牙槽骨垂直牵引成骨种植术的临床研究

目的 评价牙槽骨垂直牵引成骨技术在改善种植区域骨量中的可行性、临床效果及优缺点。方法 19例因肿瘤切除术或外伤等原因造成重度牙槽突垂直向骨缺损（缺损均大于10mm)患者接受了垂直骨牵引术，其中男性15例，女性4例，平均年龄35岁。常规行术前、术后及牵引前、后X线检查记录及取牵引器时直接测量牵引高度。安放牵引器7d后开始牵引，每日牵引1mm至设计高度。保留牵引器2－3个月，局麻下拆除牵引器，植入种植体。结果 19例中11例已完成种植上部结构修复，已植入种植体尚未完成上部修复6例，共植入种植体65枚。19例在牵引成骨后均形成理想新骨，平均新生骨的高度13mm。牵引区意外骨折2例，牵引区感染1例，植入种植体后感染1例。结论 牙槽骨垂直牵引术是解决重度骨量不足的有效的替代方法。

Clinical study of alveolar vertical distraction osteogenesis for implant

Objective To evaluate the clinical result of alveolar vertical distraction osteogenesis for implant. Methods 19 cases with severe vertical alveolar defects (more than 10 mm defect) underwent vertical distraction procedure before implant placement. 15 cases were male and 4 cases were female. The alveolar bone defects were caused by tumor resection in 10 cases, by trauma in 8 cases, and due to congenital defect in 1 case. The vertical defects in all cases were over 10 mm. X ray examination were taken prior to operation and in 1week, 2week, 4week, the end of active distraction and before removing distractor. Implants were placed in 17 cases after removing distractors. The prosthesis were finished 6 month later. Results 11 cases out of 19 had implant prosthesis. 6 cases had implant in the jaw but waiting for the prosthesis. Altogether 65 dental implants were placed, 2 cases did not receive further implant treatment because of cost problem. The study showed that new bone formed after distraction in all 19 cases. Average gained height of new bone was 13 mm. Complications: Unexpected mandible fracture in 2 cases, infection in 1 case. Conclusions Alveolar vertical distraction is a good alterative for severe alveolar defects. The distractor should be further developed and modified.