颏部块状骨移植改善前牙区种植骨量不足CBCT的研究

Research of Mental Autogenous Bone Block Grafts for the Implantation of Anterior Alveolar Ridges and CBCT Measure

摘要: 目的：探讨20例颏部块状骨移植术后供骨区和受骨区CBCT测量情况，以期为临床手术提供参考。方法：2016年5月~2018年5月间完成的前牙区牙槽骨骨量严重不足、颏部块状骨移植后二期种植病例20例，CBCT测量供骨区的愈合骨量、愈合率以及受骨区骨块的成骨量和吸收率。结果：移植骨块平均愈合期6.5个月(6~8个月)，CBCT测量显示受骨区植骨后水平方向骨量增加明显，平均增加量3.73 ± 0.88 mm；移植骨块的吸收率为18.98%，平均吸收0.90 ± 0.40 mm；供骨区恢复良好，供骨区愈合骨量为2.99 ± 0.41 mm，愈合率达到67.76% ± 6.96%。块状骨移植后皆满足种植要求，最终20例患者全部完成了种植及种植后的上部修复，种植成功率达100%，修复后平均随访时间为13.5个月(6~39个月)，随访期内骨结合良好，未发生明显骨吸收，未见不良反应。结论：颏部块状骨移植可以显著改善前牙区种植水平骨量不足，创伤小，术后愈后良好，是合理的取骨植骨方案，同时可以最大程度上减少移植骨块的吸收。

Abstract: Objective: To research the mental autogenous bone block grafts for the implantation of anterior alveolar ridges and observe the resorption of block graft and reconstruction of mentum for statistics with CBCT. Methods: From May 2016 to May 2018, 20 patients with alveolar ridge seriously resorption were included in this survey. CBCT was used to observe and measure the amount of bone healing, rate of bone healing, amount of bone formation and the absorptivity of bone masses in the donor area. Results: Mean healing stage was 6.5 month. CBCT observation and measurement showed that the horizontal bone mass increased significantly after bone grafting in the bone receiving area, with an average increase of 3.73 ± 0.88 mm. The absorptivity of bone graft was 18.98%, with an average absorptivity of 0.90 ± 0.40 mm. The donor area healing amount is 2.99 ± 0.41 mm and a healing rate of 67.76 ± 6.96%. All the 20 patients completed the restoration of various and post-implantation superstructures, with the success rate of implantation reaching 100%. Conclusion: Using autogenous block from mentum to improve insufficiency in patients with severe horizontal ridge deficiencies in anterior maxilla and mandible is viable.