环状植骨修复牙列缺损伴骨量不足

Bone ring technique for restoration of dentition defects with bone deficiency

背景:目前,因牙周炎、创伤等原因导致的牙缺失后骨量缺损较为普遍,各类骨增量技术仅解决了一部分此类难题。目前常用的各类骨增量技术均存在不同程度的局限性。为改善上述问题,一项改良技术——环状植骨术的提出,为临床工作者提供更多骨增量方案选择。目的:归纳环状植骨术相关研究动态,对环状植骨术的临床应用情况进行综述。方法:由第一作者应用计算机检索PubMed、万方、维普、知网、CBM数据库,以“dentition defect,bone augmentation,dental implants,bone defect,bone graft material,bone ring technique”为英文关键词,以“牙列缺损,骨增量,牙种植体,骨缺损,骨移植材料,环状植骨术”为中文关键词,检索时限为1986年1月至2022年2月,共搜索到431篇文献,并进行筛选、归纳分析与总结,最终纳入60篇相关文献进行综述。结果与结论:①环状植骨术并同期植入种植体具有缩短治疗时间、减少患者二次手术痛苦等优点,且因其良好的机械性能,更利于软硬组织形态的重建与恢复;②但其也存在固定不牢、自身供骨量无法满足严重骨量缺损、部分患者无法接受开辟第二术区等局限;③仍需要更多高质量、长时间、大样本的随访研究,不断改良环状植骨术,使其更好地应对各类牙列缺损伴骨缺损患者的种植治疗。

BACKGROUND:At present,bone defect after tooth loss due to periodontitis and trauma is common and the application of various kinds of bone augmentation techniques has partially solved these problems.However,various commonly used bone augmentation techniques have limitations to varying degrees.To alleviate the above-mentioned problems,an improved technique,bone ring technique,has been proposed to provide clinical workers with more options for bone augmentation.OBJECTIVE:To summarize and review the related research trends of bone ring technique and its clinical application.METHODS:A computer-based search of PubMed,WanFang,VIP,and CBM was performed by the first author.The keywords were“dentition defect,bone augmentation,dental implants,bone defect,bone graft material,bone ring technique”in English and Chinese.The retrieval time was from January 1986 to February 2022.A total of 431 articles were initially retrieved followed by screening,analysis,and summarization,and 60 articles were finally included for literature review.RESULTS AND CONCLUSION:Bone ring technique with concurrent dental implantation can shorten treatment time and avoid secondary operation in patients.Moreover,due to the good mechanical properties,this method is more conducive to the reconstruction and recovery of soft and hard tissue morphology.However,there are also some limitations,such as poor fixation,insufficient bone mass to meet the needs of patients with severe bone defects,and unacceptability of opening a second surgical area.Therefore,more high-quality,long-term and large-sample follow-up studies are still needed to continuously improve the bone ring technique so that it can better cope with dental implantation treatment for various types of dentition defects and bone defects.