A Clinical Study on Alveolar Bone Ridge Augmentation with Autogenous Particulate Bone Graft and Titanium Mesh

  • OHTA Mizuho
    Department of Oral and Maxillofacial Surgery,Showa University School of Dentistry
  • MATSUI Yoshiro
    Department of Oral and Maxillofacial Surgery,Showa University School of Dentistry
  • TAKAESU Kei
    Department of Oral and Maxillofacial Surgery,Showa University School of Dentistry
  • SHIROTA Tatsuo
    Department of Oral and Maxillofacial Surgery,Showa University School of Dentistry
  • OH-NO Kohsuke
    Department of Oral and Maxillofacial Surgery,Showa University School of Dentistry

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Other Title
  • 自家骨細片とチタンメッシュを用いた歯槽堤形成術に関する臨床的研究

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Abstract

Recent reports have described the use of titanium mesh and autogenous bone particles for alveolar ridge augmentation. However, it has been unclear how much bone volume, height, or width would be obtained by this technique. This paper studied the predictability of the alveolar bone ridge augmentation with autogenous particulate bone graft and titanium mesh by investigating postoperative complications and quantitative measurements of augmented bone.<br/> The subjects were 13 patients, 6 males and 7 females. The range of patients'age was 18 to 56 years old, and the average age was 37.5 years old. Alveolar ridge augmentation was performed by using autogeneous bone graft and titanium mesh. The primary lesion was dental disease in nine and trauma in four. The operation mainly aimed at increasing bone height in four patients and bone width in nine.<br/> Donor sites were the iliac bone or the jaw bone.<br/> First, the kinds and incidence of postoperative complications were surveyed. The augmented bone was then quantitatively evaluated with the reconstructed CT images. Parameters were as follows:augmented bone ratio (ABR); the percentage of bone in the space created by titanium mesh, increased bone height (IBH); the difference of the bone height before and after the operation of the patients aiming at increasing bone height, the ratio of the increased bone height (%IBH); the percentage of increased bone height against the vertical gap between the mesh and the alveolar crest in the patients, increased bone width (IBW); the difference of the bone width before and after the operation on patients aiming at increasing bone width, and the ratio of the increased bone width (%IBW);the percentage of increased bone width against the horizontal gap between the mesh and the cortical bone in the patients.<br/> The following results were obtained<br/> 1. The mesh was exposed in one patient (7.7%) 8 months after the bone graft.<br/> 2. The ABR was 39.7~100%, average 90.4%.<br/> 3. The IBH was 2.5~11.8 mm, average 6.4 mm and the%IBH was 70~100%, average 91.5%.<br/> 4. The IBW was 1.0~11.2 mm, average 4.9 mm and the%IBW was 22~100%, average 87.4%.<br/> 5. Even the patients who underwent CT examination 20 months after the bone graft showed high quantitative data: ABRs were from 89.1% to 97.2%, average 93.6%.<br/> 6. The low values in an image -ABR of 39.7% and %IBW of 22%- might result from the deficit of bone particles at the operation.<br/> These results indicated the predictability of alveolar bone ridge augmentation with autogenous particulate bone graft and titanium mesh. It is accomplished by adequate surgical procedures avoiding wound dehiscence and tight packing of bone particles into the space created by the titanium mesh.<br/>

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