自体骨-异种骨混合的钛网支撑的引导骨再生伴角化龈增量的美学区连续牙列缺损种植修复一例

doi:10.12337/zgkqzzxzz.2024.06.013

中国口腔种植学杂志 ›› 2024, Vol. 29 ›› Issue (3): 272-276.DOI: 10.12337/zgkqzzxzz.2024.06.013

自体骨-异种骨混合的钛网支撑的引导骨再生伴角化龈增量的美学区连续牙列缺损种植修复一例

蒋娟娜^1,2, 李俊满¹, 陈琳¹, 谢亮焜¹

¹昆明医科大学附属口腔医院口腔种植科 650000,云南;
²保山市人民医院口腔医学中心 678000,云南

收稿日期:2023-08-17 出版日期:2024-06-30 发布日期:2024-06-28
通讯作者: 谢亮焜,Email：liangkunxie@qq.com,电话：0871-65330099-8070
作者简介:蒋娟娜硕士、主治医师,研究方向：口腔种植修复;谢亮焜博士、副主任医师、副教授、硕士研究生导师,研究方向：口腔种植学

Implant restoration of extended edentulous spaces in the aesthetic zone using autogenous-heterogeneous bone grafting GBR with titanium mesh combined with keratinized tissue augmentation: a case report

Jiang Juanna^1,2, Li Junman¹, Chen Lin¹, Xie Liangkun¹

¹Department of Oral Implantology, Kunming Medical University School and Hospital of Stomatology, Kunming 650000, Yunnan, China;
²Center of Stomatology, Baoshan People’s Hospital, Baoshan 678000, Yunnan, China

Received:2023-08-17 Online:2024-06-30 Published:2024-06-28
Contact: Xie Liangkun, Email: liangkunxie@qq.com, Tel: 0086-871-65330099-8070

摘要/Abstract

摘要： 本病例报告了一例自体骨-异种骨混合的钛网支撑的引导骨再生（guided bone regeneration,GBR）伴角化龈增量的美学区连续牙列缺损种植修复。患者因外伤致上颌前牙区骨折、水平向骨丧失,连续多颗天然牙缺失。临床治疗取自体骨混合去蛋白牛骨矿物质（deproteinized bovine bone mineral,DBBM）异种骨填入骨缺损区,在唇侧放置钛网和生物可吸收性胶原膜。半年后行简易修复导板引导下种植体植入,二期术前行角化龈增量,临时修复体佩戴6个月后完成最终美学修复。结果可见,自体骨-异种骨混合的钛网支撑的GBR获得了理想的骨增量效果,为种植体植入提供了理想的位点,同时角化龈增量手术为最终美学修复提供了令医患满意的临床效果。因此,自体骨-异种骨混合用于钛网支撑的GBR是一种增加前牙区水平骨量的有效方法。

关键词: 美学区种植, 引导骨再生, 自体骨, 钛网, 角化龈增量

Abstract: This case report describes the implant restoration of extended edentulous spaces in the aesthetic zone using an autogenous-heterogeneous bone mixture as the bone grafting material for guided bone regeneration (GBR) with titanium mesh, combined with keratinized tissue augmentation. The patient presented with a traumatic fracture of the anterior maxilla, horizontal alveolar bone loss, and loss of multiple consecutive teeth. Autogenous bone was mixed with deproteinized bovine bone mineral heterograft and implanted in the area of bone loss. Titanium mesh and a bioresorbable barrier membrane were placed labially. After six months, implants were placed under the guidance of a simple prosthetic guide. Keratinized tissue augmentation was performed before second-stage surgery. The final esthetic restoration was completed after 6 months of wearing the provisional denture. The treatment outcomes demonstrated that the use of an autogenous-heterogeneous bone mixture as grafting material for guided bone regeneration with titanium mesh resulted in ideal bone augmentation, providing an optimal site for implant placement. The keratinized tissue augmentation procedure provided satisfactory clinical outcomes for the final aesthetic restoration. Therefore, we concluded that using an autogenous-heterogeneous bone mixture as grafting material for guided bone regeneration with titanium mesh is an effective method for increasing horizontal alveolar bone volume in the anterior region.

Key words: Implant in the esthetic zone, Guided bone regeneration (GBR), Autogenous bone, Titanium mesh, Keratinized tissue augmentation

蒋娟娜,李俊满,陈琳,等. 自体骨-异种骨混合的钛网支撑的引导骨再生伴角化龈增量的美学区连续牙列缺损种植修复一例[J]. 中国口腔种植学杂志, 2024, 29(3): 272-276. DOI: 10.12337/zgkqzzxzz.2024.06.013

Jiang Juanna, Li Junman, Chen Lin, Xie Liangkun. Implant restoration of extended edentulous spaces in the aesthetic zone using autogenous-heterogeneous bone grafting GBR with titanium mesh combined with keratinized tissue augmentation: a case report[J].Chinese Journal of Oral Implantology, 2024, 29(3): 272-276.DOI: 10.12337/zgkqzzxzz.2024.06.013.

参考文献

[1] Bister D.The SAC classification in implant dentistry (2009)[J].Eur J Orthod, 2009,31(5):564.DOI:10.1093/ejo/cjp074.
[2] Braut V, Bornstein MM, Belser U, et al.Thickness of the anterior maxillary facial bone wall-a retrospective radiographic study using cone beam computed tomography[J]. Int J Periodontics Restorative Dent, 2011,31(2):125-131.
[3] Araújo MG, Sukekava F, Wennström JL, et al.Ridge alterations following implant placement in fresh extraction sockets: an experimental study in the dog[J]. J Clin Periodontol, 2005,32(6):645-652. DOI: 10.1111/j.1600-051X.2005.00726.x.
[4] Darby I, Chen ST, Buser D.Ridge preservation techniques for implant therapy[J]. Int J Oral Maxillofac Implants, 2009,24(Suppl):S260-S271.
[5] Buser D, Chappuis V, Bornstein MM, et al.Long-term stability of contour augmentation with early implant placement following single tooth extraction in the esthetic zone: a prospective, cross-sectional study in 41 patients with a 5- to 9-year follow-up[J]. J Periodontol, 2013,84(11):1517-1527. DOI: 10.1902/jop.2013.120635.
[6] Wang HL, Boyapati L.“pass” principles for predictable bone regeneration[J]. Implant Dent, 2006,15(1):8-17. DOI: 10.1097/01.id.0000204762.39826.0f.
[7] 满毅, 王天璐. 钛网在口腔种植骨量扩增中的应用[J].口腔颌面外科杂志,2015,(4):241-245. DOI: 10.3969/j.issn.1005-4979.2015.04.001.
[8] Rakhmatia YD, Ayukawa Y, Furuhashi A, et al.Current barrier membranes: titanium mesh and other membranes for guided bone regeneration in dental applications[J]. J Prosthodont Res, 2013,57(1):3-14. DOI: 10.1016/j.jpor.2012.12.001.
[9] Briguglio F, Falcomatà D, Marconcini S, et al.The use of titanium mesh in guided bone regeneration: a systematic review[J]. Int J Dent, 2019,2019:9065423. DOI: 10.1155/2019/9065423.
[10] Celletti R, Davarpanah M, Etienne D, et al.Guided tissue regeneration around dental implants in immediate extraction sockets: comparison of e-PTFE and a new titanium membrane[J]. Int J Periodontics Restorative Dent, 1994,14(3):242-253.
[11] Gutta R, Baker RA, Bartolucci AA, et al.Barrier membranes used for ridge augmentation: is there an optimal pore size?[J]. J Oral Maxillofac Surg, 2009,67(6):1218-1225. DOI: 10.1016/j.joms.2008.11.022.
[12] Tallarico M, Ceruso FM, Muzzi L, et al.Effect of simultaneous immediate implant placement and guided bone reconstruction with ultra-fine titanium mesh membranes on radiographic and clinical parameters after 18 months of loading[J]. Materials (Basel), 2019,12(10):1710. DOI: 10.3390/ma12101710.
[13] Lizio G, Corinaldesi G, Marchetti C.Alveolar ridge reconstruction with titanium mesh: a three-dimensional evaluation of factors affecting bone augmentation[J]. Int J Oral Maxillofac Implants, 2014,29(6):1354-1363. DOI: 10.11607/jomi.3417.
[14] Warrer K, Buser D, Lang NP, et al.Plaque-induced peri-implantitis in the presence or absence of keratinized mucosa. An experimental study in monkeys[J]. Clin Oral Implants Res, 1995,6(3):131-138. DOI: 10.1034/j.1600-0501.1995.060301.x.
[15] Grischke J, Karch A, Wenzlaff A, et al.Keratinized mucosa width is associated with severity of peri-implant mucositis. A cross-sectional study[J]. Clin Oral Implants Res, 2019,30(5):457-465. DOI: 10.1111/clr.13432.
[16] Souza AB, Tormena M, Matarazzo F, et al.The influence of peri-implant keratinized mucosa on brushing discomfort and peri-implant tissue health[J]. Clin Oral Implants Res, 2016,27(6):650-655. DOI: 10.1111/clr.12703.
[17] Tarasenko S, Ashurko I, Taschieri S, et al.Comparative analysis of methods to increase the amount of keratinized mucosa before stage-two surgery: a randomized controlled study[J]. Quintessence Int, 2020,51(5):374-387. DOI: 10.3290/j.qi.a44216.
[18] Schmitt CM, Tudor C, Kiener K, et al.Vestibuloplasty: porcine collagen matrix versus free gingival graft: a clinical and histologic study[J]. J Periodontol, 2013,84(7):914-923. DOI: 10.1902/jop.2012.120084.
[19] Bassetti RG, Stähli A, Bassetti MA, et al.Soft tissue augmentation procedures at second-stage surgery: a systematic review[J]. Clin Oral Investig, 2016,20(7):1369-1387. DOI: 10.1007/s00784-016-1815-2.
[20] Wallace SS, Tarnow DP, Froum SJ, et al.Maxillary sinus elevation by lateral window approach: evolution of technology and technique[J]. J Evid Based Dent Pract, 2012,12(3 Suppl):161-171. DOI: 10.1016/S1532-3382(12)70030-1.
[21] Klijn RJ, Meijer GJ, Bronkhorst EM, et al.A meta-analysis of histomorphometric results and graft healing time of various biomaterials compared to autologous bone used as sinus floor augmentation material in humans[J]. Tissue Eng Part B Rev, 2010,16(5):493-507. DOI: 10.1089/ten.TEB.2010.0035.
[22] Urban IA, Monje A, Wang HL.Vertical ridge augmentation and soft tissue reconstruction of the anterior atrophic maxillae: a case series[J]. Int J Periodontics Restorative Dent, 2015,35(5):613-623. DOI: 10.11607/prd.2481.
[23] 郭倩倩. 美学区种植修复后牙龈软组织的变化及美学评估[D]. 济南:山东大学, 2017.

自体骨-异种骨混合的钛网支撑的引导骨再生伴角化龈增量的美学区连续牙列缺损种植修复一例

Implant restoration of extended edentulous spaces in the aesthetic zone using autogenous-heterogeneous bone grafting GBR with titanium mesh combined with keratinized tissue augmentation: a case report

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

[1]	王怀升, 王心彧, 韩泽奎, 姜婷婷, 陈贺, 刘璐. 双曲抛物面形态和传统近似牙槽嵴形态3D打印钛网的力学性能研究[J]. 中国口腔种植学杂志, 2024, 29(3): 258-265.
[2]	《中国口腔种植学杂志》编辑部. 钛网支撑的引导骨再生的专家共识[J]. 中国口腔种植学杂志, 2024, 29(2): 95-100.
[3]	苏雅娣, 邹节娟, 王超, 黄元丁. 3D打印个性化钛网辅助下的引导骨再生与块状自体骨移植在复杂牙槽骨缺损重建中的临床回顾性研究[J]. 中国口腔种植学杂志, 2024, 29(2): 169-177.
[4]	韩振佳, 王心彧, 董美希, 张亮, 韩泽奎, 宿玉成, 臧旖欣, 段峰. 3D打印仿生钛网及聚氨酯涂层对钛网暴露后骨增量效果的生物学性能研究[J]. 中国口腔种植学杂志, 2023, 28(6): 444-450.
[5]	杨波, 韩泽奎, 代浩然, 张亮, 臧旖欣, 王心彧, 宿玉成. 聚四氟乙烯膜改性个性化钛网的制备及其抗菌性能研究[J]. 中国口腔种植学杂志, 2023, 28(6): 451-459.
[6]	杨博, 满毅. 骨代用品在切牙管种植中的应用[J]. 中国口腔种植学杂志, 2023, 28(5): 315-319.
[7]	张笑涵, 吕鸣樾, 张士文, 袁泉. 垂直骨增量手术中的骨增量材料选择[J]. 中国口腔种植学杂志, 2023, 28(5): 320-326.
[8]	武诗语, 陈卓凡, 黄宝鑫, 陈泽涛, 刘远翔. 单纯应用低替代率异种骨增量材料行上颌窦底提升的思考[J]. 中国口腔种植学杂志, 2023, 28(5): 327-331.
[9]	周麟, 丁佳敏, 邢益丰, 林彦君, 吴东. 钛网联合帐篷螺钉技术与自体骨移植在前牙区水平骨增量的对比：一项回顾性研究[J]. 中国口腔种植学杂志, 2023, 28(5): 340-346.
[10]	王凌旭, 王芳芳, 王鹏来. 个性化增材制造钛网在口腔种植骨增量中的应用及研究进展[J]. 中国口腔种植学杂志, 2023, 28(5): 364-370.
[11]	马蕊, 王志会, 刘洋, 高阳. 基于有限元法的引导骨再生用个性化钛网受力分析[J]. 中国口腔种植学杂志, 2023, 28(3): 198-203.
[12]	李效宇, 何捷, 王雪珂, 段静旖, 葛畅, 孟维艳. 应用骨胶原结合帐篷技术行上颌后牙连续缺失垂直骨增量一例[J]. 中国口腔种植学杂志, 2023, 28(2): 97-101.
[13]	徐亦凡, 叶颖. 美学区牙槽骨解剖特征对引导骨再生效果的影响[J]. 中国口腔种植学杂志, 2023, 28(1): 47-52.
[14]	邓磊, 黄海涛. 上颌窦底提升术后窦腔内成骨机制的研究进展[J]. 中国口腔种植学杂志, 2023, 28(1): 53-57.
[15]	季平. 3D打印个性化钛网用于复杂骨缺损增量治疗的研究进展[J]. 中国口腔种植学杂志, 2022, 27(6): 334-339.