自体颏部块状骨移植二期种植修复上颌前牙区骨量不足的临床研究  

Clinical research of autogenous chin bone graft and secondary implantation in repairing the bone deficiency of anterior maxilla

作　　者：田柳[1] 周巧珍[1] 郑瑞斌[1] 麻健丰[1] 

机构地区：[1]温州医科大学口腔医学院/医院,浙江温州325027

出　　处：《中国口腔种植学杂志》2014年第2期69-73,共5页Chinese Journal of Oral Implantology

基　　金：浙江省大学生科技创新活动计划(新苗人才计划);项目编号:2013R413058

摘　　要：目的：探讨以颏部块状骨移植修复上颌前牙区骨量不足，二期行ITI种植术修复该区缺失牙的临床效果。方法：2009年7月~2012年5月间完成的上前牙区颏部块状骨移植后种植修复病例21例，平均年龄27.7岁（18～42岁）。单牙缺失14例，多牙缺失7例，共28枚种植体。结果：移植骨块愈合期平均6.3个月（4.5～10.0个月），种植体骨结合期平均5.2个月（3.5～9.0个月）。1例术后创口开裂，经局部处理后为粘膜重新覆盖；3例术后出现下唇麻木、其中1例同时伴下前牙感觉异常，经治疗后3例下唇麻木症状消失，下前牙感觉异常症状改善。21例均完成最终修复，平均随访17.3个月（12～30个月）。植入的28枚种植体成功率达100％。结论：通过自体颏部块状骨移植改善上颌前牙区骨量不足，种植治疗能取得比较理想的效果。Objective： To demonstrate the clinical effectiveness of ridge augmentation by using autogenous chin graft for the lack of bone mass of the anterior maxilla, following by secondary ITI implantation. Methods： From July 2009 to May 2012, 21 patients with severe alveolar ridge resorption in anterior maxilla were included in this survey. The patients age ranged from 18 to 42 with an average age of 27.7 years old. 14 out of the 21 patients presented with missing single tooth while the rest of 7 lost multiple teeth. A total of 28 implants were embedded. Bone grafts harvested from mandible chin were used for augmentation. Results：After 4.5 to 10.0 months healing period （mean 6.3 months）, 21 patients underwent dental implants placement, 3 to 9 months later（mean 5.2 months）these implants were all re-stored with ceramic crowns/bridges. Flap dehiscence was observed in one case, which is recovered by mucosa after local treatment; 3 patients were observed with postoperative lower lip hypoesthesia, 1 of them combined with changed pulp sensitivity of the mandibular anterior teeth. After the use of mecobalamin, all lower lip hypoesthesia disappeared, while the mandibular anterior teeth＆#39;s clinical symptoms improved. The follow-up period was 12 month to 30 month （mean 17.3 months）. The survival rate of all 28 implants was 100%. Conclusions： By using autogenous block grafts from chin to improve the lack of bone mass in anterior maxilla, the results of ITI implants restore the loss of upper anterior teeth can be satisfied.

关 键 词：自体块状骨移植 口腔种植 颏部取骨 上颌前牙区 

分 类 号：R783.6[医药卫生—口腔医学]