牙槽突扩张联合GBR植骨术同期种植的临床回顾研究

A retrospective study of ridge expansion with guided bone regeneration in dental implantation

目的： 评价牙槽突扩张联合引导骨再生术（GBR）和植骨术同期植入ITI种植体的远期效果。方法： 回顾分析对55 名患者（男35 名，女20 名）行牙槽突扩张联合GBR植骨术，同期植入ITI Straumann种植体83 颗的临床效果。结果： 患者平均年龄36.3 岁（18-60 岁），平均骨愈合时间6.9 个月（4.0-20.7 个月）。完成56 例修复体，其中种植单冠28 例，种植联冠8 例，种植单端桥5 例，种植固定桥13 例，种植支持式覆盖义齿2 例。修复完成后每年定期随访，包括临床检查和X线测量，累计观察期8 年。2 名患者（3.6%）术中发生唇侧骨板骨折。4 名患者（7.5%）修复后失访。49 名患者平均随访时间3.1 年（0.5-7.5 年），种植体8 年累计存留率为100%。种植体平均边缘骨高度为颈缘下2.57 mm。10 例修复体发生修复并发症。结论： 针对严重牙槽突宽度骨量不足的患者，牙槽突扩张联合GBR植骨牙种植术是一种可行的种植方案。

Objective： To evaluate the long-term outcomes of ridge expansion combined with guided bone regeneration （GBR）for implantation in narrow alveolar ridge. Methods： 55 patients （35 males and 20 females） aged 18 to 60 （mean 36.3 ） years old with insufficient alveolar ridge were treated with ridge expansion combined with GBR. A total of 83 implants were placed during surgery. After a mean 6.9 （4.0 - 20.7 ） months of unloaded healing, the implants were connected to abutments and 56 prosthesis, including 28 single crowns, 8 combination crowns, 5 cantilever fixed bridges, 13 partial bridges and 2 implant-supported overdentures. The patients were followed up for 0. 5 - 7.5 years. Results： Labial bony plate fractured in 2 cases （ 3.6% ） during surgery. 4 patients （7.5%） were lost to follow-up after prosthetic loading. No implant was lost in follow-up, yielding a 8-year survival rate of 100%. The average marginal bone loss at the last follow-up was 2.57 mm. 10 implant-supported restorations were involved in prosthetic complications. Conclusion： Ridge expansion with GBR is effective for dental implantation in patients with insufficient alveolar ridge.