三明治法Onlay植骨结合GBR技术在上颌骨洞穿性缺损种植修复中的应用思考

Application of Sandwich Onlay Bone Grafting Combined with GBR in Implant Repair of Maxillary Puncture

目的研究三明治法Onlay植骨结合GBR技术应用于上颌骨洞穿性骨缺损后牙槽嵴水平向及垂直向骨量的变化;评价该项技术在口腔种植中的应用效果。方法抽取泰州市中医院近年的5名病例作为研究对象,通过口腔专科检查和口腔颌面CT检查进行术前评估,通过Onlay植骨结合GBR技术修复骨缺损区,恢复缺牙区的骨量和缺失牙,手术后8个月通过CT检查,评估骨增量效果,并行种植修复。结果植骨术后8个月,患者缺牙区牙槽嵴水平骨量提升4.2mm,垂直骨量提升18mm,患者口腔软组织、牙龈颜色、牙龈乳头均基本恢复正常,供骨区无神经症状、继发性感染及其他不适。种植体骨结合良好,稳定性佳,患者对修复效果满意。种植牙留存率100%。结论三明治法Onlay自体骨移植结合GBR技术是解决上颌骨洞穿性骨缺损的有效临床途径,能够使牙槽骨水平向及垂直向骨量均得到良好改善,为后期的种植修复提供良好的骨基础。

Objective To investigate the changes of the horizontal and vertical bone mass of the alveolar ridge after the sandwich method of Onlay bone autologous bone grafting for maxillary perforating bone defect.This technology is used to evaluate the application in oral implants.Methods A typical case of Taizhou Traditional Chinese Medicine Hos⁃pital in recent years is selected as the research object.Preoperative evaluation is performed by dental examination and oral maxillofacial CT examination.The reasonable Onlay autologous bone graft combined with GBR technology is de⁃signed to restore bone mass and missing teeth in the missing tooth area.The CT examination is performed 8 months af⁃ter the operation to detect alveolar bone mineral density,and statistics of dental implant survival.Results 8 months after surgery,the patient's alveolar crest has a horizontal bone mass of 4.2 mm and a vertical bone mass of 18 mm.The oral soft tissues,gingival nipples,and gingival colors of the patient return to normal.The donor area is free of neurological symptoms,secondary infections,and other discomforts.The dental implant survival rate is 100%.Conclusion The sand⁃wich method Onlay autologous bone grafting combined with GBR technology is an effective clinical way to solve the maxillary perforating bone defect,which improves the alveolar bone horizontally and vertically,and provides a good foundation for later implant restoration.