摘要 目的：探讨微创骨劈开术引导骨组织再生术（guide bone regeneration，GBR），行下颌骨增量的临床效果，并评估细直径钛锆种植体用于狭窄牙槽嵴的效果。方法：术前临床及影像学检查显示，患者下颌缺牙区骨量严重不足。左下颌拟种植区行微创骨劈开术，同期植入细直径钛锆种植体。常规植入其他部位种植体，植体颊侧暴露处行GBR。4个月后，选用多基基台，制作纯钛烤塑联冠修复体，最终戴入6枚种植体支持的12单位的永久修复体。结果：患者缺损的牙列和丧失的咬合关系得以重建，种植体稳定，修复体咬合关系良好。结论：微创骨劈开术联合GBR，可成功地用于下颌前牙区骨量不足的患者，避免了常规自体骨块移植需要开辟第二术区的缺陷，同时使用细直径钛锆种植体，获得了理想的美学效果及功能。患者满意，远期效果需进一步观察。
Objective: To report a clinical application of combination using of minimally invasive bone splitting, bone condensing, guided bone regeneration(GBR) and immediate planting. Methods: A 58-year-old male with an unmarkable medical history requested replacement of missing lower teeth with an implant-supported restoration. Clinical examination revealed the patient’s mandibular teeth were all missing except 42,43 retained in loose condition. There were vertical and horizontal defects of the residual alveolar ridge of the mandible. Imagiology examination showed in 33 rd and 34 th tooth site area, available bone width was 4 mm, available bone height was 13-15 mm; in 43 rd and 44 th tooth sites, the width/height of alveolar were, 5 mm/12-16 mm; in 36 th and 34 th tooth site area, 8 mm/12 mm respectively. Bone density of the mandible appeared normal. Various augmentation techniques were discussed in detail with the patient and eventually the patient decided to undergo ridge augmentation with the combination using of minimally invasive bone splitting, bone condensing, and guided bone regeneration. The procedure was carried out under local anesthesia. Then minimally invasive bone splitting and bone condensing were performed in proposed implant area of left lower mandible with simultaneous placement of titanium-zirconium narrow diameter implants. The remaining implants were placed routinely in other sites, GBR was performed around the buccal exposed implants. Results: 4 months later, multi-base abutments were used tomake resin fused to titanium crown prosthesis. Finally, 12 units of permanent prosthesis supported by 6 implants were restored. Conclusion: Combination using of minimally invasive bone splitting, bore condeusing, and GBR, is successful in this case, bnt lorg time observation is stll necessary.
WANG Yan-Mei, Zou-Duo-Hong, He-Jia-Cai. Combination Using of Minimally Invasive Bone Splitting, Bone Condensing, Guided Bone Regenerationin Vertical Ridge Augmentation and Simultaneous Installation of Narrow-diameter Implants[J]. Journal of Oral and Maxillofacial Surgery, 2017, 27(4): 257-262.
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