Iliac crest vertical block grafts −placing outside or inside the bone contour: A cohort study

IF 3.7 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical Implant Dentistry and Related Research Pub Date : 2024-08-08 DOI:10.1111/cid.13370

Christian Mertens DDS, Christopher Büsch MSc, Oliver Ristow MD, DDS, Jürgen Hoffmann MD, DDS, Hom-Lay Wang DDS, MSD, PhD, Korbinian Jochen Hoffmann DDS

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Abstract

Objective and Aim

Challenging defect configurations and dimensions arise from severe, localized vertical alveolar ridge defects caused by trauma or prior surgery. This study aims to analyze three-dimensional bone gain, assess marginal bone stability in such defect configurations, and evaluate the impact of grafting outside the bone contour on the overall outcome, with a focus on iliac crest block grafts as a valid treatment option.

Materials and Methods

The prospective cohort study evaluated patients who required vertical block grafting due to localized bone defects in the maxilla or mandible and who had received iliac grafts. Three-dimensional bone gain was analyzed using cone beam computed tomography (CBCT) after 3 months of bone healing for each treated site and implant position. A comparison between bone grafts inside and outside the bone contour was conducted. Marginal bone stability was measured using intraoral radiographs during routine annual follow-up visits.

Results

Seventy patients with 89 treated sites were evaluated. After 3 months of graft healing, the mean vertical bone gain was 11.03 ± 3.54 mm, the mean horizontal bone gain was 7.18 ± 2.00 mm, and the mean graft length was 28.19 ± 11.01 mm. A total of 217 implants were placed in the augmented regions. On implant level, a mean vertical bone gain of 10.44 ± 3.44 mm and a mean horizontal bone gain of 6.54 ± 1.86 mm were measured. Over a 43-month observation period, mesial and distal marginal bone loss averaged 0.44 ± 0.92 mm and 0.49 ± 1.05 mm, respectively. Eight implants were diagnosed with periimplantitis, resulting in the loss of four implants, while no early implant losses were reported.

Conclusion

Within the limitations of this study, vertical bone grafts with iliac crest block grafts were found to be a dependable treatment option for dental implant placement, and placing block grafts outside the bone contour did not lead to inferior outcomes.

Abstract Image

查看原文本刊更多论文

髂嵴垂直块移植--置于骨轮廓外还是骨轮廓内？一项队列研究。

目的和宗旨：由于外伤或之前的手术造成的严重、局部垂直牙槽嵴缺损，其缺损结构和尺寸具有挑战性。本研究旨在分析三维骨增量，评估此类缺损构型的边缘骨稳定性，并评估骨轮廓外移植对整体效果的影响，重点是将髂嵴块状移植作为一种有效的治疗方案：这项前瞻性队列研究评估了因上颌骨或下颌骨局部骨缺损而需要进行垂直块状移植，并接受过髂骨移植的患者。在每个治疗部位和种植体位置的骨愈合 3 个月后，使用锥形束计算机断层扫描（CBCT）分析了三维骨增量。对骨轮廓内外的植骨进行了比较。在每年的例行随访中，使用口内X光片测量边缘骨的稳定性：对 70 名患者的 89 个治疗部位进行了评估。移植骨愈合 3 个月后，垂直骨增量平均为 11.03 ± 3.54 毫米，水平骨增量平均为 7.18 ± 2.00 毫米，移植骨长度平均为 28.19 ± 11.01 毫米。在增量区域共植入了 217 个种植体。在种植体水平上，垂直骨增量平均为（10.44 ± 3.44）毫米，水平骨增量平均为（6.54 ± 1.86）毫米。在 43 个月的观察期内，中轴和远轴边缘骨量损失平均分别为 0.44 ± 0.92 毫米和 0.49 ± 1.05 毫米。8颗种植体被诊断为种植体周围炎，导致4颗种植体脱落，但没有早期种植体脱落的报告：结论：在本研究的局限性范围内，发现垂直骨移植与髂嵴块移植是种植牙的可靠治疗方案，在骨轮廓外放置块移植不会导致较差的结果。

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来源期刊

Clinical Implant Dentistry and Related Research 医学-牙科与口腔外科

CiteScore

6.00

自引率

13.90%

发文量

103

审稿时长

4-8 weeks

期刊介绍： The goal of Clinical Implant Dentistry and Related Research is to advance the scientific and technical aspects relating to dental implants and related scientific subjects. Dissemination of new and evolving information related to dental implants and the related science is the primary goal of our journal. The range of topics covered by the journals will include but be not limited to: New scientific developments relating to bone Implant surfaces and their relationship to the surrounding tissues Computer aided implant designs Computer aided prosthetic designs Immediate implant loading Immediate implant placement Materials relating to bone induction and conduction New surgical methods relating to implant placement New materials and methods relating to implant restorations Methods for determining implant stability A primary focus of the journal is publication of evidenced based articles evaluating to new dental implants, techniques and multicenter studies evaluating these treatments. In addition basic science research relating to wound healing and osseointegration will be an important focus for the journal.