自体骨-异种骨混合的钛网支撑的引导骨再生伴角化龈增量的美学区连续牙列缺损种植修复一例

Implant restoration of extended edentulous spaces in the aesthetic zone using autogenous-heterogeneous bone grafting GBR with titanium mesh combined with keratinized tissue augmentation:a case report

本病例报告了一例自体骨-异种骨混合的钛网支撑的引导骨再生(guided bone regeneration,GBR)伴角化龈增量的美学区连续牙列缺损种植修复。患者因外伤致上颌前牙区骨折、水平向骨丧失,连续多颗天然牙缺失。临床治疗取自体骨混合去蛋白牛骨矿物质(deproteinized bovine bone mineral,DBBM)异种骨填入骨缺损区,在唇侧放置钛网和生物可吸收性胶原膜。半年后行简易修复导板引导下种植体植入,二期术前行角化龈增量,临时修复体佩戴6个月后完成最终美学修复。结果可见,自体骨-异种骨混合的钛网支撑的GBR获得了理想的骨增量效果,为种植体植入提供了理想的位点,同时角化龈增量手术为最终美学修复提供了令医患满意的临床效果。因此,自体骨-异种骨混合用于钛网支撑的GBR是一种增加前牙区水平骨量的有效方法。

This case report describes the implant restoration of extended edentulous spaces in the aesthetic zone using an autogenous-heterogeneous bone mixture as the bone grafting material for guided bone regeneration(GBR)with titanium mesh,combined with keratinized tissue augmentation.The patient presented with a traumatic fracture of the anterior maxilla,horizontal alveolar bone loss,and loss of multiple consecutive teeth.Autogenous bone was mixed with deproteinized bovine bone mineral heterograft and implanted in the area of bone loss.Titanium mesh and a bioresorbable barrier membrane were placed labially.After six months,implants were placed under the guidance of a simple prosthetic guide.Keratinized tissue augmentation was performed before second-stage surgery.The final esthetic restoration was completed after 6 months of wearing the provisional denture.The treatment outcomes demonstrated that the use of an autogenous-heterogeneous bone mixture as grafting material for guided bone regeneration with titanium mesh resulted in ideal bone augmentation,providing an optimal site for implant placement.The keratinized tissue augmentation procedure provided satisfactory clinical outcomes for the final aesthetic restoration.Therefore,we concluded that using an autogenous-heterogeneous bone mixture as grafting material for guided bone regeneration with titanium mesh is an effective method for increasing horizontal alveolar bone volume in the anterior region.