Abstract:

Objective    To evaluate the short-term clinical efficacy of the combination of bone splitting， bone condensing，guided bone regeneration technology and simultaneous implantation surgery program for patients with narrow alveolar ridge. Methods    We chose a total of 54 implant restorations in 24 patients with narrow alveolar ridge from June 2009 to May 2014，in Center of Implant Dentistry，School of Stomatology of China Medical University.Simultaneously，we combined the use of techniques of bone splitting，bone condensing and guided bone regeneration，and completed superstructure  within 4-6 months after surgery. The 54 implant restorations were diveded into 4 groups： the  maxillary anterior region， the maxillary posterior region， the mandibular anterior region and the mandibular posterior region based on different implant parts.  Compare the change of bone width and bone height after six months and 1 year of follow-up based on the clinical examination and panoramic radiograph. Results    There was no implant loosening； all implants functioned well and the retention rate was 100% after more than 1 year of follow-up.The bone width was compared between pre-surgery and post-surgery，the difference being statistically significant（ P < 0.05）.The bone width was compared between post-surgery and six months after surgery，the difference having no statistical significance（P > 0.05）. The change of bone width and bone height was compared among four different implant parts at appointed time，and the differences all had no statistical significance（P > 0.05）. Conclusion     Combination of bone splitting， bone condensing， guided bone regeneration technology and simultaneous implantation surgery program for patients with narrow alveolar ridge can increase the bone mass and achieve the amplification of the width. Different implant parts have no significant effect on the absorption of bone tissue around the implant.

Key words: bone splitting, bone condensing, guided bone regeneration, narrow alveolar ridge

摘要：

目的    评价牙槽嵴唇（颊）鄂（舌）向宽度不足的患者联合应用骨劈开、骨挤压术及引导骨组织再生（GBR）技术并同期种植的短期临床疗效。方法    选取2009—2014年就诊于中国医科大学附属口腔医院种植中心的患者24例，联合应用骨劈开、骨挤压术，植入54枚种植体后同期植入骨粉，行GBR技术，术后4～6个月内完成上部结构修复。将54枚种植体按不同植入部位分为上颌前牙区、上颌后牙区、下颌前牙区及下颌后牙区4组，通过临床检查、X线片及锥形束CT（CBCT）等观察比较4组种植体手术前后及术后半年牙槽骨宽度的变化，修复后6个月及1年的骨高度变化等。结果    种植手术当天至修复后1年的临床随访检查显示，无种植体松动，全部种植体行使功能良好，存留率100%。种植术后牙槽骨宽度与术前相比，差异有统计学意义（P＜0.05）。牙槽骨宽度在术后与术后半年的对比中，差异无统计学意义（P＞0.05）。术后半年，比较4组植入部位的骨宽度变化，差异无统计学意义（P＞0.05）。修复后6个月及1年，比较4组植入部位的骨高度变化，差异均无统计学意义（P＞0.05）。结论    对牙槽嵴唇（颊）鄂（舌）向宽度不足的患者，联合应用骨劈开、骨挤压术和GBR技术并同期种植，可增加骨量，达到牙槽嵴宽度的水平扩增。不同种植部位对种植体周围骨组织吸收量没有明显影响。

关键词: 骨劈开, 骨挤压术, 引导骨组织再生, 狭窄牙槽嵴