自体颌骨碎骨移植在即刻种植术中的应用评价

Clinical evaluation of autologous jaw chips used in simultaneous dental implantation

目的:评价自体颌骨碎骨移植在人工种植牙即刻种植术中的应用效果,探讨即刻种植并行自体颌骨碎骨移植填充种植体周围与牙槽骨间隙的可行性。方法:对28例患者的31颗上颌前牙行即刻种植术,采用直径4.0mm的中空钻或骨凿,在种植部位邻近或颏部取骨并碾成碎骨,在种植体未完全就位前充填其间隙,压紧后旋紧种植体,通过种植体的挤压作用达到密切接触,减少骨组织愈合前纤维组织的长入。人工种植牙即刻种植术后3周做临时冠修复,半年后做永久冠修复。结果:治疗后随访1～3.5a,其中3a以上9颗,2～3a14颗,2a以内8颗。31颗种植体合并自体颌骨碎骨移植者,效果达到优22颗,良6颗,失败3颗,保存率为90.3%。结论:在即刻种植术中,应用自体颌骨碎骨填充种植体周围与牙槽骨间隙是可行的有效方法。

PURPOSE: To evaluate the clinical effect of autologous jaw chips used in simultaneous dental implantation, and investigate the feasibility of using autologous jaw chips to fill the gap between the implant and the alveolar bone. METHODS: 31 maxillary anterior teeth in 28 patients were simultaneously implanted with transplantation of autologous jaw chips. Pieces of the maxilla near the area of implantation or from the chin were harvested with bone chisel or hollow bur, and crushed down. Then, the harvested bone chips were inserted into the gap between the implant and surrounding alveolar bone to prevent ingrowth of fibrous tissues. Temporary crown was made 3 weeks after implantation, and permanent crown was placed 6 months postoperatively. RESULTS: All the patients were followed up for 1 to 3.5 years, 9 teeth were followed up over 3 years, 14 teeth were followed up for 2 to 3 years and 8 teeth were followed up less than 2 years. The results showed that 28 teeth were successfully implanted after 1-3.5 years with failure in 3 teeth, excellent results were achieved in 22 teeth, and good results in 6 teeth. The overall retaining rate was 90.3%. CONCLUSION: In simultaneous implantation, autologous jaw bone chips transplantation is feasible and reliable to fill the space between the implant and the alveolar bone.