Abstract:

Objective: To evaluate the clinical effect of guided bone regeneration technique (GBR) with resorbable collagen membrane and particulate xenograft in horizontal bone augmentation in the posterior mandible. Methods: A total of 33 patients who had missed a single mandibular posterior tooth and received implant placement combined with GBR procedure were included. Patients were divided into two groups: the premolar group (n=16) and the first molar group (n=17). CBCT datasets of patients before surgery, immediate post-surgery and 6-8 months after surgery were three-dimensionally reconstructed and superimposed. After that, alterations of bone graft contour at 0, 3, 6 mm below the implant platform during the healing stage were measured to evaluate the effect of horizontal bone augmentation. Results: There were no statistically significant differences about the amount of bone grafting, bone resorption, new bone formation between the premolar group and the first molar group at different vertical levels（P>0.05）. In each group, the amount of bone grafting and resorption at 0 mm and 3 mm below the implant platform were higher than that at 6 mm (P<0.05), and there was no statistical difference in the amount of new bone formation at different vertical levels (P>0.05). Conclusion: When GBR was performed in the posterior mandible using resorbable collagen membrane and particulate xenograft, greater horizontal reduction was observed near the coronal alveolar ridge during the healing stage. In addition, for two- or three-wall bone defects, the GBR procedure in posterior mandible can achieve a horizontal bone augmentation of about 2.0-2.5 mm.

Key words: posterior mandible, guided bone regeneration, implant, cone-beam computed tomography

摘要：

目的： 评估可吸收胶原膜与颗粒状异种骨在下颌后牙区水平骨增量中应用的临床效果。方法： 收集33例下颌单颗后牙缺失后接受种植同期引导骨再生（guided bone regeneration，GBR）患者的资料，将患者分为前磨牙组（n=16）和第一磨牙组（n=17）。将患者术前、术后即刻、术后6~8个月的锥形束CT（CBCT）数据经三维重建后进行拟合，测量种植体平台根方0、3、6 mm处植骨区轮廓的变化，评估水平骨增量的效果。结果： 前磨牙组和第一磨牙组在不同高度处的植骨量、吸收量、成骨量差异均无统计学意义（P>0.05）；同一组内，在种植体平台根方0、3 mm处的植骨量与吸收量均高于6 mm处（P<0.05），不同高度处的成骨量差异无统计学意义（P>0.05）。结论： 使用可吸收胶原膜与颗粒状异种骨在下颌后牙区行GBR时，植骨区冠方的轮廓在愈合期间发生明显的收缩；对于二壁或三壁型骨缺损，下颌后牙区GBR能够获得约2.0~2.5 mm的水平骨增量。

关键词: 下颌后牙区, 引导骨再生, 种植, 锥形束CT