目的:使用新型三维打印个性化钛网(3D-PITM)用于引导骨再生(GBR),评估牙槽嵴增大的临床和影像学结果。
方法:术前使用锥形束计算机断层扫描(CBCT)评估牙槽嵴缺损,然后增加具有圆形和纺锤形孔的高孔隙率3D-PITM。术后立即和愈合6个月后进行CBCT扫描。将这些扫描与术前扫描进行比较,以计算骨体积的变化,高度,和宽度,以及相应的吸收率。然后对结果进行统计分析。
结果:共有21名患者参与了这项研究,涉及38个植入部位的牙槽隆起。经过6个月的康复,21例患者的平均骨增量量保持在489.71±252.53mm3,吸收率为16.05%±8.07%。对于38个植入部位,平均垂直骨增量为3.63±2.29mm,吸收率为17.55%±15.10%。设计植入平台的水平骨增量为4.43±1.85mm,吸收率为25.26%±15.73%。平台下方2mm的水平骨增量为5.50±2.48mm,吸收率为16.03%±9.57%。主要并发症是暴露于3D-PITM,发生率为15.79%。
结论:用于GBR的新型3D-PITM可导致可预测的骨增强。在设计中适度的过度增强,适当的软组织管理,严格的随访有利于减少移植物吸收和暴露的发生率。
OBJECTIVE: To assess the clinical and radiographic outcomes of alveolar ridge augmentation using a novel three-dimensional printed individualized titanium mesh (3D-PITM) for guided bone regeneration (GBR).
METHODS: Preoperative cone-beam computed tomography (CBCT) was used to evaluate alveolar ridge defects, followed by augmentation with high-porosity 3D-PITM featuring circular and spindle-shaped pores. Postoperative CBCT scans were taken immediately and after 6 months of healing. These scans were compared with preoperative scans to calculate changes in bone volume, height, and width, along with the corresponding resorption rates. A statistical analysis of the results was then conducted.
RESULTS: A total of 21 patients participated in the study, involving alveolar ridge augmentation at 38 implant sites. After 6 months of healing, the average bone augmentation volume of 21 patients remained at 489.71 ± 252.53 mm3, with a resorption rate of 16.05% ± 8.07%. For 38 implant sites, the average vertical bone increment was 3.63 ± 2.29 mm, with a resorption rate of 17.55% ± 15.10%. The horizontal bone increment at the designed implant platform was 4.43 ± 1.85 mm, with a resorption rate of 25.26% ± 15.73%. The horizontal bone increment 2 mm below the platform was 5.50 ± 2.48 mm, with a resorption rate of 16.03% ± 9.57%. The main complication was exposure to 3D-PITM, which occurred at a rate of 15.79%.
CONCLUSIONS: The novel 3D-PITM used in GBR resulted in predictable bone augmentation. Moderate over-augmentation in the design, proper soft tissue management, and rigorous follow-ups are beneficial for reducing the graft resorption and the incidence of exposure.