Bone augmentation by means of a stiff occlusive titanium barrier - A study in rabbits and humans

被引:63
作者
van Steenberghe, D
Johansson, C
Quirynen, M
Molly, L
Albrektsson, T
Naert, I
机构
[1] Katholieke Univ Leuven, Dept Periodontol, Sch Dent Oral Pathol & Maxillofacial Surg, Fac Med, B-3000 Leuven, Belgium
[2] Gothenburg Univ, Dept Biomat Handicap Res, S-41346 Gothenburg, Sweden
[3] Katholieke Univ Leuven, BIOMAT Res Grp,Dept Prosthet Dent, Sch Dent Oral Pathol & Maxillofacial Surg, Fac Med, B-3000 Leuven, Belgium
关键词
bone; guided tissue augmentation; neogenesis; titanium barrier;
D O I
10.1034/j.1600-0501.2003.140109.x
中图分类号
R78 [口腔科学];
学科分类号
1003 ;
摘要
It has already been shown that occlusive titanium barriers have osteoconcluctive properties. These barriers, however, cover only a limited surface area and have only been used in animal experiments. The aim of this study was to evaluate bone neogenesis under a pre-shaped titanium barrier placed over the top of the rabbit skull and the top of highly resorbed edentulous upper-jaw bone in patients. Computed tomography (CT) scans made it possible to pre-shape the titanium barrier according to individual bone shape in human experiments. On the rabbit skull, tissue augmentation of up to 6 mm 1 year after barrier placement was observed, while the original thickness of skull bone was on average between 1.5 and 2.5 mm. The bone, which remained histologically immature for 1 year, grew systematically along the titanium surface, illustrating its osteoconductivity. Even after removal of the barrier, on average, 75.3 and 59.4% of the newly created tissue volume was maintained after 3 and 9 months, respectively. Clinical observations on 10 consecutive patients showed that, in those (5/10) in which the barrier remained unexposed for several months, an increase of the jawbone height and width of up to 16 mm could be observed when the barrier was removed after 12-18 months. As in the rabbits at barrier removal, the bone demonstrated a limited degree of mineralization as ascertained from biopsies. This newly formed osteoid tissue allowed the insertion of 33 screw-shaped titanium implants which in most cases (30/33) successfully osseointegrated to support a fixed prosthesis. The surrounding marginal bone level remained stable even up to 5 years after implant placement. Both animal and clinical data demonstrate that guided bone neogenesis under a subperiosteally placed titanium barrier can reach large volumes.
引用
收藏
页码:63 / 71
页数:9
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