微创骨劈开技术在上颌前牙明显骨凹陷患者种植修复中的应用

Applications of minimally invasive bone splitting technique in cases with missing maxillary anterior teeth and obvious labial alveolar bone depression for dental implantation

目的 :介绍一种适用于前牙唇侧骨倒凹明显的牙缺失病例的骨劈开技术,并评价其临床效果。方法 :对8例健康成年上前牙缺失伴唇侧牙槽骨骨凹陷的患者行微创骨劈开术,将常规骨劈开的唇侧骨切口减小,仅做牙槽骨凹陷区的骨切口,其余操作同常规骨劈开术。对术前及术后6个月植牙区行锥形束CT(CBCT)检查,自行设计定点方式,对术区牙槽骨高度和宽度进行测量。采用SPSS 21.0软件包对测量数据进行配对t检验。结果:术区骨凹陷在术后及术后6个月显著改善,牙槽嵴顶骨高度无显著变化(P>0.05),骨宽度显著增加(P<0.05)。结论:微创骨劈开技术在保留前牙唇侧牙槽骨的基础上,能获得良好的种植区植骨效果,有利于种植体的植入及后期美学效果改善,但远期效果有待进一步观察。

PURPOSE： The purpose of this study was to introduce a minimally invasive bone splitting technique which is suitable for cases with missing anterior teeth and obvious depression of alveolar bone in labial side, and to evaluate its clinical results. METHODS： Minimally invasive bone splitting technique was used in 8 healthy adults with bone defects in the aesthetic zone. The labial alveolar bone incisions were confined around the bone defects which were smaller than traditional incisions. The other procedures were the same as conventional bone splitting technique. Cone-beam CT （CBCT） for missing anterior teeth was taken before surgery, after the surgery and 6 months after surgery and alveolar bone height and width were recorded with landmark identification designed by ourselves in this study. The data were analyzed with SPSS 21.0 software package for paired t test. RESULTS： Paired t test indicated that after surgery and six months after surgery, the labial bone defect was significant improved （P〈0.05）, but the height of the alveolar ridge bone didn＇t increase significantly （P〉0.05） while the width of the alveolar ridge bone significant improved （P〉0.05）. CONCLUSIONS： This minimally invasive technique can achieve good clinical results for not only intact labial alveolar ridge bones but also good bone grafts, which is beneficial to implantation and prosthetic aesthetics. The long-term outcome needs to be observed.