口腔种植骨增量中的减张技术

doi:10.12439/kqhm.1005-4979.2024.01.011

摘要/Abstract

摘要：

临床上，种植位点骨量不足是种植治疗中常遇到的难题。为确保种植区符合种植条件，骨增量手术尤为重要。而骨增量手术成功的关键要素之一是创口无张力的一期愈合。减张技术是获得创口无张力愈合的关键。本文将从减张切口、减张瓣及减张缝合3个方面介绍口腔种植骨增量中的减张技术，以期为临床提供参考。

关键词: 口腔种植, 骨增量, 减张技术, 减张切口, 减张瓣, 减张缝合

Abstract:

Deficiency of alveolar bone is a common problem in dental implant clinical practice. Bone augmentation techniques are particularly important in order to ensure that the implant area meets the conditions of implant surgery. One of the key elements of successful bone augmentation surgery is primary wound healing without tension. Tension-release techniques are the key to achieving tension-free wound healing. In this review, we will introduce the tension-release techniques in the bone augmentation for dental implant from three aspects: Tension-release incision, tension-release flap and tension-release suture, in order to provide clinical reference.

Key words: dental implant, bone augmentation, tension-release techniques, tension-release incision, tension-release flap, tension-release suture

中图分类号:

R782

袁泉, Khadka Prapti, 张笑涵, 张士文. 口腔种植骨增量中的减张技术[J]. 《口腔颌面外科杂志》, 2024, 34(1): 67-73.

YUAN Quan, Khadka Prapti, ZHANG Xiaohan, ZHANG Shiwen. Tension-release techniques in the bone augmentation for dental implant[J]. 《Journal of Oral and Maxillofacial Surgery》, 2024, 34(1): 67-73.

https://journal06.magtech.org.cn/Jweb_joms/CN/Y2024/V34/I1/67

图/表 3

图1 双层瓣示意图

Figure 1 Diagram of double-flap

图2 颊侧半厚带蒂反折瓣示意图

Figure 2 Diagram of buccal split pedicle retrograde flap

图3 水平内褥式减张缝合方法示意图 A—C.SEI缝合法示意图；D.SEI联合水平内褥式及间断缝合法示意图。

Figure 3 Diagram of mattress tension-release suture

参考文献 35

[1]	Chiapasco M, Casentini P, Zaniboni M. Bone augmentation procedures in implant dentistry[J]. Int J Oral Maxillofac Implants, 2009, 24(Suppl): 237-259.
[2]	Wang HL, Boyapati L. “PASS” principles for predictable bone regeneration[J]. Implant Dent, 2006, 15(1): 8-17. doi: 10.1097/01.id.0000204762.39826.0f URL
[3]	Burkhardt R, Lang NP. Role of flap tension in primary wound closure of mucoperiosteal flaps: A prospective cohort study[J]. Clin Oral Implants Res, 2010, 21(1): 50-54. doi: 10.1111/clr.2010.21.issue-1 URL
[4]	Abed PF, El Chaar E, Boltchi F, et al. The novel periosteal flap stretch technique: A predictable method to achieve and maintain primary closure in augmentative procedures[J]. J Int Acad Periodontol, 2020, 22(1): 11-20. pmid: 31896103
[5]	Urban I. Vertical and horizontal ridge augmentation: New perspectives[M]. Berlin: Quintessence, 2017: 361-381.
[6]	Buser D, Dula K, Belser UC, et al. Localized ridge augmentation using guided bone regeneration. II. Surgical procedure in the mandible[J]. Int J Periodontics Restorative Dent, 1995, 15(1): 10-29.
[7]	Zuhr O, Hurzeler M, Hurzeler B, et al. Plastic-esthetic periodontal and implant surgery: A microsurgical approach [M]. United Kingdom: Quintessence, 2012: 96-97.
[8]	Park JC, Kim CS, Choi SH, et al. Flap extension attained by vertical and periosteal-releasing incisions: A prospective cohort study[J]. Clin Oral Implants Res, 2012, 23(8): 993-998. doi: 10.1111/clr.2012.23.issue-8 URL
[9]	Block MS, Degen M. Horizontal ridge augmentation using human mineralized particulate bone: Preliminary results[J]. J Oral Maxillofac Surg, 2004, 62(9 Suppl 2): 67-72.
[10]	D'Albis G, D'Albis V, Cesário de Oliveira J Jr, et al. Tunnel access for ridge augmentation: A review[J]. J Dent Implant Res, 2021, 40(2): 48-53. doi: 10.54527/jdir.2021.40.2.48 URL
[11]	Park SH, Wang HL. Mucogingival pouch flap for sandwich bone augmentation: Technique and rationale[J]. Implant Dent, 2005, 14(4): 349-354. doi: 10.1097/01.id.0000188379.46220.91 URL
[12]	Steigmann M, Wang HL. Esthetic buccal flap for correction of buccal fenestration defects during flapless immediate implant surgery[J]. J Periodontol, 2006, 77(3): 517-522. pmid: 16512767
[13]	Lee EA. Subperiosteal minimally invasive aesthetic ridge augmentation technique (SMART): A new standard for bone reconstruction of the jaws[J]. Int J Periodontics Restorative Dent, 2017, 37(2): 165-173. doi: 10.11607/prd.3171 pmid: 28196155
[14]	程璐, 史剑杰. 骨膜减张技术在引导骨再生术中的应用研究进展[J]. 口腔医学研究, 2020, 36(9): 814-816. doi: 10.13701/j.cnki.kqyxyj.2020.09.004
[15]	Romanos GE. Periosteal releasing incision for successful coverage of augmented sites. A technical note[J]. J Oral Implantol, 2010, 36(1): 25-30. doi: 10.1563/AAID-JOI-D-09-00068 pmid: 20218867
[16]	Hur Y, Bui MN, Griffin TJ, et al. Modified periosteal releasing incision for flap advancement: A practical technique for tensionless closure[J]. Clin Adv Periodontics, 2015, 5(4): 229-234. doi: 10.1902/cap.2014.140009 URL
[17]	Inoko M, Rubin S, Ono Y, et al. Releasing incisions using upward-motion scissors technique for flap mobilization for guided bone regeneration or periodontal surgery: Technical introduction and a case report[J]. Int J Periodontics Restorative Dent, 2018, 38(4): 503-507. doi: 10.11607/prd.3205 pmid: 29889913
[18]	Moslemi N, Khorsand A, Torabi S, et al. Periosteal releasing incision with diode laser in guided bone regeneration procedure: A case series[J]. J Lasers Med Sci, 2016, 7(4): 259-264. doi: 10.15171/jlms.2016.46 pmid: 28491263
[19]	Hur Y, Tsukiyama T, Yoon TH, et al. Double flap incision design for guided bone regeneration: A novel technique and clinical considerations[J]. J Periodontol, 2010, 81(6): 945-952. doi: 10.1902/jop.2010.090685 pmid: 20450365
[20]	Ogata Y, Griffin TJ, Ko AC, et al. Comparison of double-flap incision to periosteal releasing incision for flap advancement: A prospective clinical trial[J]. Int J Oral Maxillofac Implants, 2013, 28(2): 597-604. doi: 10.11607/jomi.2714 pmid: 23527365
[21]	Ronda M, Stacchi C. Management of a coronally advanced lingual flap in regenerative osseous surgery: A case series introducing a novel technique[J]. Int J Periodontics Restorative Dent, 2011, 31(5): 505-513. pmid: 21845245
[22]	Zazou N, Diab N, Bahaa S, et al. Clinical comparison of different flap advancement techniques to periosteal releasing incision in guided bone regeneration: A randomized controlled trial[J]. Clin Implant Dent Relat Res, 2021, 23(1): 107-116. doi: 10.1111/cid.v23.1 URL
[23]	Urban I, Traxler H, Romero-Bustillos M, et al. Effectiveness of two different lingual flap advancing techniques for vertical bone augmentation in the posterior mandible: A comparative, split-mouth cadaver study[J]. Int J Periodontics Restorative Dent, 2018, 38(1): 35-40. doi: 10.11607/prd.3227 pmid: 29240202
[24]	Fugazzotto PA. Maintenance of soft tissue closure following guided bone regeneration: Technical considerations and report of 723 cases[J]. J Periodontol, 1999, 70(9): 1085-1097. pmid: 10505812
[25]	Triaca A, Minoretti R, Merli M, et al. Periosteoplasty for soft tissue closure and augmentation in preprosthetic surgery: A surgical report[J]. Int J Oral Maxillofac Implants, 2001, 16(6): 851-856.
[26]	Yu HJ, Qiu LX. Efficacy of the split-thickness labial flap method for soft tissue management in anterior ridge horizontal augmentation procedures: A clinical prospective study in the anterior maxilla[J]. J Craniomaxillofac Surg, 2018, 46(2): 323-328. doi: 10.1016/j.jcms.2017.11.018 URL
[27]	Steigmann M, Salama M, Wang HL. Periosteal pocket flap for horizontal bone regeneration: A case series[J]. Int J Periodontics Restorative Dent, 2012, 32(3): 311-320. pmid: 22408776
[28]	Steigmann L, Steigmann M, Wang HL. Mucosal detachment technique for flap advancement in a thin tissue phenotype: Technique illustration[J]. Int J Periodontics Restorative Dent, 2021, 41(4): 555-560. doi: 10.11607/prd.5072 pmid: 34328474
[29]	Tinti C, Parma-Benfenati S. Coronally positioned palatal sliding flap[J]. Int J Periodontics Restorative Dent, 1995, 15(3): 298-310.
[30]	Frisch E, Ratka-Krüger P, Ziebolz D. Increasing the width of keratinized mucosa in maxillary implant areas using a split palatal bridge flap: Surgical technique and 1-year follow-up[J]. J Oral Implantol, 2015, 41(5): e195-e201. doi: 10.1563/aaid-joi-D-14-00025 URL
[31]	Goldstein M, Boyan BD, Schwartz Z. The palatal advanced flap: A pedicle flap for primary coverage of immediately placed implants[J]. Clin Oral Implants Res, 2002, 13(6): 644-650. doi: 10.1034/j.1600-0501.2002.130611.x URL
[32]	Cankaya, A.B. and Demirel K., The art of dental suturing: A clinical guide[M]. Berlin: Quintessence, 2021: 128-142.
[33]	Stavola L, Tunkel J. The role played by a suspended external-internal suture in reducing marginal flap tension after bone reconstruction: A clinical prospective cohort study in the maxilla[J]. Int J Oral Maxillofac Implants, 2014, 29(4): 921-926. doi: 10.11607/jomi.3370 pmid: 25032773
[34]	Zucchelli, G. and Gori G., Mucogingival esthetic surgery[M]. Milan: Quintessenza Edizioni Milan, 2013: 376-377.
[35]	Wachtel H, Fickl S, Zuhr O, et al. The double-sling suture: A modified technique for primary wound closure[J]. Eur J Esthet Dent, 2006, 1(4): 314-324. pmid: 19655501

选择文件类型/文献管理软件名称

选择包含的内容