块状及片状自体骨重建牙槽嵴重度骨缺损的临床研究

doi:10.12337/zgkqzzxzz.2021.02.005

中国口腔种植学杂志 ›› 2021, Vol. 26 ›› Issue (1): 18-24.DOI: 10.12337/zgkqzzxzz.2021.02.005

块状及片状自体骨重建牙槽嵴重度骨缺损的临床研究

尉华杰, 邱立新

北京大学口腔医学院·口腔医院第四门诊部国家口腔疾病临床医学研究中心口腔数字化医疗技术和材料国家工程实验室口腔数字医学北京市重点实验室 100025

收稿日期:2020-10-09 出版日期:2021-02-10 发布日期:2021-06-04
通讯作者: 邱立新,Email：bdkqqlx@163.com ,电话：010-85715965,主任医师、博士,研究方向：骨量不足情况下的多种植骨技术、复杂病例的软硬组织美学重建与美学修复
作者简介:尉华杰,副主任医师、博士,研究方向：复杂骨缺损重建,美学区域种植及植骨材料的相关研究
基金资助:
国家自然科学基金（81801031）

Clinical study of autogenous bone grafting for reconstruction of atrophic alveolar ridges in long-term performance

Yu Huajie, Qiu Lixin

Department of Fourth Clinical Division, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100025, China

Received:2020-10-09 Online:2021-02-10 Published:2021-06-04
Contact: Qiu Lixin, Email: bdkqqlx@163.com, Tel: 0086-10-85715965
Supported by:
National Natural Science Foundation of China（81801031）

摘要/Abstract

摘要： 目的通过对块状或片状自体骨植骨病例的长期随访研究,评价其骨增量方法的有效性及临床效果,分析影响块状或片状自体骨移植及种植成功的因素。材料与方法 通过回顾研究自2000年以来,作者团队采用块状或片状自体骨技术恢复牙槽嵴水平向或垂直向骨缺损,对植骨治疗后5年以上的66个病例,测量植骨前后及种植体植入时植骨区的体积变化,统计块状或片状自体骨块移植成功率、种植体留存率及并发症的发生情况,分析其植骨治疗影响因素。结果共有89名患者完成自体骨移植,排除失访等病例,最终纳入66名患者,其中,水平骨增量50例,垂直骨增量16例,共116个种植位点;平均随访时间8.1年。骨吸收率分别为9.0%和10.9%,自体骨的成活率为95.8%,种植体留存率为95.7%。其中3例出现骨块松动,5例发生种植体周炎,1例发生下牙槽神经支配区软组织麻木。结论块状或片状自体骨移植可以安全有效的重建牙槽嵴重度骨缺损,而自体骨的良好固定、合适的技术选择和软组织瓣的处理对植骨成功及减小术后骨吸收具有重要影响。

关键词: 自体骨, 骨缺损, 引导骨再生

Abstract: Objective The aim of this study is to evaluate the efficacy and long-term clinical outcomes of autogenous bone block/laminar reconstruction of alveolar ridge defect, and analyze the key factors affecting the success rate of autogenous bone graft and implants. Methods And Materials This retrospective study was conducted from January 2000 to December 2015. A total of 66 patients underwent autogenous onlay bone graft to reconstruct bone defect were enrolled in this trial, and all the patients were followed-up for at least 5 years, The width and vertical height of alveolar bone were measured at the time of surgery and reentry surgery. Integration of graft, implant survival rates and complications were recorded. Results 89 patients were screened for eligibility. Eventually, 66 patients with 116 implant sites were enrolled in this trial. Of these, 50 patients received horizontal augmentation, while 16 received vertical augmentation. The average of follow-up was 8.1 years. Bone resorption rate after horizontal and vertical augmentation was 9.0% and 10.9% respectively. Graft integration and implant survival rates were 95.8% and 95.7% respectively. 3 bone blocks failed to integrate. Among all the 116 implants, periimplantitis occurred in 5 cases. 1 case presented paresthesia lasting up to 6 months because of minor nerve impairment. Conclusion This study demonstrated that autogenous bone graft was effective and reliable for reconstruction of severe atrophic alveolar ridges. Favorable fixation, appropriate technology selection and flap management had great influence on graft integration and bone maintenance.

Key words: autogenous bone, bone defect, guided bone regeneration

尉华杰,等邱立新. 块状及片状自体骨重建牙槽嵴重度骨缺损的临床研究[J]. 中国口腔种植学杂志, 2021, 26(1): 18-24. DOI: 10.12337/zgkqzzxzz.2021.02.005

Yu Huajie, Qiu Lixin. Clinical study of autogenous bone grafting for reconstruction of atrophic alveolar ridges in long-term performance[J].Chinese Journal of Oral Implantology, 2021, 26(1): 18-24.DOI: 10.12337/zgkqzzxzz.2021.02.005.

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块状及片状自体骨重建牙槽嵴重度骨缺损的临床研究

Clinical study of autogenous bone grafting for reconstruction of atrophic alveolar ridges in long-term performance

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