数字化改良栅栏技术在垂直骨缺损重建中的应用  

Aplication of digitally modified fence technique in vertical bone reconstruction

作　　者：刘菁晶 王婧 满毅[1] 屈依丽[1] LIU Jingjing;WANG Jing;MAN Yi;QU Yili(State Key Laboratory of Oral Diseases&National Clinical Research Center for Oral Diseases&West China Hospital of Stomatology,Sichuan University,Chengdu 610041,China)

机构地区：[1]口腔疾病研究国家重点实验室,国家口腔疾病临床医学研究中心,四川大学华西口腔医院,四川成都610041

出　　处：《口腔疾病防治》2022年第10期733-739,共7页Journal of Prevention and Treatment for Stomatological Diseases

基　　金：国家自然科学基金项目(81870801)。

摘　　要：目的 探讨数字化改良的不可吸收钛板支撑的引导骨再生技术在垂直骨缺损重建中的应用效果。方法 纳入缺牙区严重垂直骨缺损但要求进行种植修复治疗的病例8例,使用数字化改良的不可吸收钛板支撑的引导骨再生技术(栅栏技术)进行骨缺损重建。获取患者颌骨、牙列及软组织数据,进行修复为导向的种植和骨增量设计。打印模拟骨增量后的颌骨模型,并在该模型上弯制钛板;通过导板(包括基底导板、骨膜钉植入附件、骨增量块附件)将虚拟设计进行转化,使得术中可实现与设计一致的成骨空间构建。按照改良的技术流程完成引导骨再生手术。骨增量术后6~8个月,拍摄锥形束CT评估骨增量效果;按照初始种植设计植入种植体,植入时获取骨组织进行HE染色及Masson染色检测。结果 骨增量术后6~8个月,垂直线性骨增量达到(5.44±1.73)mm。按照初始种植设计植入种植体,植入时获取的骨组织组织学检查结果显示新骨形成。结论 使用数字化改良的栅栏技术,能够简化术前及手术操作,获得良好的垂直骨增量效果,是一种值得推广应用的垂直骨增量技术。Objective To propose a digitally modified and guided bone regeneration technique supported by a non-absorbable titanium plate and explore its effect on vertical bone regeneration.Methods A total of 8 patients with severe vertical bone defects in the edentulous area who wanted to be treated with implants were included in this study.A digitally modified and guided bone regeneration technique supported by a nonabsorbable titanium plate(fence technique)was used for bone augmentation.The patient's jaw,dentition,and soft tissue data were obtained for prosthetically guided implantation and bone regeneration.After virtual bone augmentation,a model of the jaw was obtained through 3D printing technology,and the titanium plate was bent accordingly.The virtual design was transformed through the template(including the base template and the attachment of a periosteal screw and bone block),so the actual osteogenesis space consistent with the design could be realized in the operation.Guided bone regeneration was performed according to the improved procedure and technical process.After 6~8 months of bone augmentation,cone beam CT was taken to evaluate the effect of bone augmentation.The implant was implanted according to the initial implant design,and bone tissue was obtained for HE and Masson staining.Results After 6~8 months of bone augmentation,the vertical linear bone increment reached(5.44±1.73)mm.The implant was implanted according to the initial implant design,and the bone tissue was obtained for histological examination to show the formation of new bone.Conclusion Digital improved fence technique can simplify the preoperative and surgical procedures,and obtain good vertical bone augmentation results.In short,it is a kind of vertical bone augmentation technique worth popularizing and applying.

关 键 词：垂直骨增量 引导骨再生 栅栏技术 修复引导种植 修复引导植骨 钛板 数字化导板 3D打印 种植 

分 类 号：R78[医药卫生—口腔医学]