利用部分脱矿牙本质板进行水平牙脊增高:病例报告

IF 0.9 Q3 DENTISTRY, ORAL SURGERY & MEDICINE Clinical Advances in Periodontics Pub Date : 2024-05-02 DOI:10.1002/cap.10291
Pooyan Refahi, Samar Shaikh
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引用次数: 0

摘要

背景:本文旨在展示一例引导骨再生(GBR)病例,该病例利用从拔出的第二颗臼齿上加工的部分脱矿牙本质板对后嵴进行水平增量,以植入种植体:一名 60 岁的患者 30 号牙齿出现水平牙脊缺损,31 号牙齿经过根管治疗后反复蛀牙。治疗方案是拔除 31 号牙,并利用该牙的牙本质移植来增加 30 号牙的牙脊。在无创伤拔除 31 号牙齿后,将其切成 1 毫米厚的牙本质板,进行消毒和处理,以获得脱矿牙本质移植体。在进行中冠切口和全厚皮瓣抬高后,用 10 毫米的固定螺钉将牙本质板固定在 30 号部位的颊面缺损上,并用 0.5 毫升 50/50 水合盐水的软骨-硬骨同种异体骨填充牙本质板和颊面骨之间的间隙,用胶原膜覆盖,然后进行初级封闭。术后 6 个月,患者接受了锥形束计算机断层扫描(CBCT),以评估牙脊宽度,结果显示牙脊宽度足够,种植体植入效果最佳。在 CBCT 上可以看到不透射线的牙本质板与牙槽嵴的结合。按照手术种植体准备方案,在修复驱动位置植入了直径 4 毫米、长度 8.5 毫米的种植体:本病例报告了使用部分脱矿化的牙本质板替代自体骨块移植进行水平牙槽嵴增量以用于未来种植体植入的 GBR 的良好结果:本病例介绍了一种新方法,利用从拔牙中提取的部分脱矿牙本质板进行引导性骨再生,展示了其在解决牙脊缺损方面的潜在功效。在这种情况下,成功与否取决于对牙齿进行细致的切片和牙本质移植的处理、移植体与残余牙脊的精确适应和固定,以及实现初级闭合以达到不受干扰的愈合。成功的限制因素包括:拔牙时间与牙脊增高的需要相吻合,以及移植物固定不稳定。
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Utilizing partially demineralized dentin plate for horizontal ridge augmentation: A case report.

Background: This article intends to showcase a case of guided bone regeneration (GBR) utilizing a partially demineralized dentin plate processed from an extracted second molar for horizontal augmentation of the posterior ridge for implant placement.

Methods and results: A 60-year-old patient presented with horizontal ridge deficiency at site #30 and an endodontically treated tooth #31 with recurrent decay. A treatment plan was proposed to extract tooth #31 and utilize a dentin graft from the tooth for ridge augmentation at site #30. Following the atraumatic extraction of tooth #31, it was sectioned into a 1 mm thick dentin plate, sterilized, and processed to obtain a demineralized dentin graft. Following a mid-crestal incision and full-thickness flap elevation, the dentin plate was adapted on the buccal defect of site #30 with 10 mm fixation screws, and the gap between the plate and the buccal bone was filled with 0.5 cc of 50/50 cortico-cancellous bone allograft hydrated with saline, covered with collagen membrane followed by primary closure. At 6 months, a postoperative cone-beam computed tomography (CBCT) was obtained to evaluate the ridge width revealing sufficient ridge width for optimal implant placement. The radio-opaque dentin plate was visible on the CBCT depicting integration with the alveolar ridge. Following surgical implant preparation protocol, a 4 mm diameter and 8.5 mm length implant was placed in a restoratively driven position.

Conclusion: This case reports favorable outcomes for GBR using a partially demineralized dentin plate as an alternative to an autogenous bone block graft for horizontal ridge augmentation for future implant placement.

Key points: This case introduces a novel method utilizing partially demineralized dentin plates derived from extracted teeth for guided bone regeneration, showcasing its potential efficacy in addressing ridge deficiencies. Success, in this case, relies on meticulous sectioning of the tooth and processing of the dentin graft, precise adaptation and fixation of the graft to the residual ridge, and achieving primary closure for undisturbed healing. Limitations to success include the availability of teeth for extraction coinciding with the need for ridge augmentation and unstable graft fixation.

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来源期刊
Clinical Advances in Periodontics
Clinical Advances in Periodontics DENTISTRY, ORAL SURGERY & MEDICINE-
CiteScore
1.60
自引率
0.00%
发文量
40
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