自体骨移植-适应症和限制

A. Papatheodorou, Konstantinos Petsinis, Stavros Sarivalassis
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摘要

引言:自体骨移植,尤其是口腔内自体骨移植已经成功应用了几个世纪,并且在今天仍然很普遍。它们涉及到同一患者的骨从口腔内供体部位转移到另一个口腔内供体部位。目的与方法:本海报的目的是介绍口腔内自体骨移植,并评估这些技术的适应证和限制。材料和方法:自体移植物通常从口腔内部位获得,如:下颌骨联合、下颌骨分支、前窦壁和颧外侧支撑。当所需要的增强骨厚度小于4mm且最多跨越四颗牙齿时,使用从下颌分支采集的自体移植物骨。尽管这种移植物存在损伤下牙槽神经的风险,但与其他口内部位相比,它具有继发性并发症。一般来说,骨增强手术的适应症是通过以下参数确定的:a)存在严重的牙槽嵴萎缩,根据Cawood和Howell分类分为IV级和V级;b)从牙槽嵴到窦底的残余上颌骨小于5mm。结果:对于严重吸收的颌骨,即使采用自体移植物进行大型隆胸手术,成功率也超过95%。结论:尽管自体骨移植物偶尔也存在明显的缺陷,如术后发病率增高、需要二次手术、供区骨量不足等,但由于其具有骨传导、骨诱导和成骨诱导的特点,仍被认为是牙槽骨重建的金标准。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
AUTOLOGOUS BONE GRAFTS – INDICATIONS AND RESTRICTIONS
INTRODUCTION : Autologous bone grafts and especially intraoral autografts have been used with increasing success for centuries and remain in common use today. They involve the transport of bone from an intraoral donor site to a different intraoral site, in the same patient. AIM AND METHOD: The aim of this poster is to introduce the intraoral autogenous bone grafts and evaluate the indications and restrictions of these techniques. MATERIAL AND METHOD: Autografts are commonly obtained from intraoral sites such as: symphysis mandible, ramus mandible, anterior sinus wall and lateral zygomatic buttress. Autograft bone harvested from mandibular ramus is used when the requiring augmentation is less than 4mm in thickness and span a maximum of four teeth. Although this graft presents a risk of damage to the inferior alveolar nerve, it is associated with secondary complications compared to other intraoral sites. Generally, indications for bone augmentation procedures are determined by means of the following parameters: a)Presence of severe alveolar ridge atrophy rated classes IV and V according to the Cawood and Howell classification b)Residual maxillary bone less than 5 mm from the alveolar crest to the sinus floor. RESULTS: Even when major augmentation procedures with autografts had to be carried out for severely resorbed jaws, success rates exceeding 95% have been achieved. CONCLUSION: Although, autolografts occasionally have significant drawbacks, such as increased postoperative morbidity, the need of secondary surgical visit and the lack of sufficient bone mass at the donor site, it is still regarded as the gold standard in alveolar reconstruction, due to its osteoconduction, osteoinduction and osteogenesis-inducing characteristics.
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