下颌升支区半柱状自体骨移植与颏部矩形自体骨移植在美学区水平向骨增量中的临床应用效果评价——随机对照临床实验

doi:10.13701/j.cnki.kqyxyj.2018.09.012

口腔医学研究 ›› 2018, Vol. 34 ›› Issue (9): 969-973.DOI: 10.13701/j.cnki.kqyxyj.2018.09.012

下颌升支区半柱状自体骨移植与颏部矩形自体骨移植在美学区水平向骨增量中的临床应用效果评价——随机对照临床实验

赵雪竹,唐志辉^*,邹立东,许卫华

北京大学口腔医院第二门诊部北京 100101

收稿日期:2018-03-10 出版日期:2018-09-28 发布日期:2018-09-25
作者简介:赵雪竹(1983~ ),女,北京人,博士,主治医师,研究方向为骨增量技术及数字化技术在口腔种植中的应用。

Clinical Outcomes of Horizontal Alveolar Ridge Augmentation by Harvesting Half-columnar Block Bone from Ramus versus Rectangular Bone from Chin for Dental Implants in Aesthetic Zone-A Randomized Controlled Clinical Trial.

ZHAO Xue-zhu, TANG Zhi-hui^*, ZOU Li-dong, XU Wei-hua.

Peking University School and Hospital of Stomatology, 2nd Dental Center, Beijing 100101, China.

Received:2018-03-10 Online:2018-09-28 Published:2018-09-25

摘要/Abstract

摘要： 目的: 比较通过下颌升支半柱状自体骨移植及颏部矩形自体骨移植进行前牙区水平向骨增量的临床效果。方法: 将患者随机分为两组。组1:在下颌升支区取半柱状自体骨,组2:在颏部取矩形块状自体骨,分别进行水平向骨增量手术。观察植骨后即刻及植骨后4个月骨厚度及高度的变化,以及负重后1年种植体周围边缘骨吸收。结果: 共纳入患者47例,植入种植体61枚。植骨后即刻测量,两组在嵴顶区的骨厚度增加量无显著性差异[组1为(3.9±1.6) mm,组2为(3.3±1.8) mm] ,在嵴顶根方4 mm的骨厚度增加量无显著性差异[组1为(3.9±1.4) mm,组2为(3.5±1.7) mm] 。植骨后4个月,两组在嵴顶区的水平向骨吸收无显著性差异[组1为(0.59±0.69) mm,组2为(1.13±1.6) mm] ;在嵴顶根方4 mm位置,组1的水平向骨吸收(0.03±0.96) mm显著小于组2(0.87±1.16) mm。种植负重后1年,组1的边缘骨吸收(0.13±0.65) mm显著小于组2(0.74±1.09) mm。结论: 自下颌升支区半柱状取骨及颏部矩形取骨进行前牙区水平向块状自体骨移植,均可得到满意的临床效果。植骨后4个月及负重后1年,下颌升支半柱状取骨组的骨维持量更高。

关键词: 块状自体骨移植, 半柱状, 牙种植, 下颌升支, 颏部

Abstract: Objective: To compare clinical outcomes of ridge augmentation with half columnar block bone from ramus versus rectangular bone graft from chin. Methods: Patients were randomly divided into two groups. Group 1 received half-columnar autogenous bone graft from ramus, and Group 2 received rectangular bone graft from chin. Changes of ridge width and height in recipient area were measured. Results: Forty-seven patients (61 implants) were included. Immediately after bone grafting, ridge thickness increased (3.9±1.6) mm in Group I, and (3.3±1.8) mm in Group II with no significant difference. Four months later, the horizontal bone resorption at alveolar crest had no significant difference between Group 1 (0.59±0.69) mm and Group 2 (1.13±1.6) mm, while at the level of 4 mm below crest, the horizontal resorption in Group 1 (0.03±0.96) mm was significantly lower than Group 2 (0.87±1.16) mm. 1 year after loading, Group 1 exhibited significantly less marginal bone loss (0.13±0.65) mm than Group 2 (0.74±1.09) mm. Conclusion: Half-columnar group demonstrate a better bone graft stability than rectangular group at both 4 months after bone augmentation and 1year after loading.

Key words: Autogenous block bone graft , Half-columnar , Dental implant , Ramus, Chin

赵雪竹,唐志辉,邹立东,许卫华. 下颌升支区半柱状自体骨移植与颏部矩形自体骨移植在美学区水平向骨增量中的临床应用效果评价——随机对照临床实验[J]. 口腔医学研究, 2018, 34(9): 969-973.

ZHAO Xue-zhu, TANG Zhi-hui, ZOU Li-dong, XU Wei-hua.. Clinical Outcomes of Horizontal Alveolar Ridge Augmentation by Harvesting Half-columnar Block Bone from Ramus versus Rectangular Bone from Chin for Dental Implants in Aesthetic Zone-A Randomized Controlled Clinical Trial.[J]. Journal of Oral Science Research, 2018, 34(9): 969-973.

参考文献

[1] Pistilli R, Felice P, Piatelli M, et al. Blocks of autogenous bone versus xenografts for the rehabilitation of atrophic jaws with dental implants: preliminary data from a pilot randomised controlled trial [J] . Eur J Oral Implantol, 2014, 7(2)∶153-171
[2] Barone A, Covani U. Maxillary alveolar ridge reconstruction with nonvascularized autogenous block bone: clinical results [J] . J Oral Maxillofac Surg, 2007, 65(10)∶2039-2046
[3] Pourabbas R, Nezafati S. Clinical results of localized alveolar ridge augmentation with bone grafts harvested from symphysis in comparison with ramus [J] . J Dent Res Clin Dent Prospects, 2007, 1(1)∶7-12
[4] Aloy-Prósper A, Pe arrocha-Oltra D, Pe arrocha-Diago M,et al. The outcome of intraoral onlay block bone grafts on alveolar ridge augmentations: A systematic review [J] . Med Oral Patol Oral Cir Bucal, 2015, 20(2)∶e251-e258
[5] 马士卿,张旭,孙迎春,等.引导骨组织再生膜的研究进展[J] .口腔医学研究,2016,32(3)∶309-310
[6] Cordaro L, Terheyden H.国际口腔种植学会口腔种植临床指南.口腔种植的牙槽嵴骨增量程序:分阶段方案[M] .宿玉成,译.辽宁科学技术出版社, 2016
[7] Chiapasco M, Zaniboni M, Boisco M. Augmentation procedures for the rehabilitation of deficient edentulous ridges with oral implants [J] . Clin Oral Implant Res, 2006, 17(2)∶136-159
[8] Lee HG, Kim YD. Volumetric stability of autogenous bone graft with mandibular body bone: cone-beam computed tomography and three-dimensional reconstruction analysis [J] . J Korean Assoc Oral Maxillofac Surg, 2015, 41(5)∶232-239
[9] Jensen SS, Terheyden H. Bone augmentation procedures in localized defects in the alveolar ridge: clinical results with different bone grafts and bone-substitute materials [J] . Int J Oral Maxillofac Implants, 2009, 24 Suppl∶218-236
[10] von Arx T, Buser D. Horizontal ridge augmentation using autogenous block grafts and the guided bone regeneration technique with collagen membranes: a clinical study with 42 patients [J] . Clin Oral Implants Res, 2006, 17(4)∶359-366
[11] Rosenthal AH, Buchman SR. Volume maintenance of inlay bone grafts in the craniofacial skeleton [J] . Plast Reconstr Surg, 2003, 112(3)∶802-811

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下颌升支区半柱状自体骨移植与颏部矩形自体骨移植在美学区水平向骨增量中的临床应用效果评价——随机对照临床实验

Clinical Outcomes of Horizontal Alveolar Ridge Augmentation by Harvesting Half-columnar Block Bone from Ramus versus Rectangular Bone from Chin for Dental Implants in Aesthetic Zone-A Randomized Controlled Clinical Trial.

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