收集骨修复种植体周围骨缺损的效果评价

目的:测量aspeo12000骨收集器在牙种植术中收集的骨量,观察收集骨的组织学特点、成骨活性及即刻移植修复种植体周围骨缺损的临床效果。方法:分2组进行。第1组,15例健康牙种植患者,应用aspeo12000骨收集器收集18颗ITI种植窝制备时钻出的骨屑,测量收集骨的体积,并用t检验比较不同性别、不同部位之间是否存在差别;每一样本脱钙后常规包埋、HE染色,光镜下观察其形态结构,计算骨组织面积所占的比例。第2组:11例患者,植入16颗种植体时发生12处骨缺损,所有缺损应用收集骨即刻移植或收集骨与Bio-oss混合移植。结果:健康牙种植患者收集骨量在不同性别、不同部位之间无显著差异,制备1个种植体窝平均可获得0.93倍体积的“湿骨”。光镜下收集骨以骨组织为主,其面积约占94.2%。牙种植术后3～6个月,原缺损处局部形态饱满,二期手术时见缺损处已覆盖成熟骨质,移植骨成活良好。结论:应用骨收集器获得的收集骨即刻移植修复种植体周围小的骨缺损,是一种简单实用的方法。

Evaluation of peri-implant augmentation with collected bone

PURPOSE: To determine the amount of bone harvested from dental implant osteotomies with aspeo 12000 bone collector, to characterize the nature of the debris, and to evaluate the histological viability and clinical effect of peri-implant augmentation with immediate implantation of collected bone. METHODS: From May 2004 to Oct 2005, 15 recruited patients without peri-implant imperfections underwent 18 ITI implants installation. During the implant bed preparation, 18 samples of bone were collected using the instrument and an analysis of variance was used to determine if there were statistical differences between female versus male, maxilla versus mandible, anterior versus posterior alveolar bone. After decalcification, the material from each sample was fixed in paraffin wax and stained with haematoxylin and eosin, all sections were examined by optical microscope and the proportion of bone was established histomorphometrically. During the time, 12 defects occurred in 11 patients when 16 dental implants were installed, and all the defects were augmented with collected bone debris simultaneously. RESULTS: About 93% volume of 'wet' bone could be obtained from one dental implant osteotomy, and there were no statistical differences between female and male, maxilla and mandible, anterior and posterior alveolar bone. Histological observation showed that all samples contained bone and coagulum, the mean bone proportion was 94.2%. 3 to 6 months after surgery, the defects were successfully augmented, and during the secondary operation, bone growth was found over the defects. CONCLUSION: The use of bone collectors is a good method for obtaining material to fill small bone imperfections in dental implantation.