Sandwich technique을 이용한 하악골 증대술의 치험 보고

PIEZOELECTRIC VERTICAL BONE AUGMENTATION USING SANDWICH TECHNIQUE IN ATROPHIC MANDIBLE: TWO CASES REPORT

  • 이지수 (대구가톨릭대학교병원 치과 구강악안면외과학교실) ;
  • 이정광 (대구가톨릭대학교병원 치과 구강악안면외과학교실) ;
  • 이현진 (대구가톨릭대학교병원 치과 구강악안면외과학교실) ;
  • 안미라 (대구가톨릭대학교병원 치과 구강악안면외과학교실) ;
  • 손동석 (대구가톨릭대학교병원 치과 구강악안면외과학교실)
  • Lee, Ji-Soo (Dept. of Dentistry, Oral & Maxillofacial Surgery, Daegu Catholic University Hospital) ;
  • Lee, Jung-Kwang (Dept. of Dentistry, Oral & Maxillofacial Surgery, Daegu Catholic University Hospital) ;
  • Lee, Hyun-Jin (Dept. of Dentistry, Oral & Maxillofacial Surgery, Daegu Catholic University Hospital) ;
  • Ahn, Mi-Ra (Dept. of Dentistry, Oral & Maxillofacial Surgery, Daegu Catholic University Hospital) ;
  • Sohn, Dong-Seok (Dept. of Dentistry, Oral & Maxillofacial Surgery, Daegu Catholic University Hospital)
  • 발행 : 2008.05.30

초록

Objective: This is to report the efficacy of the sandwich technique for bone augmentation in a moderate atrophic posterior mandible through clinical and histological results in two cases. Subjects and Method: Two patients selected had moderate bone resorption in left lower edentulous area. Sandwich osteotomy using the piezosurgery was performed and the osteomized alveolar segments were elevated by 6mm in each two patients. The interpositional mineral allograft materials were inserted in the atrophic posterior mandibles. After four months healing period, bone biopsies in the grafted areas and placement of dental implants were performed. In both cases, panoramic views were taken preoperatively to measure the alveolar bone height for diagnosis, to monitor patient healing, and to evaluate bone healing and bone gain. Results: Sufficient vertical bone height was gained by using the sandwich technique and implants were placed successfully. In radiological evaluation, there was minimal resorption of bone height after the second operation and in histomorphometric evaluation, they showed favorable new bone formation without inflammation in the grafted areas. Conclusion: The sandwich technique can be an effective choice for augmenting vertical bone height in the atrophic mandible. More of cases and long term follow-up are needed to evaluate bone resorption and implant prognosis.

키워드

참고문헌

  1. Peterson LJ, Slade EW Jr : Mandibular ridge augmentation by a modified visor osteotomy: a preliminary report. J Oral Surg 35 : 999, 1977
  2. Harle F : Follow-up investigation of surgical correction of the atrophic alveolar ridge by visor osteotomy. J Maxillofac Surg 7 : 283, 1979 https://doi.org/10.1016/S0301-0503(79)80053-3
  3. Harle F : Visor osteotomy to increase the absolute height of the atrophied mandible, A preliminary report. J Maxillofac Surg 3 : 257, 1975 https://doi.org/10.1016/S0301-0503(75)80052-X
  4. Schettler D : Sandwich technique with cartilage transplant for raising the alveolar process in the lower jaw. Fortschr Kiefer Gesichtschir 20: 61, 1976
  5. de Koomen HA, Stoelinga PJ, Tideman H, Huybers TJ : Interposed bone-graft augmentation of the atrophic mandible (a progress report). J Maxillofac Surg 7 : 129, 1979 https://doi.org/10.1016/S0301-0503(79)80025-9
  6. Stoelinga PJ : Preprosthetic reconstructive surgery. Principles of oral and maxillofacial surgery. Philadelphia:JB Lippincott Co 1169, 1992
  7. Politi M, Robiony M : Localized alveolar sandwich osteotomy for vertical augmentation of the anterior maxilla. J Oral Maxillofac Surg 57 : 1380, 1999 https://doi.org/10.1016/S0278-2391(99)90883-2
  8. Jensen OT, Kuhlke L, Bedard JF, White D : Alveolar segmental sandwich osteotomy for anterior maxillary vertical augmentation prior to implant placement. J Oral Maxillofac Surg 64 : 290, 2006 https://doi.org/10.1016/j.joms.2005.10.021
  9. Egbert M, Stoelinga PJ, Blijdorp PA, de Koomen HA : The "Three-piece"osteotomy and interpositional bone graft for augmentation of the atrophic mandible. J Oral and Maxillofac Surg 44 : 680, 1986 https://doi.org/10.1016/0278-2391(86)90034-0
  10. Jensen OT : Alveolar segmental "Sandwich"osteotomies for posterior edentulous mandibular sites for dental implants. J Oral Maxillofac Surg 64 : 471, 2006 https://doi.org/10.1016/j.joms.2005.11.030
  11. Vercellotti T : Technological characteristics and clinical indications of piezoelectric bone surgery. Minerva Stomatol 53 :207, 2004
  12. Vercellotti T, De Paoli S, Nevins M : The piezoelectric bony window osteotomy and sinus membrane elevation: Introduction of a new technique for simplification of the sinus augmentation procedure. Int J Periodontics and Restorative Dent 21 : 561, 2001
  13. Sohn DS : Piezoelectric block bone graft in severely atrophic posterior maxilla with simultaneous implant placement. Dental Success 128, 2003
  14. Sohn DS, Ahn MR, Lee WH, et al : Piezoelectric osteotomy for intraoral harvesting of bone blocks. Int J Periodontics Restorative Dent 27 :127, 2007
  15. Eggers G, Klein J, Blank J, Hassfeld S : Piezosurgery: an ultrasound device for cutting bone and its use and limitations in maxillofacial surgery. Br J Oral and Maxillofac Surg 42 : 451, 2004
  16. Shin HI, Sohn DS : A method of sealing perforated sinus membrane and histologic finding of bone substitutes: A case report, Implant Dentistry 14 : 328, 2004
  17. Ziran B, Cheung S, Smith W, Westerheide K : Comparative Efficacy of 2 different demineralized bone matrix allografts in treating long-bone nonunions in heavy tobacco smokers. The American Journal of Orthopedics 329, 2005
  18. Cheung S, Westerheide K, Ziran B : Efficacy of contained metaphyseal and periarticular defects treated with two different demineralized bone matrix allografts. International Orthopedics 27 : 56, 2003