下颌升支区半柱状自体骨移植与颏部矩形自体骨移植在美学区水平向骨增量中的临床应用效果评价——随机对照临床实验

Clinical Outcomes of Horizontal Alveolar Ridge Augmentation by Harvesting Half-columnar Block Bone from Ramus versus Rectangular Bone from Chin for Dental Implants in Aesthetic Zone-A Randomized Controlled Clinical Trial

目的:比较通过下颌升支半柱状自体骨移植及颏部矩形自体骨移植进行前牙区水平向骨增量的临床效果。方法:将患者随机分为两组。组1:在下颌升支区取半柱状自体骨,组2:在颏部取矩形块状自体骨,分别进行水平向骨增量手术。观察植骨后即刻及植骨后4个月骨厚度及高度的变化,以及负重后1年种植体周围边缘骨吸收。结果:共纳入患者47例,植入种植体61枚。植骨后即刻测量,两组在嵴顶区的骨厚度增加量无显著性差异[组1为(3.9±1.6)mm,组2为(3.3±1.8)mm],在嵴顶根方4mm的骨厚度增加量无显著性差异[组1为(3.9±1.4)mm,组2为(3.5±1.7)mm]。植骨后4个月,两组在嵴顶区的水平向骨吸收无显著性差异[组1为(0.59±0.69)mm,组2为(1.13±1.6)mm];在嵴顶根方4mm位置,组1的水平向骨吸收(0.03±0.96)mm显著小于组2(0.87±1.16)mm。种植负重后1年,组1的边缘骨吸收(0.13±0.65)mm显著小于组2(0.74±1.09)mm。结论:自下颌升支区半柱状取骨及颏部矩形取骨进行前牙区水平向块状自体骨移植,均可得到满意的临床效果。植骨后4个月及负重后1年,下颌升支半柱状取骨组的骨维持量更高。

Objective:To compare clinical outcomes of ridge augmentation with half columnar block bone from ramus versus rectangular bone graft from chin.Methods:Patients were randomly divided into two groups.Group 1 received half-columnar autogenous bone graft from ramus,and Group 2 received rectangular bone graft from chin.Changes of ridge width and height in recipient area were measured.Results:Forty-seven patients(61 implants)were included.Immediately after bone grafting,ridge thickness increased(3.9±1.6)mm in Group I,and(3.3±1.8)mm in Group II with no significant difference.Four months later,the horizontal bone resorption at alveolar crest had no significant difference between Group 1(0.59±0.69)mm and Group 2(1.13±1.6)mm,while at the level of 4 mm below crest,the horizontal resorption in Group 1(0.03±0.96)mm was significantly lower than Group 2(0.87±1.16)mm.1 year after loading,Group 1 exhibited significantly less marginal bone loss(0.13±0.65)mm than Group 2(0.74±1.09)mm.Conclusion:Half-columnar group demonstrate a better bone graft stability than rectangular group at both 4 months after bone augmentation and 1year after loading.