Quality and quantity of bone following alveolar distraction osteogenesis in the human mandible

被引:42
作者
Chiapasco, Matteo [1 ]
Lang, Niklaus P.
Bosshardt, Dieter D.
机构
[1] Univ Milan, San Paolo Hosp, Dept Med Surg & Dent, Unit Oral Surg, Milan, Italy
[2] Univ Bern, Sch Dent Med, Dept Periodontol & Fixed Prosthodont, Bern, Switzerland
关键词
alveolar distraction osteogenesis; bone; histology; histomorphometry; oral implants;
D O I
10.1111/j.1600-0501.2005.01247.x
中图分类号
R78 [口腔科学];
学科分类号
1003 ;
摘要
Purpose: The purpose of this prospective study on humans were to evaluate (a) the clinical outcome of alveolar distraction osteogenesis for the correction of vertically deficient edentulous mandibular ridges, (b) the clinical outcome of dental implants placed in the distracted areas, and (c) the quality and quantity of the bone that had formed in the distraction gap. Material and methods: Seven patients presenting vertically deficient edentulous ridges were treated by means of distraction osteogenesis with an intraoral alveolar distractor. Approximately 3 months after consolidation of the distracted segments, 20 ITI solid screw SLA implants were placed in the distracted areas. Three to 4 months later, abutments were connected and prosthetic loading of the implants started. During implant site preparation, bone biopsies were taken at the implant sites with trephine burrs for histologic and histometric analyses. Results: The mean follow-up after the initial prosthetic loading was 18 months (range 12-24 months). The mean bone gain obtained at the end of distraction was 7 mm (range 5-9 mm). The cumulative success rate of implants 2 years after the onset of prosthetic loading was 95%, whereas the survival rate of implants was 100%. The newly formed bone consisted of woven bone reinforced by parallel-fibered bone with bone marrow spaces between the bone trabeculae. The bone area fraction in the distraction region ranged from 21.6% to 57.8% (38.5 +/- 11.7%). Discussion and conclusions: Results from this study showed that (a) distraction osteogenesis is a reliable technique for the correction of vertically deficient edentulous ridges, (b) the regenerated bone withstood the functional demands of implant loading, (c) survival and success rates of implants placed in the distracted areas were consistent with those of implants placed in native bone, and (d) there is sufficient bone volume and maturity in the distracted region for primary stability of the implant.
引用
收藏
页码:394 / 402
页数:9
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