骨劈开、牙槽嵴扩张联合GBR技术同期上颌前牙区种植的临床疗效观察

Clinical effectiveness of bone splitting and alveolar ridge expansion associated with guided bone regeneration with simultaneous implant placement in anterior region of maxilla

目的：评价上前牙区牙槽骨水平宽度不足的患者应用骨劈开、牙槽嵴扩张联合GBR技术同期植入种植体的的临床疗效。方法：2011年5月～2013年9月，选取来本院就诊的24例上前牙种植区剩余骨量不足患者，应用超声骨刀行前牙牙槽骨劈开术，骨扩张、同期植入30枚Ankylos种植体，辅以GBR技术。6个月后，平行投照根尖片、 CBCT复查，完成修复，随访1年。结果：牙槽嵴唇腭侧术前、术后平均宽度分别为（3.2±0.12） mm和（6.4±0.16）mm，差异有统计意义（t=239.024， P〈0.05），牙槽骨宽度在术后基线与半年后结果相比，差异无统计意义（t=1.795， P〉0.05）。结论：骨劈开、牙槽嵴扩张联合GBR技术并同期植入种植体短期临床效果较好，远期效果有待于进一步观察。

Objective： To evaluate the clinical effectiveness of bone splitting and alveolar ridge expansion associated with a guided bone regeneration with simultaneous implant placement in anterior region of maxilla where deficiency of bone mass. Methods： From May 2011 to September 2013, 24 patients with insufficient bone mass in the anterior maxilla area were simultaneous bone splitting, ridge expansion and GBR technique with 30 implant placement. 6 months later, these implants were connected to the final prosthesis after reexamination by periapical film and CBCT. The patients were followed up for 1 year. Results： The mean labial-palatal width of alveolar ridge changed from 3.2±0.12mm to 6.4 ＆#177; 0.16mm after operations, the mean increase were 3.2 ±0.07mm and the differences were statistically significant（t=239.024, P〈0.05）. The differences of means between postoperation and half a year were not statistically significant（t=1.795, P〉0.05）. Conclusion： Simultaneous bone splitting, rigde expansion and GBR technique with implant placement in the maxillary anterior region may achieve good clinicaleffect. We still need more evidence to support the long-term effect.