- 期刊
以腸骨J形骨塊重建複雜性齒槽骨脊缺損
Iliac "J-Bone Block" for Augmentation of Complicated Alveolar Defect
摘要
自體骨移植仍爲目前重建複雜性教骨缺損的最佳移植材料，本文主旨在提出以自體腸骨骨塊重建複雜性齒槽骨脊缺損，以利後續人工植牙的手術方法。自2006年至2009年，本院共有22位以J形骨塊重建的病例，患者年齡分佈爲19到59歲，術前及術後均以電腦斷層掃描影像，仔細評估齒槽脊缺才員之外形及體積。重建所需骨材均取自於腸骨的前上骨脊內緣，術中依照缺損齒槽脊的形態，將腸骨塊裁塑爲英文字母”J”的外形，以利同時增加齒槽脊的高度及寬度，每一個月最骨塊都以鈦金屬骨釘固定於受骨區。術後所有移植骨均癒合良好，供骨區亦無重大後遺症，目前已有16位忠者於植骨區接受共64支人工牙根植入手術。研究結果發現，腸骨塊可重塑形，而”J”形骨塊可重建良好的齒槽脊外型和骨質，有利將人工牙根植入最理想的角度或位置，進而提高複雜性人工植牙病例的成功率。
並列摘要
Autogenous bone is still; believed to be the most effective grafting material for reconstruction of the comp1icated jaw bone defects. The pw-pose of this retrospective study is to address the technique of autogenous iliac bone block to rebuild complicated alveolar defects, thereby facilitates subsequent dental implant supported restorations. 22 consecutive iliac ”J-bone block” procedures from 2006 through 2009 were enrolled for data analysis Patients aged from 19-59 years. All of the reconstruction materials were harvested from the superior and medial aspects of the anterior iliac crest. Each and every iliac bone block was tailored to be passively fitting the contour of the alveolar defect and secured in position by titanium mini-screws to achieve significant bone volume expansion in both transverse and vertical dimensions. Pre-and postoperative CT image studies with radiographic guide in position were also conducted to evaluate the shape and volume change of the recipient sites All iliac bone grafts healed uneventfully with minimal volume shrinkage and unremarkable donor site morbidity. By now, there're 64 dental implants survived well in 16 of our patients. The promising results have shown to us that iliac cortico-cancellous bone blocks are very easy to be manipulated by hand instruments and transformed into a ”J-block” which not only leads to excellent quantity and quality of bone augmentation but also allows ideal implant positioning with proper axial alignment. With all these advantages, iliac ”J-bone block” would no doubt give rise to a higher success rate of complicated implant restorations.