Biointegration of bone grafting materials and osseointegrated implants in oral and maxillofacial surgery.

摘要

Two different studies have been performed. The objective of the former was to determine whether donor site morbidity could be avoided by using pure-phase beta-tricalcium phosphate (beta-TCP). Bilateral sinus grafting was performed on 20 selected patients; beta-TCP was used on the experimental side, and autogenous bone was used on the control side. In each patient, one side was randomly designated the experimental side. In 10 of the 20 patients, the maxilla reconstruction included sinus grafting and onlay bone grafting. Implants were placed 6 months after the procedure. Eighty bone biopsy specimens were taken at the time of implant placement. Histologically and histomorphometrically, there was no significant difference (P=.25) between the experimental and control grafts in terms of the quantity and rate of ossification. Comparisons with other studies reveal that beta-TCP is a satisfactory graft material, even without autogenous bone. The objective of the latter was to verify if it is possible to use osseointegrated implants in Ectodermal Dysplasia Syndrome (EDS) patients. Dental and surgical-implantological treatment for EDS patients may be very complicated. Guided Bone Regeneration (GBR) membrane technique associated to bone grafting was used to facilitate placement of osseointegrated implants in a guided prosthetically position. Two groups with the same bony anatomical features were assessed. The first consisted of 13 Ectodermal Dysplasia patients, where 66 implants together bone grafts and membranes were inserted. In the second control group 120 implants with GBR were placed in 20 patients. The implants were controlled at second stage surgery, and at a follow-up of a 1 year, 2 and 3 years functional loading period. The results showed no statistically significant difference in the osseointegration rate between the two groups. Despite anatomical defects associated with decreased occlusal vertical dimension and the diminished edentulous alveolar ridges, both in height and in width, osseointegrated implants together GBR and bone grafts may be successfully used in EDS.