치과용 Cone-beam CT를 이용한 상악동 골 이식 후 나타난 골 이식재의 부피 변화평가
Evaluation of the Volume Changes of Grafted Bone Materials in Sinus Augmentation Procedure Using Dental Cone-beam CT
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
이 연구의 목적은 상악동 골증대술과 동반된 이식된 골의 3차원적인 형태를 평가하고 골이식 재료 및 임플란트의 종류, 수술 방법과 골흡수 정도 사이의 관계를 평가하는 것이다. 임플란트 식립을 위한 상악동 골증대술을 시행받은 환자들의 차트를 후향적으로 검토하였고 골이식재의 부피 및 부위의 방사선학적 분석을 시행하였다. 임플란트 식립 6개월 후 잔존 골 이식재의 비율로 측정된 부피 재생은 이식 재료의 형태 및 수술 방법과 연관성이 있었다. 원광대학교 산본 치과병원에서 15명의 환자에서 상악동 골이식술과 동반하여 53개의 임플란트가 식립되었다. 임플란트 식립 6개월 후 촬영된 컴퓨터 단층촬영에서 PurosⓇ 와 다른 여러 가지 골이식재를 혼용한 그룹에 비해 PurosⓇ 이식재를 단독으로 사용한 그룹에서 더 높은 골흡수 정도를 보였다 (P<0.05). 그리고 수술 방법에 따른 골흡수 정도는 통계학적으로 유의성있는 차이를 보였다 (P<0.05). 골이식과 동시에 임플란트를 식립한 그룹에 비해 지연된 임플란트 식립을 시행한 그룹에서 더 높은 골이식재의 부피 변화율을 보였다. 후향적 자료 분석을 통해 PurosⓇ 와 다른 여러 가지 골이식재를 혼용한 그룹에 비해 PurosⓇ 이식재를 단독으로 사용한 그룹에서 더 높은 골흡수 정도를 보였다. 또한 골이식과 동시에 임플란트를 식립한 그룹에서 지연 식립한 그룹보다 더 낮은 흡수율을 보여주었다.
Abstract
To evaluate the 3-dimensional features of the grafted bone with maxillary sinus augmentation and to assess the relation between the degree of bone resorption and the type of bone grafting source and implant, and the operation method. A retrospective chart review of patients receiving sinus augmentation procedures for implant positioning was conducted: radiographic analysis of the volume and area of bone grafts was performed. The volumetric remodeling—measured at 6 months after implant positioning as the percentage of residual bone graft—was correlated to type of graft materials and operation methods. 53 dental implants positioned with sinus bone graft in 15 patients at Wonkwang University Sanbon Dental Hospital. Computed tomography scans,taken implant positioning after 6 months, showed greater resorption values for the group of PurosⓇ graft alone from the group of mixed with PurosⓇ and various bone graft (P<0.05, respectively). And resorption values according to operation methods have statistically significant difference(P<0.05). Volume change ratio of bone graft showed greater values for the group of delayed implant position from the group of simultaneously implant placement with bone graft. Retrospective data analysis shows that the method of graft with PurosⓇ alone may occur greater resorption of graft materials than mixed graft material with PurosⓇ and other graft materials. The group of simultaneously implant placement with bone graft also display smaller resorption ratio of bone graft than the group of delayed implant placement.
참고문헌 (39)
- Lundgren S, "Bone reformation with sinus membrane elevation: a new surgical technique for maxillary sinus floor augmentation", Clin Implant Dent Relat Res, 6, pp.165~173 (2004)
- Zitzmann NU, "Sinus elevation procedures in the resorbed posterior maxilla. Comparison of the crestal and lateral approaches", Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 85, pp.8~17 (1998)
- Jemt T, "Implant treatment in edentulous maxillae: a 5-year follow-up report on patients with different degrees of jaw resorption", Int J Oral Maxillofac Implants, 10(3), pp.303~311 (1995)
- Smiler D.G, "Sinus lift grafts and endosseous implants. Treatment of the atrophic posterior maxilla", Dent. Clin. North Am, 36, pp.151~188 (1992)
- Tatum H, "Maxillary and sinus implant reconstructions", Dent. Clin. North Am, 30, pp.207~229 (1986)
- Boyne PJ, "Grafting of the maxillary sinus floor with autogenous marrow and bone", J Oral Surg, 38, pp.613~616 (1980)
- Wallace SS, "Effect of maxillary sinus augmentation on the survival of endosseous dental implants. A systematic review", Ann. Periodontol, 8, pp.328~343 (2003)
- Moy PK, "Maxillary sinus augmentation: Histomorphometric analysis of graft materials for maxillary sinus floor augmentation", J. Oral Maxillofac. Surg, 51, pp.857~862 (1993)
- Tadjoedin ES, "High concentrations of bioactive glass material (BioGran) vs. autogenous bone for sinus floor elevation", Clin Oral Implants Res, 13, pp.428~ (2002)
- Kent JN, "Simultaneous maxillary sinus floor bone grafting and placement of hydroxylapatite- coated implants", J. Oral Maxillofac. Surg, 47, pp.238~242 (1989)
- Loukota RA, "A technique for inserting endosseous implants in the atrophic maxilla in a single stage procedure", Br J Oral Maxillofac Surg, 30, pp.46~49 (1992)
- Haas R, "Bovine hydroxyapatite for maxillary sinus augmentation: analysis of interfacial bond strength of dental implants using pull-out tests", Clin Oral Implants Res, 9, pp.117~122 (1998)
- Johansson B, "A clinical study of changesin the volume of bone grafts in the atrophic maxilla", Dentomaxillofacial Radiology, 30, pp.157~ (2001)
- Moy PK, "Maxillary sinus augmentation: histomorphometric analysis of graft materials for maxillary sinus floor augmentation", J. Oral Maxillofac. Surg, 51, pp.857~862 (1993)
- Tatum SA, "Cranial bone grafting in maxillofacial trauma and reconstruction", Facial Plast Surg, 14, pp.117~129 (1998)
- Jensen OT, "Report of the Sinus Consensus Conference of 1996", Int J Oral Maxillofac Implants, 13(Suppl), pp.11~45 (1998)
- Trisi P, "The bone growing chamber: a new model to investigate spontaneous and guided bone regeneration of artificial defects in the human jawbone", Int J Periodontics Restorative Dent, 18, pp.151~159 (1998)
- Block MS, "Sinus augmentation for dental implants: the use of autogenous bone", J. Oral Maxillofac. Surg, 55, pp.1281~1286 (1997)
- Del Fabbro M, "Systematic review of survival rates for implants placed in the grafted maxillary sinus", Int J Periodontics Restorative Dent, 24, pp.565~577 (2004)
- Hürzeler M.B, "Reconstruction of the severely resorbed maxilla with dental implants in the augmented maxillary sinus: a 5-year clinical investigation", Int J Oral Maxillofac Implants, 11, pp.466~475 (1996)
- Hohlweg-Majert B, "Qualitative and Quantitative Evaluation of Bony Structures Based on DICOM Dataset", J. Oral Maxillofac. Surg, 69, pp.2763~2770 (2011)
- Jensen J, "In vitro analysis of the accuracy of subtraction radiography and computed tomography scanning for determination of bone graft volume", J. Oral Maxillofac. Surg, 56, pp.743~748 (1998)
- Block MS, "Maxillary sinus grafting for totally and partially edentulous patients", J Am Dent Assoc, 124, pp.139~143 (1993)
- Nishibori M, "Short-term healing of autogenous and allogeneic bone grafts after sinus augmentation: a report of 2 cases", J. Periodontol, 65, pp.958~966 (1994)
- Urist MR, "A bone morphogenetic system in residues of bone matrix in the mouse", Clin. Orthop. Relat. Res, pp.210~220 (1973)
- Valentini P, "Sinus grafting with porous bone mineral (Bio-Oss) for implant placement: a 5-year study on 15 patients", Int J Periodontics Restorative Dent, 20, pp.245~253 (2000)
- Hench L, "Bioceramics: from concept to clinic", Journal of the American Ceramic Society (1991)
- Misch CE, "Contemporary Implant Dentistry", Implant Dentistry, 8, pp.90~ (1999)
- Hatano N, "A clinical long-term radiographic evaluation of graft height changes after maxillary sinus floor augmentation with a 2:1 autogenous bone", xenograft mixture and simultaneous placement of dental implants, 2004, pp.15, 339~345
- Rodriguez A, "Maxillary sinus augmentation with deproteinated bovine bone and platelet rich plasma with simultaneous insertion of endosseous implants", J. Oral Maxillofac. Surg, 61, pp.157~163 (2003)
- Hallman M, "A clinical histologic study of bovine hydroxyapatite in combination with autogenous bone and fibrin glue for maxillary sinus floor augmentation. Results after 6 to 8 months of healing", Clin Oral Implants Res, 12, pp.135~143 (2001)
- Iezzi G, "Histologic results from a human implant retrieved due to fracture 5 years after insertion in a sinus augmented with anorganic bovine bone", J. Periodontol, 79, pp.192~198 (2008)
- Testori T, "A multicenter prospective evaluation of 2-months loaded Osseotite implants placed in the posterior jaws: 3-year follow-up results", Clin Oral Implants Res, 13, pp.154~161 (2002)
- Block MS, "Bone maintenance 5 to 10 years after sinus grafting", J. Oral Maxillofac. Surg, 56, pp.706~715 (1998)
- Wannfors K, "A prospective randomized study of 1- and 2-stage sinus inlay bone grafts: 1-year follow-up", Int J Oral Maxillofac Implants, 15, pp.625~632 (2000)
- Stricker A, "Maxillary sinus floor augmention with autogenous bone grafts to enable placement of SLA-surfaced implants: preliminary results after 15-40 months", Clin Oral Implants Res, 14, pp.207~212 (2003)
- Moses J, "Sinus lift complications: avoiding problems and finding solutions" (1997), Dental implantology
- Timmenga NM, "Maxillary sinus function after sinus lifts for the insertion of dental implants", J. Oral Maxillofac. Surg, 55, pp.936~940 (1997)
- Pikos MA, "Maxillary sinus membrane repair: update on technique for large and complete perforations", Implant Dentistry, 17, pp.24~31 (2008)