下颌前部垂直牵张成骨在种植义齿中的临床应用  

Application of vertical alveolar distraction with dental implant in anterior mandible

作　　者：陈宁[1] 袁华[1] 方赵平[2] 张双越[1] 王国平[2] 

机构地区：[1]南京医科大学口腔医学研究所南京医科大学口腔医学院口腔颌面外科,南京210029 [2]南京医科大学口腔医学研究所南京医科大学口腔医学院口腔种植中心,南京210029

出　　处：《口腔医学》2009年第1期17-19,共3页Stomatology

基　　金：江苏省科技厅社会发展项目(BS2006062);江苏省卫生厅科研基金(H20037)

摘　　要：目的应用牵张成骨技术治疗下颌前部牙槽骨垂直高度不足,并进行种植义齿治疗下前牙缺失。方法应用国产骨牵张器对3例外伤后多个前牙缺失伴有严重骨缺损、骨高度不足的患者进行下颌前部垂直牵张成骨,牵引增高下颌骨至理想的高度并固定2个月后,去除骨牵张器,同期植入牙种植体,术后3个月完成种植修复。结果3例患者骨牵张手术伤口愈合良好,牵引顺利,平均牵引增高下颌骨8.2 mm。X线检查牵引骨块生长良好,无明显骨吸收。二期手术时未见明显感染,固定骨和牵引骨之间的间隙内充满了新生骨,牵引骨块稳固。共植入骨内种植体14颗,3个月后完成种植二期手术和种植修复。1年后复查,种植体稳固,咬合功能良好,外形满意。结论牵张成骨技术是治疗下颌骨前部严重骨缺损牙槽骨高度明显不足一项非常有效的方法,可以为牙种植术提供足够的骨量。在此基础上及时进行下颌前牙区种植义齿修复临床疗效满意。Objective The technique of vertical alveolar distraction osteogenesis（DO） is used for treating the patients with bone height deficiency in anterior mandible. After that, dental implantation was used for teeth reconstruction. Methods Civilized intra-oral distracter was used for three patients with severe anterior mandibular bone deficiency to increase the bone height. Distraction proceeded from the 5th to 7th postoperative day until the bone height was suitable for dental implantation. Two months later, the distractor was removed and dental implantation was performed simultaneously. After 3 months of primary dental implanting surgery, the secondary operation was performed and teeth reconstruction was finished. Results The average bone height of vertical alveolar ridges was increased by about 8.2 mm with the satisfactory wound healing. The x-ray showed the bone regeneration without obvious bone absorption. The distracted bone block was stable and new bone had regenerated in the space between the bones. 14 dental implants were performed into the new bone with good primary stability. After 1 year of the treatment, the reconstructed teeth were satisfactory. Conclusion The technique of DO is an effective method for treating severe alveolar bone deficiency in anterior mandible. It can provide enough bone height for dental implantation.

关 键 词：牵张成骨 种植体 下颌骨缺损 

分 类 号：R782.23[医药卫生—口腔医学]