Pathophysiological aspects of bone tissue regeneration when increasing the width of the jaw alveolar crest with the application of piezosurgical technique
Ilyin Semen V., Bobyntsev Igor’ I., Grebnev Gennady A., Iordanishvili Andrey K.
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引用次数: 0
Abstract
One of the main problems that impede dental rehabilitation with the use of dental implants is the limited amount of bone tissue in cases of its pronounced atrophy. According to a number of authors, about 50% of patients need additional osteoplastic operations before or at the stage of dental implantation. Objective. The aim of the paper is to assess the effectiveness of piezosurgical apparatus for splitting the alveolar crest of the jaw in the insertion of dental implants. Materials and methods. Forty adult patients (15 men and 25 women) aged 36 to 49 years who had undergone surgery for partial tooth loss on one and/or both jaws were evaluated. All in all, 48 implants were placed against the narrow alveolar crest of the jaws, which was surgically split using microsaws (Group 1- 11 patients), thin dental drills (Group 2 -15 patients) and piezosurgery apparatus (Group 3, 14 patients). The postoperative follow-up period was 4 to 6 months before the orthopaedic treatment. Results. During crestal splitting, the smallest bone reduction was obtained using piezosurgical technique, which was 0.84±0.22 mm, while with microsaws and dental drills, this figure was slightly higher, 0.93±0.21 mm (p≥0.05) and 1.23±019 mm (p≤0.05), respectively. One of the properties of a piezosurgical instrument is the effect on protein molecules, namely, their denaturation. This reduces the number of postoperative complications. Conclusion. The technique of alveolar crest splitting with a piezosurgical instrument works according to the absolutely natural and unique mechanism of bone healing - the mechanism of fracture repair. This technique uses the local bone resource and avoids or significantly reduces the use of foreign bone grafting materials. There is a tendency to a better rate of restoration of the lost width of the alveolar crest of the jaw when using the piezosurgical apparatus, in contrast to the use of microsaws and dental drills.
一个主要的问题,阻碍牙科康复与使用牙种植体是有限的骨组织在其明显萎缩的情况下。根据一些作者的研究,大约50%的患者在植牙前或植牙阶段需要额外的骨成形术。目标。本文的目的是评估在牙种植体插入中劈开颌骨牙槽嵴的压电手术器械的有效性。材料和方法。对40例年龄在36至49岁之间因单侧和/或双侧牙齿部分脱落而接受手术治疗的成年患者(15男25女)进行了评估。总共48个种植体放置在狭窄的颌牙槽嵴上,使用显微锯(组1- 11例),薄牙钻(组2 -15例)和压电手术器械(组3,14例)进行手术分裂。术后随访4 ~ 6个月,进行矫形治疗。结果。在冠裂过程中,骨复位最小的方法是使用压骨刀,为0.84±0.22 mm,而使用显微锯和牙钻时,这一数字略高,分别为0.93±0.21 mm (p≥0.05)和1.23±019 mm (p≤0.05)。压电外科仪器的特性之一是对蛋白质分子的影响,即它们的变性。这减少了术后并发症的数量。结论。利用压电器械进行牙槽嵴劈裂技术是根据绝对自然和独特的骨愈合机制——骨折修复机制来工作的。该技术利用了本地骨资源,避免或显著减少了外来植骨材料的使用。与使用微锯和牙钻相比,使用压电外科器械时,下颌牙槽嵴宽度的恢复率有更好的趋势。