国际口腔医学杂志

国际口腔医学杂志 ›› 2024, Vol. 51 ›› Issue (3): 319-325.doi: 10.7518/gjkq.2024050

• 综述 • 上一篇    下一篇

计算机辅助设计和计算机辅助制造预成个性化同种异体骨块在种植骨增量手术中的应用进展

钟雨欣(),于海洋()   

  1. 口腔疾病防治全国重点实验室 国家口腔医学中心 国家口腔疾病临床医学研究中心四川大学华西口腔医院修复科 成都 610041
  • 收稿日期:2023-08-25 修回日期:2024-01-16 出版日期:2024-05-01 发布日期:2024-05-06
  • 通讯作者: 于海洋
  • 作者简介:钟雨欣，硕士，Email：<email>1024477290@qq.com</email>
  • 基金资助:
    四川省科技计划项目(2020YFS0040)

Computer aided design and computer aided manufacturing of prefabricated personalized allografts in bone augmentation surgery

Yuxin Zhong(),Haiyang Yu()   

  1. State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Dept. of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
  • Received:2023-08-25 Revised:2024-01-16 Online:2024-05-01 Published:2024-05-06
  • Contact: Haiyang Yu
  • Supported by:
    Sichuan Province Science and Technology Plan Project(2020YFS0040)

RichHTML

13

PDF (PC)

347

摘要：

计算机辅助设计和计算机辅助制造（CAD/CAM）成形技术可以预成与受区更匹配的目标骨块，目前常应用于复杂的牙槽嵴增量术，通过数字化设计生产个性化的同种异体骨块，避免了传统椅旁骨块成形的步骤，大大增加了临床操作效率，提高了移植物适应的精度，利于移植物的血管化和骨整合，在未来骨增量的临床应用中前景可期。因此，本文就CAD/CAM预成个性化同种异体骨块（CABB）在当前种植骨增量手术的应用现状进行综述，并进一步探讨其存在的问题和挑战。

关键词: 计算机辅助设计和计算机辅助制造, 牙槽嵴增量术, 同种异体骨块

Abstract:

Computer aided design and computer aided manufacturing and molding technology can preform the target bone block, which is suitable for the recipient area. It is often used in complex alveolar ridge augmentation surgery. The digital design and production of personalized allogeneic bone block can prevent the traditional step of chair-side bone block forming, increase the efficiency of clinical operation, improve the precision of graft adaptation, and facilitate the vascularization and osseointegration of the graft. This technology shows clinical application potential in bone augmentation. Therefore, this article reviews the current application status of customized allogenous bone blocks in implant bone augmentation surgery and further discusses its existing problems and challenges.

Key words: computer aided design and computer aided manufacturing, alveolar ridge augmentation, allogenic bone block

中图分类号: 

  • R782.13
1 Rocchietta I, Fontana F, Simion M. Clinical outcomes of vertical bone augmentation to enable dental implant placement: a systematic review[J]. J Clin Periodontol, 2008, 35(8 ): 203-215.
2 Barone A, Varanini P, Orlando B, et al. Deep-frozen allogeneic onlay bone grafts for reconstruction of atrophic maxillary alveolar ridges: a preliminary study[J]. J Oral Maxillofac Surg, 2009, 67(6): 1300-1306.
3 Tan WL, Wong TL, Wong MC, et al. A systematic review of post-extractional alveolar hard and soft tissue dimensional changes in humans[J]. Clin Oral Implants Res, 2012, 23(): 1-21.
4 Carlsson GE, Persson G. Morphologic changes of the mandible after extraction and wearing of dentures. A longitudinal, clinical, and X-ray cephalome-tric study covering 5 years[J]. Odontol Revy, 1967, 18(1): 27-54.
5 Cordaro L, Terheyden H. 口腔种植的牙槽嵴骨增量程序：分阶段方案[M]. 7版. 宿玉成, 译. 沈阳: 辽宁科学技术出版社, 2016.
Cordaro L, Terheyden H. Ridge augmentation procedures in implant patients: a staged approach[M]. 7th ed. Su YC, trans. Shenyang: Liaoning Science and Technology Press, 2016.
6 McAllister BS, Haghighat K. Bone augmentation techniques[J]. J Periodontol, 2007, 78(3): 377-396.
7 Jacotti M, Barausse C, Felice P. Posterior atrophic mandible rehabilitation with onlay allograft created with CAD-CAM procedure: a case report[J]. Implant Dent, 2014, 23(1): 22-28.
8 Jacotti M. Simplified onlay grafting with a 3-dimensional block technique: a technical note[J]. Int J Oral Maxillofac Implants, 2006, 21(4): 635-639.
9 Felice P, Pistilli R, Lizio G, et al. Inlay versus onlay iliac bone grafting in atrophic posterior mandible: a prospective controlled clinical trial for the comparison of two techniques[J]. Clin Implant Dent Relat Res, 2009, 11(): e69-e82.
10 Chaushu G, Mardinger O, Peleg M, et al. Analysis of complications following augmentation with cancellous block allografts[J]. J Periodontol, 2010, 81(12): 1759-1764.
11 Motamedian SR, Khojaste M, Khojasteh A. Success rate of implants placed in autogenous bone blocks versus allogenic bone blocks: a systematic literature review[J]. Ann Maxillofac Surg, 2016, 6(1): 78-90.
12 Sheikh Z, Sima C, Glogauer M. Bone replacement materials and techniques used for achieving vertical alveolar bone augmentation[J]. Materials (Basel), 2015, 8(6): 2953-2993.
13 Misch CM. Autogenous bone: is it still the gold standard[J]. Implant Dent, 2010, 19(5): 361.
14 Gazdag AR, Lane JM, Glaser D, et al. Alternatives to autogenous bone graft: efficacy and indications[J]. J Am Acad Orthop Surg, 1995, 3(1): 1-8.
15 Jacotti M, Wang HL, Fu JH, et al. Ridge augmentation with mineralized block allografts: clinical and histological evaluation of 8 cases treated with the 3-dimensional block technique[J]. Implant Dent, 2012, 21(6): 444-448.
16 Jensen SS, Terheyden H. Bone augmentation procedures in localized defects in the alveolar ridge: clinical results with different bone grafts and bone-substitute materials[J]. Int J Oral Maxillofac Implants, 2009, 24(): 218-236.
17 Misch CM. Maxillary autogenous bone grafting[J]. Oral Maxillofac Surg Clin North Am, 2011, 23(2): 229-238.
18 Cricchio G, Lundgren S. Donor site morbidity in two different approaches to anterior iliac crest bone harvesting[J]. Clin Implant Dent Relat Res, 2003, 5(3): 161-169.
19 Sbordone C, Toti P, Guidetti F, et al. Volume chan-ges of autogenous bone after sinus lifting and graf-ting procedures: a 6-year computerized tomographic follow-up[J]. J Craniomaxillofac Surg, 2013, 41(3): 235-241.
20 Boogaard Maarten J, Romanos Georgios E. Allograft customized bone blocks for ridge reconstruction: a case report and radiological analysis[J]. Appl Sci, 2021, 11(21): 10413.
21 Nkenke E, Weisbach V, Winckler E, et al. Morbidity of harvesting of bone grafts from the iliac crest for preprosthetic augmentation procedures: a prospective study[J]. Int J Oral Maxillofac Surg, 2004, 33(2): 157-163.
22 Summers BN, Eisenstein SM. Donor site pain from the ilium. A complication of lumbar spine fusion[J]. J Bone Joint Surg Br, 1989, 71(4): 677-680.
23 Chiapasco M, Zaniboni M. Clinical outcomes of GBR procedures to correct peri-implant dehiscences and fenestrations: a systematic review[J]. Clin Oral Implants Res, 2009, 20(): 113-123.
24 Lima RG, Lima TG, Francischone CE, et al. Bone volume dynamics and implant placement torque in horizontal bone defects reconstructed with autologous or xenogeneic block bone: a randomized, controlled, split-mouth, prospective clinical trial[J]. Int J Oral Maxillofac Implants, 2018, 33(4): 888-894.
25 Li J, Xuan F, Choi BH, et al. Minimally invasive ridge augmentation using xenogenous bone blocks in an atrophied posterior mandible: a clinical and histological study[J]. Implant Dent, 2013, 22(2): 112-116.
26 Romanos GE. Severe atrophy of the posterior mandible and inferior alveolar nerve transposition[J]. Int J Periodontics Restorative Dent, 2021, 41(5): e199-e204.
27 Virolainen P, Heikkilä J, Hirn M, et al. 30 years of bone banking at Turku bone bank[J]. Cell Tissue Bank, 2003, 4(1): 43-48.
28 Aho AJ, Eskola J, Ekfors T, et al. Immune responses and clinical outcome of massive human osteoarticular allografts[J]. Clin Orthop Relat Res, 1998(346): 196-206.
29 Pfaffeneder-Mantai F, Meller O, Schneider B, et al. Specially designed and CAD/CAM manufactured allogeneic bone blocks using for augmentation of a highly atrophic maxilla show a stable base for an all-on-six treatment concept: a case report[J]. Maxillofac Plast Reconstr Surg, 2022, 44(1): 21.
30 Schlee M, Rothamel D. Ridge augmentation using customized allogenic bone blocks: proof of concept and histological findings[J]. Implant Dent, 2013, 22(3): 212-218.
31 Blume O, Back M, Born T, et al. Treatment of a bilaterally severely resorbed posterior mandible due to early tooth loss by Guided Bone Regeneration u-sing customized allogeneic bone blocks: a case report with 24 months follow-up data[J]. J Esthet Restor Dent, 2018, 30(6): 474-479.
32 Blume O, Donkiewicz P, Back M, et al. Bilateral maxillary augmentation using CAD/CAM manufactured allogenic bone blocks for restoration of congenitally missing teeth: a case report[J]. J Esthet Restor Dent, 2019, 31(3): 171-178.
33 Kloss FR, Offermanns V, Donkiewicz P, et al. Customized allogeneic bone grafts for maxillary horizontal augmentation: a 5-year follow-up radiogra-phic and histologic evaluation[J]. Clin Case Rep, 2020, 8(5): 886-893.
34 Landsberg C, Moses O. Ridge augmentation using customized allogeneic bone block: a 3-year follow-up of two case reports[J]. Int J Periodontics Resto-rative Dent, 2020, 40(6): 881-889.
35 Blume O, Back M, Martin K, et al. A customized allogenic bone block for alveolar reconstruction quantitated by a 3D matching technique: a case report[J]. Clin Case Rep, 2021, 9(9): e04771.
36 Ambrosio F, Azimi K, López-Torres A, et al. Custom allogeneic block graft for ridge augmentation: case series[J]. Clin Adv Periodontics, 2023, 13(2): 94-101.
37 Monje A, O’Valle F, Monje-Gil F, et al. Cellular, vascular, and histomorphometric outcomes of solvent-dehydrated vs freeze-dried allogeneic graft for ma-xillary sinus augmentation: a randomized case series[J]. Int J Oral Maxillofac Implants, 2017, 32(1): 121-127.
38 Browning ES, Mealey BL, Mellonig JT. Evaluation of a mineralized cancellous bone allograft for the treatment of periodontal osseous defects: 6-month surgical reentry[J]. Int J Periodontics Restorative Dent, 2009, 29(1): 41-47.
39 Simion M, Jovanovic SA, Tinti C, et al. Long-term evaluation of osseointegrated implants inserted at the time or after vertical ridge augmentation. A re-trospective study on 123 implants with 1-5 year follow-up[J]. Clin Oral Implants Res, 2001, 12(1): 35-45.
40 Christensen DK, Karoussis IK, Joss A, et al. Simultaneous or staged installation with guided bone augmentation of transmucosal titanium implants. A 3-year prospective cohort study[J]. Clin Oral Implants Res, 2003, 14(6): 680-686.
41 Schlee M, Dehner JF, Baukloh K, et al. Esthetic outcome of implant-based reconstructions in augmen-ted bone: comparison of autologous and allogeneic bone block grafting with the pink esthetic score (PES)[J]. Head Face Med, 2014, 10: 21.
42 Kloss FR, Offermanns V, Kloss-Brandstätter A. Comparison of allogeneic and autogenous bone grafts for augmentation of alveolar ridge defects-a 12-month retrospective radiographic evaluation[J]. Clin Oral Implants Res, 2018, 29(11): 1163-1175.
43 Kim SJ, Shin HS, Shin SW. Effect of bone block graft with rhBMP-2 on vertical bone augmentation[J]. Int J Oral Maxillofac Surg, 2010, 39(9): 883-888.
44 Troeltzsch M, Troeltzsch M, Kauffmann P, et al. Clinical efficacy of grafting materials in alveolar ridge augmentation: a systematic review[J]. J Cranio Maxillofac Surg, 2016, 44(10): 1618-1629.
45 Laino L, Iezzi G, Piattelli A, et al. Vertical ridge augmentation of the atrophic posterior mandible with sandwich technique: bone block from the chin area versus corticocancellous bone block allograft: clinical and histological prospective randomized controlled study[J]. Biomed Res Int, 2014, 2014: 982104.
[1] 雒琪玥,柳叶语,罗依麟,满毅. 以正中关系为中心、面部美学及修复为导向的数字化无牙颌种植修复1例[J]. 国际口腔医学杂志, 2022, 49(4): 426-431.
[2] 詹聃婷, 张帆, 郑立舸. 虚拟颌架的应用及研究进展[J]. 国际口腔医学杂志, 2018, 45(2): 228-232.
[3] 万乾炳. 关于全锆冠的几个问题[J]. 国际口腔医学杂志, 2018, 45(1): 9-13.
[4] 陈春秀 文学锦. 计算机辅助设计和计算机辅助制造二氧化锆全瓷修复体的护理配合[J]. 国际口腔医学杂志, 2014, 41(2): 140-142.
[5] 万乾炳. 数码全瓷修复技术的现状及展望[J]. 国际口腔医学杂志, 2011, 38(5): 497-501.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
[1] 王昆润. 在种植体上制作固定义齿以后下颌骨密度的动态变化[J]. 国际口腔医学杂志, 1999, 26(06): .
[2] 张新春. 桩冠修复与无髓牙的保护[J]. 国际口腔医学杂志, 1999, 26(06): .
[3] 王昆润. 长期单侧鼻呼吸对头颅发育有不利影响[J]. 国际口腔医学杂志, 1999, 26(05): .
[4] 王昆润. 后牙冠根斜形牙折的治疗[J]. 国际口腔医学杂志, 1999, 26(05): .
[5] 杨凯. 淋巴化疗的药物运载系统及其应用现状[J]. 国际口腔医学杂志, 1999, 26(05): .
[6] 柴枫. 可摘局部义齿用Co-Cr合金的激光焊接[J]. 国际口腔医学杂志, 1999, 26(04): .
[7] 赵艳丽. 手术刀、电凝、CO_2和KTP激光对大鼠舌部创口的作用[J]. 国际口腔医学杂志, 1999, 26(04): .
[8] 王昆润. 牙周炎加重期应选用何种抗生素[J]. 国际口腔医学杂志, 1999, 26(04): .
[9] 蔡霞,李成章. 前列腺素E_2受体EP亚型在牙周炎发病机制中的作用[J]. 国际口腔医学杂志, 2005, 32(06): 461 -462 .
[10] 轩东英,张建波 金岩. 胚胎发育期TGF-β超家族成员与腭裂发生的关系[J]. 国际口腔医学杂志, 2004, 31(02): 132 -134 .