应用种植体牵张成骨增高下颌前牙牙槽嵴的临床研究

目的:探讨同期植入种植体并应用牵张成骨原理永久增高下颌前牙牙槽嵴的临床方法。方法:选择下前牙区重度牙槽嵴萎缩患者6例,其中男4例,女2例。术前选择适当规格的抗旋转柱状螺纹组合式种植体,局麻下在缺牙区近远中行横过牙槽嵴顶的纵行切口,剥离并掀起颊舌侧黏骨膜瓣后,用来复锯于萎缩的牙槽嵴顶的近、远中行垂直骨切开,切口长度为预选种植体长度的1/2。在纵行骨切口的末端水平截骨并使骨块游离,将种植体按术前设计植入游离骨块,种植体植入长度为总长度的1/2。严密缝合松弛切口。术后10天拆线。术后2周开始旋入种植体,每日4次,每次旋入1/4圈,牵引速度为1mm/d,直至种植体全部植入时止。术后1、3和6月摄X线片。骨牵引结束后6个月修复种植体上部结构。追踪观察3年。结果:6例患者截骨线均一期愈合,牙槽嵴顶增高5·0~7·5mm。11枚种植体术后3个月与骨块完全整合。种植体上部结构修复后随访5年均能正常行使功能。结论:利用同期植入种植体牵引增高牙槽嵴高度为牙槽嵴重度萎缩患者义齿修复开辟了一条新途径,是一种有效的永久的治疗方法。

Clinical study of distraction osteogenesis using implants to increase mandibular alveolus

Objective:To study the clinical method to increase the altitude of mandibular alveolus with the theory of distraction osteogenesis.Methods:Implants of CDIC cylindric screw implant system was carried on 6 patients with heavy atrophy mandibular alveolus.Longitudinal incisions were maken at admedial and axifugal side of implanting.The mucoperiosteum flap was lifted up,and down fracture was done at the alveolus with saw.The length of longitudinal bone incisions was the 1/2 of pre-choicing implant.Implants were turned into the free bone block to the length of 1/2,then sutured incisions.Totallay four times of opening the screw implants a day were performed.Results:The new bone was formed between the opened suture in two weeks,and filled the suture in2 to 4 months.The altitude of the alveolus was increased as much as 5 to 7 mm.Conclusions:Distraction osteogenesis with implants could get a good resuit for the patients with atrophy mandibular alveolus.