Piattelli M, Scarano A, Piattelli A
Oral Pathology and Medicine, Dental School, University of Chieti, Italy.
J Periodontol. 1996 Feb;67(2):158-61. doi: 10.1902/jop.1996.67.2.158.
The vertical dimension may be very important clinically where anatomic structures may limit the bone height available for implant insertion. Moreover, lack of bone tissue may result in exposure of implant threads, soft tissue recession, less-than-optimal implant stability, and esthetic problems in the prosthetic reconstruction. Attempts have been made to increase the bone height with the placement of autografts and allografts on top of the ridge, but long-term results have been unsatisfactory. Recently an increase of bone in a vertical direction has been obtained in rats, rabbits, and man using expanded polytetrafluoroethylene (ePTFE) membranes. The authors present a case in which an increase of the vertical dimension of the alveolar ridge was obtained using a resorbable freeze-dried dura mater membrane in association with demineralized freeze-dried bone. After a 6-month uneventful healing period the space under the membrane was filled by a tissue with the macroscopic features of bone, and the two implants were almost covered by the newly-formed tissue. An histological examination of a retrieved sample of the newly formed tissue demonstrated the presence of mature bone. It can be concluded that a localized vertical increase of the alveolar ridge may be obtained with the use of a resorbable freeze-dried dura mater membrane.
在临床上，垂直维度可能非常重要，因为解剖结构可能会限制种植体植入时可用的骨高度。此外，骨组织的缺乏可能会导致种植体螺纹暴露、软组织退缩、种植体稳定性欠佳以及修复重建中的美学问题。人们曾尝试通过在牙槽嵴顶部植入自体骨和异体骨来增加骨高度，但长期效果并不理想。最近，在大鼠、兔子和人类中，使用膨体聚四氟乙烯（ePTFE）膜在垂直方向上实现了骨量增加。作者展示了一个病例，其中使用可吸收冻干硬脑膜膜结合脱矿冻干骨实现了牙槽嵴垂直维度的增加。经过6个月的平稳愈合期后，膜下空间被具有骨宏观特征的组织填充，并且两个种植体几乎被新形成的组织覆盖。对新形成组织的取出样本进行组织学检查显示存在成熟骨。可以得出结论，使用可吸收冻干硬脑膜膜可实现牙槽嵴局部垂直增加。
