背景:当前用于引导骨再生(GBR)的皮瓣释放设计强调通过采用深缝方法来保留骨膜下微脉管系统,将骨膜与皮瓣分开.虽然生物学上有声音,可能会遇到生物力学上的缺点。本研究旨在描述一种改进的设计,安全解剖驱动皮瓣延伸(SAFE)技术,用于有效的面部皮瓣释放并回顾性地初步评估该技术的临床结果。
方法:在2020年5月至2022年3月期间,进行了图表审查,以确定在阶段GBR手术中通过面部皮瓣释放治疗的患者。解剖学,生物,并对该技术的生物力学原理进行了描述。收集以下临床资料:术中和术后并发症,GBR之前和之后5-6个月的初始和最终水平脊宽度,和植入物性能。
结果:共确定10例患者。在基线,这些患者的平均脊宽为2.05±0.52mm。在这些患者中没有观察到术中和术后并发症(出血,伤口开口,神经感觉障碍,等。)在2-3周的随访中。在重返赛场时,测得的平均脊宽为6.50±0.55毫米(p<0.01),导致平均4.45±0.65毫米的脊宽增益。21个植入物成功植入,集成,平均21.5±9.2个月随访后,功能无种植体周围炎的体征/症状。
结论:初步结果表明,SAFE技术是在GBR手术期间释放面部皮瓣的一种安全且可预测的方法。
BACKGROUND: Current flap-releasing designs for guided bone regeneration (GBR) emphasize preserving subperiosteal microvasculature by adapting a deep slit approach, separating theperiosteum from the flap. While biologically sound, a biomechanical disadvantage may be encountered. This study aimed to describe a modified design, the Secured Anatomy-driven Flap Extension (SAFE) technique, for effective facial flap release and to preliminarily evaluate the clinical outcomes of this technique retrospectively.
METHODS: Chart reviews were conducted to identify patients treated by facial flap release in staged GBR procedures between May 2020 and March 2022. The anatomical, biological, and biomechanical rationale of this technique were described. The following clinical data were collected: intraoperative and postoperative complications, initial and final horizontal ridge width before and 5-6 months after the GBR, and implant performance.
RESULTS: A total of 10 patients were identified. At baseline, these patients presented with a mean ridge width of 2.05 ± 0.52 mm. No intraoperative and postoperative complications were observed in these patients (bleeding, wound opening, neurosensory disturbance, etc.) at the 2-3-week follow-up visit. At the re-entry, a mean ridge width of 6.50 ± 0.55 mm was measured (p < 0.01), resulting in a mean of 4.45 ± 0.65 mm ridge width gain. Twenty-one implants were successfully placed, integrated, and in function without signs/symptoms of peri-implantitis after a mean 21.5 ± 9.2 months follow-up period.
CONCLUSIONS: Preliminary results suggest that the SAFE technique is a safe and predictable approach for releasing facial flaps during GBR procedures.