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Implant placement after guided bone regeneration (GBR) in severe defected mandibular alveolar ridge: case report

심하게 결손된 하악 치조골에서 골유도재생술(GBR) 후 임플란트의 식립: 증례보고

  • Chee, Young-Deok (Department of Oral & Maxillofacial Surgery, Sanbon Dental Hospital, College of Dentistry, Wonkwang University) ;
  • Yu, Tae-Hoon (Department of Oral & Maxillofacial Surgery, Sanbon Dental Hospital, College of Dentistry, Wonkwang University)
  • 지영덕 (원광대학교 치과대학 산본치과병원 구강악안면외과) ;
  • 유태훈 (원광대학교 치과대학 산본치과병원 구강악안면외과)
  • Received : 2014.02.25
  • Accepted : 2014.04.21
  • Published : 2014.06.30

Abstract

In the mandibular posterior molar area, ridge deficiency is an unfortunate obstacle in the field of implant dentistry. Many techniques are available to rebuild the deficient ridge. Selection and necessity of these techniques are associated with significant morbidity and often require a second surgical site. With the advent of guided bone regeneration (GBR), one may now graft the deficient ridge with decreased morbidity and without a second surgical site. In this case, guided bone regeneration procedures were performed with a combination of allograft, xenograft, and alloplast, excepting autogerous bone at severe defected mandibular alveolar ridge and then placed to the implant successfully. We report that implant placement were good in two cases.

하악 구치부에 있어서 치조제 결손은 임플란트 치과학에 있어서 큰 장애물이라 할 수 있다. 이러한 치조제를 재건하는데 있어서 여러 가지 술식이 활용되고 있다. 술식들의 선택 및 필요성은 현저한 질병의 이환률과 관련이 있으며, 2차적인 수술 부위를 요구하는 경우도 있다. 골 유도 재생술(GBR, guided bone generation)의 발전은 결손이 존재하는 치조제의 이환률을 낮추며, 2차적인 수술 부위를 요구하지 않는 경우로 볼 수 있다. 본 증례에서는 심하게 결손된 하악 치조골에 자가골을 제외한 동종골, 이종골, 합성골 입자형 골이식재를 조합하여 골 유도 재생술(GBR)을 진행한 후에 임플란트를 성공적으로 식립을 하였다. 두 증례에서 양호한 식립을 보였음에 보고하는 바이다.

Keywords

References

  1. Lekovic V, Kenney EB, Weinlaender M, Han T, Klokkevold P, Nedic M, Orsini M. A bone regenerativ approach to alveolar ridge maintenance following tooth extraction. Report of 10 cases. J Periodontol 1997;68:563-70. https://doi.org/10.1902/jop.1997.68.6.563
  2. Johnson K. A study of the dimensional changes occurring in the maxilla after tooth extraction. Part 1: normal healing. Aust Dent J 1963;8:428-34. https://doi.org/10.1111/j.1834-7819.1963.tb02649.x
  3. Schropp L, Wenzel A, Kostopoulos L, Karring T. Bone healing and soft tissue contour changes following single-tooth extraction: a clinical and radiographic 12-month prospective study. Int J Periodontics Restorative Dent 2003;23:313-23.
  4. Buser D, Dula K, Belser U, Hirt HP, Berthold H. Localized ridge augmentation using guided bone regeneration. 1. Surgical procedures in the maxilla. Int J Periodontics Restorative Dent 1993;13:29-45.
  5. Mellonig JT, Nevins M. Guided bone regeneration of bone defects associated with implants: an evidence-based outcome assessment. Int J Periodontics Restorative Dent 1995;15:168-85.
  6. Pikos MA. Block autografts for localized ridge augmentation: Part I. The posterior maxilla. Implant Dent 1999;8:279-85. https://doi.org/10.1097/00008505-199903000-00009
  7. Proussaefs P, Lozada J. The use of intraorally harvested autogenous block grafts for vertical alveolar ridge augmentation: a human study. Int J Periodontics Restorative Dent 2005;25:351-63.
  8. Chang YY, Kang DH, Park JC, Kim JH, Yun JH, Kim ST, Jung UW, Park YB, Kim CS, Shim JS, Moon HS, Choi SH. Treatment of dehiscence or fenestration defect on maxillary anterior implants using guided bone regeneration: case report. J Korean Acad Implant Dent 2011;30:44-9.
  9. Melcher AH. On the repair potential of periodontal tissues. J Periodontol 1976;47:256-60. https://doi.org/10.1902/jop.1976.47.5.256
  10. Nyman S, Gottlow J, Karring T, Lindhe J. The regenerative potential of periodontal ligament. An experimental study in the monkey. J Clin Periodontol 1982;9:257-65. https://doi.org/10.1111/j.1600-051X.1982.tb02065.x
  11. Gottlow J, Nyman S, Karring T, Lindhe J. New attachment formation as the result of controlled tissue regeneration. J Clin Periodontol 1984;11:494-503. https://doi.org/10.1111/j.1600-051X.1984.tb00901.x
  12. Kim YK, Lee HJ, Kim KW, Kim SG, Um IW. Guided bone regeneration using autogenous teeth:case reports. J Korean Assoc Oral Maxillofac Surg 2011;37:142-7. https://doi.org/10.5125/jkaoms.2011.37.2.142
  13. Rangert B, Jemt T, Jorneus L. Forces and moments on Branemark implants. Int J Oral Maxillofac Implants 1989;4:241-7.
  14. Khraisat A, Abu-Hammad O, Dar-Odeh N, Al-Kayed AM. Abutment screw loosening and bending resistance of external hexagon implant system after lateral cycle loading. Clin Implant Dent Relat Res 2004;6:157-64. https://doi.org/10.1111/j.1708-8208.2004.tb00216.x
  15. Nyman S, Gottlow J, Karring T, Lindhe J. The regenerative potential of periodontal ligament. An experimental study in the monkey. J Clin Periodontol 1982;9:257-65. https://doi.org/10.1111/j.1600-051X.1982.tb02065.x
  16. Buser D, Dula K, Hirt HP, Schenk RK. Lateral ridge augmentation using autografts and barrier membranes: a clinical study with 40 partially edentulous patients. J Oral Maxillofac Surg 1996;54:420-32. https://doi.org/10.1016/S0278-2391(96)90113-5
  17. Schwartz-Arad D, Levin L, Sigal L. Surgical success of intraoral autogenous block onlay grafting for alveolar ridge augmentation. Implant Dent 2005;14:131-8. https://doi.org/10.1097/01.id.0000165031.33190.0d
  18. Triplett RG, Schow SR. Autologous bone grafts and endosseous implants: complementary techniques. J Oral Maxillofac Surg 1996;54:486-94. https://doi.org/10.1016/S0278-2391(96)90126-3
  19. Feuille F, Knapp CI, Brunsvold MA, Mellonig JT. Clinical and histologic evaluation of bone-replacement grafts in the treatment of localized alveolar ridge defects. Part 1: mineralized freeze-dried bone allograft. Int J Periodontics Restorative Dent 2003;23:29-35.
  20. Tolman DE. Reconstructive procedures with endosseous implants in grafted bone: a review of literature. Int J Oral Maxillofac Implants 1995;10:275-94.
  21. Nevins M, Mellonig JT, Clem DS 3rd, Reiser GM, Buser DA. Implants in regenerated bone: longterm survival. Int J Periodontics Restorative Dent 1998;18:34-45.
  22. Zitzmann NU, Naef R, Scharer P. Resorbable versus nonresorbable membranes in combination with Bio-Oss for guided bone regeneration. Int J Oral Maxillofac Implants 1997;12:844-52.
  23. Hämmerle CH, Jung RE. Bone augmentation by means of barrier membranes. Periodontol 2000 2003;33:36-53. https://doi.org/10.1046/j.0906-6713.2003.03304.x
  24. Hämmerle CH, Jung RE, Feloutzis A. A systematic review of the survival of implants in bone sites augmented with barrier membranes (guided bone regeneration) in partially edentulous patients. J Clin Periodontol 2002;29 Suppl 3:226-31. https://doi.org/10.1034/j.1600-051X.29.s3.14.x
  25. Mayfield L, Skoglund A, Nobréus N, Attstrom R. Clinical and radiolographic evaluation, following delivery of fixed reconstructions at GBR treated titanium fixtures. Clin Oral Implants Res 1998;9:292-302. https://doi.org/10.1034/j.1600-0501.1998.090502.x
  26. Pikos MA. Mandibular block autografts for alveolar ridge augmentation. Atlas Oral Maxillofac Surg Clin North Am 2005;13:91-107. https://doi.org/10.1016/j.cxom.2005.05.003