loading. The level of OPG in the experimental group was greater than that in the control group, and greater than that in the natural teeth; however, this difference was not significant (P > 0.05). The RANKL concentration in the gingival crevicular fluid of the two groups was similar, and the RANKL/OPG ratio of the implants in the experimental group was slightly lower than that in the control group; whereas the RANKL and ratio of the two groups were lower than that of the natural teeth (P > 0.05).
GBR application in the horizontal bone augmentation of the mandibular posterior dental region has positive clinical outcomes. After 1-2 years of implant loading, the bone in the neck of the implant in the experimental group is slightly more active than in the control group, and may still be in the process of osteogenesis.
本回顾性对照研究旨在评估引导骨再生（GBR）对下颌后牙区牙槽嵴水平向骨增量及种植体负载1 - 2年后骨稳定性的影响。我们测量并分析牙槽嵴骨宽度的变化以观察骨移植的临床效果。定量分析种植体周围龈沟液中RANK/RANKL/OPG浓度，并与健康天然牙的进行比较以评估骨状况。
选取大连口腔医院种植科收治的52例患者。22例患者的22枚种植义齿在水平骨移植后采用软组织水平种植体修复（试验组）。30例患者的30枚种植义齿采用相同种植系统但未进行骨移植（对照组）。在种植体负载1 - 2年后，通过相同的滤纸条收集种植体周围龈沟液及健康对照天然牙的龈沟液。采用ELISA法定量检测RANKL和OPG的浓度及比值。将骨移植术前、术后1天、术后6个月及负载后拍摄的CBCT图像进行叠加，测量牙槽嵴的水平宽度。在种植体中心嵴顶下方2 mm处进行测量。
试验组术前平均牙槽嵴宽度为3.72±0.94 mm，术后1天为11.57±1.44 mm，术后6个月为8.86±1.37 mm，负载1 - 2年后为7.62±1.08 mm。试验组OPG水平高于对照组，且高于天然牙，但差异无统计学意义（P>0.05）。两组龈沟液中RANKL浓度相似，试验组种植体的RANKL/OPG比值略低于对照组；而两组的RANKL及比值均低于天然牙（P>0.05）。
GBR在下颌后牙区水平向骨增量中的应用具有积极的临床效果。种植体负载1 - 2年后，试验组种植体颈部的骨组织比对照组略活跃，可能仍处于成骨过程中。
