Triplett R G, Schow S R
Department of Oral and Maxillofacial Surgery and Pharmacology, Baylor College of Dentistry, Dallas, TX 75266-0677, USA.
J Oral Maxillofac Surg. 1996 Apr;54(4):486-94. doi: 10.1016/s0278-2391(96)90126-3.
This article describes predictable techniques to augment contour- or height-deficient edentulous alveolar processes with autologous bone grafts for simultaneous or secondary placement of endosseous implants.
Augmentation bone grafts harvested from the ilium and mandible were used to reverse alveolar atrophy of the maxilla and mandible. Endosseous implants were either placed simultaneously with the graft or 6 to 9 months after grafting. Implant success was calculated only after an implant-supported prosthesis was in function for a minimum of 12 months.
One hundred twenty-nine autologous bone grafts were placed in 99 patients. This included 70 grafts in the maxillary sinus, 32 onlay grafts, 14 veneer grafts, 9 saddle grafts, and 4 inlay grafts. Of these, 117 (90.7%) were successful. A total of 364 implants were placed in the grafted areas, 134 at the time of grafting and 230 6 to 9 months after grafting to allow time for osseous healing and remodeling. Three hundred twenty (87.9%) of the 364 implants placed in grafted areas were successful; 112 (83.6%) of the implants placed at the time of bone grafting and 208 (90.4%) of the implants placed secondarily in consolidated grafts. A total of 51 implants were placed in non-grafted areas in the same group of patients. Of these, 49 (96%) were successful.
Autologous bone grafts can be used successfully to improve the ability to place endosseous implants. The successful placement of implants in autologous grafts is more predictable when the implants are placed secondarily, 6 to 9 months after bone grafting. Failure of individual implants does not imply failure of the bone graft. In most instances when implants failed to osseointegrate, enough bone graft remains to allow subsequent successful implant placement 6 to 9 months later.
本文介绍了一些可预测的技术，用于使用自体骨移植来增加轮廓或高度不足的无牙牙槽突，以便同时或二次植入骨内种植体。
取自髂骨和下颌骨的植骨用于逆转上颌骨和下颌骨的牙槽骨萎缩。骨内种植体要么与植骨同时植入，要么在植骨后6至9个月植入。仅在种植体支持的假体至少功能12个月后计算种植成功率。
99例患者共植入129块自体骨移植。其中包括70块上颌窦植骨、32块贴附植骨、14块饰面植骨、9块鞍形植骨和4块嵌体植骨。其中，117块（90.7%）成功。共在植骨区域植入364枚种植体，植骨时植入134枚，并在植骨后6至9个月植入230枚，以便有时间进行骨愈合和重塑。在植骨区域植入的364枚种植体中，320枚（87.9%）成功；植骨时植入的种植体有112枚（83.6%）成功，二次植入巩固植骨区的种植体有208枚（90.4%）成功。同一组患者在非植骨区域共植入51枚种植体。其中，49枚（96%）成功。
自体骨移植可成功用于提高植入骨内种植体的能力。当种植体在植骨后6至九个月二次植入时，在自体植骨中成功植入种植体更可预测。个别种植体失败并不意味着骨移植失败。在大多数种植体未能骨整合的情况下，仍有足够的骨移植可允许在6至9个月后成功进行后续种植体植入。
