Nezaštićeni koštani autotransplantati u prednjem segmentu gornje vilice: stepen resorpcije i klinički rezultati

  • Ivan Kosanić Clinic of Oral Surgery, Faculty of Dental Medicine, University of Belgrade, Belgrade, Serbia
  • Miroslav Andrić Clinic of Oral Surgery, Faculty of Dental Medicine, University of Belgrade, Belgrade, Serbia
  • Božidar Brković Clinic of Oral Surgery, Faculty of Dental Medicine, University of Belgrade, Belgrade, Serbia
  • Vladimir Koković Ras Al Khaimah College of Dental Sciences, Ras Al Khaimah, United Arab Emirates
  • Milan Jurišić Clinic of Oral Surgery, Faculty of Dental Medicine, University of Belgrade, Belgrade, Serbia
DOI: https://doi.org/10.2298/VSP150429188K
Ključne reči: maxilla||, ||maksila, alveolar ridge augmentation||, ||alveolni greben, podizanje, transplantation, autologous||, ||transplantacija, autologna, dental implants||, ||stomatološki implanti, bone resorption||, ||kost, resorpcija, treatment outcome||, ||lečenje, ishod,

Sažetak


Uvod/cilj. Primena autogenih koštanih graftova (implantata) za uvećavanje smanjenog (resorbovanog) alvelarnog grebena još uvek se smatra zlatnim standardom u implantologiji. Cilj ove studije bio je analiza stepena resorpcije autolognih koštanih blok transplantata nezaštićenih barijernim mebranama, uzetih iz retromolarnog pre­dela mandibule i postavljenih u frontalni segment gornje vilice, procena stabilnosti implantata ugrađenih u povećanu regiju, kao i praćenje promene implantne stabilnosti tokom perioda oseointe­gracije. Metode. U studiju je bilo uključeno 18 pacijenata sa uku­pno 20 autotransplantata. Širina rezidualnog alveolarnog grebena merena je pre i posle postavljanja transplantata, kao i neposredno pre ugradnje implantata. Svi implantati su opterećeni privremenim nadoknadama 48 sati nakon ugradnje. Stabilnost implantata proce­njivana je primenom analize rezonantne frekvencije. Rezultati. Srednje vreme između uvećavanja grebena i ugradnje implantata iznosilo je 5,4 (4–6) meseci. Pre ugradnje implantata srednja vred­nost širine grebena iznosila je 6,1 ± 1,27 mm, a povećanja širine grebena u odnosu na vrednosti pre uvećanja 3,04 ± 1,22 mm. Po­vršinska resoprcija grafta iznosila je 18,85% (0,68 ± 0,69 mm). Srednja vrednost koeficijenta implantne stabilnosti (ISQ) u mo­mentu ugradnje iznosila je 71,25 ± 5,77. Najniže vrednosti ISQ zabeležene su u trećoj nedelji nakon ugradnje, što je bilo praćeno postepenim porastom do dvanaeste nedelje zarastanja. Nakon dvanaest nedelja vrednosti ISQ bile su statitički značajno više od vrednosti u momentu ugradnje (p < 0,05 Wilcoxon test). Tokom trogodišnjeg perioda praćenja nije bilo izgubljenih implantata.
Zaključak. Bez obzira na značajan stepen resorpcije autotransplan­tata, kod svih pacijenata bilo je moguće ugraditi implantate u uve­ćani  greben, kao i primeniti protokol ranog opterećenja bez uticaja na stepen preživljavanja implantata.

Reference

Grunder U, Gracis S, Capelli M. Influence of the 3-D bone-to-implant relationship on esthetics. Int J Periodontics Restora-tive Dent 2005; 25(2): 113−9.

Nkenke E, Radespiel-Tröger M, Wiltfang J, Schultze-Mosgau S, Winkler G, Neukam FW. Morbidity of harvesting of retromolar bone grafts: A prospective study. Clin Oral Impl Res 2002; 13(5): 514−21.

von Arx T, Hardt N, Wallkamm B. The TIME technique: A new method for localized alveolar ridge augmentation prior to placement of dental implants. Int J Oral Maxillofac Implants 1996; 11(3): 387−94.

Misch CM. Comparison of intraoral donor sites for onlay grafting prior to implant placement. Int J Oral Maxillofac Implants 1997; 12(6): 767−76.

Pikos MA. Alveolar ridge augmentation with ramus buccal shelf autografts and impacted third molar removal. Dent Im-plantol Update 1999; 10(4): 27−31.

Buser D, Dula K, Hirt HP, Schenk RK. Lateral ridge augmenta-tion using autografts and barrier membranes: a clinical study with 40partially edentulous patients. J Oral Maxillofac Surg 1996; 54(4): 420−32.

Chiapasco M, Abati S, Romeo E, Vogel G. Clinical outcome of au-togenous bone blocks or guided regeneration with e-PTFE membranes for reconstruction of narrow edentulous ridges. Clin Oral Impl Res 1999; 10(4): 278−88.

Owens KW, Yukna RA. Collagen membrane resorption in dogs: a comparative study. Implant Dent 2001; 10(1): 49−58.

Cordaro L, Amadè DS, Cordaro M. Clinical results of alveolar ridge augmentation with mandibular block bone grafts in par-tially edentulous patients prior to implant placement. Clin Oral Impl Res. 2002; 13(1): 103−11.

ten Bruggenkate CM, Kraaijenhagen HA, van der Kwast WA, Krekeler G, Oosterbeek HS. Autogenous maxillary bone grafts in conjunction with placement of I.T.I. endosseous implants. A preliminary report. Int J Oral Maxillofac Surg 1992; 21(2): 81−4.

Antoun H, Sitbon JM, Martinez H, Missika P. A prospective ran-domized study comparing two techniques of bone augmenta-tion: onlay graft alone or associated with a membrane. Clin Oral Impl Res 2001; 12(6): 632−9.

Jensen J, Sindet-Pedersen S. Autogenous mandibular bone grafts and osseointegrated implants for reconstruction of the severely atrophied maxilla: a preliminary report. J Oral Maxillofac Surg 1991; 49(12): 1277−87.

von Arx T, Buser D. Horisontal ridge augmentation using auto-genous block grafts and the guided bone regeneration tech-nique with collagen membranes: A clinical study with 42 pa-tients. Clin Oral Implants Res 2006; 17(4): 359−66.

Maiorana C, Beretta M, Salina S, Santoro F. Reduction of auto-genous bone graft resorption by means of Bio-Oss coverage: A prospective study. Int J Periodontics Restorative Dent 2005; 25(1): 19−25.

Araújo MG, Sonohara M, Hayacibara R, Cardaropoli G, Lindhe J. Lateral ridge augmentation by the use of grafts comprised of autologous bone or a biomaterial. An experiment in the dog. J Clin Periodontol 2002; 29(12): 1122−31.

von Arx T, Cochran DL, Schenk RK, Buser D. Evaluation of a prototype trilayer membrane (PTLM) for lateral ridge augmen-tation: an experimental study in the canine mandible. Int J Oral Maxillofac Surg 2002; 31(2): 190−9.

Acocella A, Bertolai R, Colafranceschi M, Sacco R. Clinical, histo-logical and histomorphometric evaluation of the healing of mandibular ramus bone block grafts for alveolar ridge aug-mentation before implant placement. J Craniomaxillofac Surg 2010; 38(3): 222−30.

Proussaefs P, Lozada J, Kleinman A, Rohrer MD. The use of ramus autogenous block grafts for vertical alveolar ridge augmenta-tion and implant placement: A pilot study. Int J Oral Maxillo-fac Implants 2002; 17(2): 238−48.

Bischof M, Nedir R, Szmukler-Moncler S, Bernard JP, Samson J. Im-plant stability measurement of delayed and immediately loaded implants during healing. Clin Oral Impl Res 2004; 15(5): 529−39.

Han J, Lulic M, Lang NP. Factors influencing resonance fre-quency analysis assessed by Osstell™mentor during implant tissue integration: II. Implant surface modifications and im-plant diameter. Clin Oral Impl Res 2010; 21(6): 605−11.

Sim CC, Lang NP. Factors influencing resonance frequency analysis assessed by Osstell™mentor during implant tissue in-tegration: I. Instrument positioning, bone structure, implant length. Clin Oral Impl Res 2010; 21(6): 598−604.

Zembić A, Glauser R, Khraisat A, Hämmerle CH. Immediate vs. early loading of dental implants: 3-year results of a randomized controlled clinical trial. Clin Oral Impl Res 2010; 21(5): 481−9.

Sennerby L, Meredith N. Analisi della freuqenza di resonanza (RFA). Conoscenze attuali e implicazioni cliniche. In: Chiapasco M, Gatti C, editors. Osteointegrazione e carico immediato. Fondamenti biologici e applicazioni cliniche. Milano, Itália:: Masson; 2001. p. 19−31.

Krafft T, Graef F, Karl M. Osstell resonance frequency mea-surement values as a prognostic factor in implant dentistry. J Oral Implantol 2015; 41(4): e133−7.

Thorwarth M, Srour S, Felszeghy E, Kessler P, Schultze-Mosgau S, Schlegel KA. Stability of autogenous bone grafts after sinus lift procedures: a comparative study between anterior and post-erior aspects of the iliac crest and an intraoral donor site. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005; 100(3): 278−84.

Hui E, Chow J, Li D, Liu J, Wat P, Law H. Immediate provi-sional for single-tooth implant replacement with Brånemark system: preliminary report. Clin Implant Dent Relat Res 2001; 3(2): 79−86.

Andersen E, Haanaes HR, Knutsen BM. Immediate loading of single-tooth ITI implants in the anterior maxilla: a prospective 5-year pilot study. Clin Oral Implants Res 2002; 13(3): 281−7.

Kan JY, Rungcharassaeng K, Lozada J. Immediate placement and provisionalization of maxillary anterior single implants: 1-Year prospective study. Int J Oral Maxillofacial Implants 2003; 18(1): 31−9.

Proussaefs P, Lozada J. Immediate loading of hydroxyapatite-coated implants in the maxillary premolar area: three-year re-sults of a pilot study. J Prosthet Dent 2004; 91(3): 228−33.

Glauser R, Ruhstaller P, Windisch S, Zembic A, Lundgren A, Gottlow J, et al. Immediate occlusal loading of Brånemark System Ti-Unite implants placed predominantly in soft bone: 4-year re-sults of a prospective clinical study. Clin Implant Dent Relat Res 2005; 7(1): 52−9.

Objavljeno
2017/06/28
Broj časopisa
Vol. 74 Br. 4 (2017)
Rubrika
Originalni članak