티타늄 메쉬와 동종골 이식재를 이용한 치조제 증대술 : 임상적, 방사선학적 평가

Abstract

OBJECTIVES : This study aims to clinically and radiographically evaluate the results of bone gain in various bone defects after ridge augmentation using titanium(Ti) mesh and allogenic bone graft to reconstruct edentulous ridges.

MATERIALS ANDMETHODS : 24 patients were included in this study whose edentulous ridges were reconstructed with ridge augmentation using Ti-mesh. Alveolar reconstruction was performed on a total of 60 defect areas. Defects were classified into three type(horizontal, vertical, combined) according to ‘Cologne Classification of Alveolar Ridge Defect’. For ridge augmentation, mixed allograft material (cancellous FDBA 50% + cortical FDBA 50% / Allo-Oss, CG Bio, Seoul, Korea) and Platelet rich fibrin(PRF) were used. In horizontal defect horizontal bone gain and shrinkage rate were evaluated at a distance 2mm(H1), 7mm(H2), and 12mm(H3) apical from the regenerated alveolar crest. In vertical defect vertical bone gain and shrinkage rate were also evaluated at the long axis of the reconstructed alveolar crest(VC) and the area 2mm(VB) buccal and 2mm(VL) lingual from the axis. In combined defect horizontal bone gain and shrinkage rate were evaluated at 3 sites(H1, H2, H3), and vertical bone gain and shrinkage rate were evaluated at 1 site(VC).

RESULTS : In horizontal defects(27 sites), average bone gain was 4.97(±2.01)mm at H1, 4.95(±2.24)mm at H2, and 1.83(±2.28)mm at H3, average shrinkage rate was 20.38(±3.78)% at H1, 15.11(±3.49)% at H2, and 18.21(±4.21)% at H3. There were no significant differences in shrinkage rates.(p>0.05) In vertical defects(14 sites), average bone gain was 7.52(±1.51) mm at VB, 7.97(±1.89)mm at VC, and 7.03(±1.45)mm at VL. And average shrinkage rate was 4.59(±2.06)% at VB, 1.89(±1.30)% at VC, and 4.01(±1.38)% at VL. There were no significant differences in shrinkage rates.(p>0.05). In combined defects(19 sites), horizontal bone gain was 7.51(±2.11)mm at H1, 6.02(±2.77)mm at H2, and 2.72±(3.16)mm at H3 and vertical bone gain was 5.73(±3.04)mm at VC. And horizontal shrinkage rate was 18.82(±3.49)% at H1, 15.90(±3.33)% at H2, and 16.35±(3.32)% at H3 and vertical shrinkage rate was 3.63(±1.44)% at VC. Vertical shrinkage rate of allografts was statistically lower than horizontal shrinkage rate. (p<0.05)

CONCLUSION : Ridge augmentation using allograft and Ti-mesh is a predictable procedure in the reconstruction of atrophic edentulous ridges.