Η Χρήση του Γενειακού Μοσχεύματος στην Αύξηση της Φατνιακής Ακρολοφίας.
Τσετσενεκου Ε.1, Καλύβας Δ.2, Αλεξανδρίδης Κ3
Από την Κλινική της Στοματικής και Γναθοπροσωπικής Χειρουργικής, Οδοντιατρική Σχολή Πανεπιστημίου Αθηνών
(Διευθυντής: ο Καθ. Α.Π. Αγγελόπουλος).
1. Μεταπτυχιακή φοιτήτρια.
2. Λέκτορας.
3. Αναπληρωτής Καθηγητής.
Αρχεία Ελληνικής Στοματικής και Γναθοπροσωπικής Χειρουργικής 5(2): 86 - 93, 2004.
ΠΕΡΙΛΗΨΗ
Η έρευνα που λαμβάνει χώρα τις τελευταίες δεκαετίες γύρω από την ανάπτυξη τεχνικών και υλικών,
επιτρέπουν οτο χειρουργό να δημιουργηθεί υπόβαθρο ικανό να δεχθεί μία προσθετική αποκατάσταση. Η
χρήση μοσχευμάτων και μεμβρανών για την αύξηση του οστικού υποστρώματος αποτελεί πλέον καθημερινή
πρακτική. Από τη σύγχρονη βιβλιογραφία προκύπτει ότι τα καλύτερα αποτελέσματα επιτυγχάνονται με
τη χρήση αυτομοσχευμάτων λόγω της βιοσυμβατότητάς τους και της ικανότητας τους να δρουν ταυτόχρονα
οστεοκαθοδηγητικά, οστεοεπαγωγικά και οστεογενετικά. Εκ του συνόλου των δοτριών θέσεων, η γενεια-
κή σϋμφυση αποτελεί την επιλογή μας τις περισσότερες φορές που απαιτείται μέτρια ποσότητα οστού.
Σκοπός της εργασίας είναι η αναφορά στην τεχνική λήψης μοσχεύματος από τη γενειακή σύμφυση στα
πλαίσια διόρθωσης ανωμαλιών του οστικού υπόβαθρου που θα δεχθεί μία προσθετική αποκατάσταση και
παρουσίαση περιστατικών λήψης μοσχεύματος και τοποθέτησης τους σε διάφορες θέσεις της άνω και
κάτω γνάθου.
Λέξεις κλειδιά: Γενειακό μόσχευμα, αυτομόσχευμα, οστική αναγέννηση.
REFERENCES
Becker W, Schenk R, Higushi K: Variations in bone regeneration
adjacent to implants augmented with barrier membranes
alone or with demineralized freeze-dried bone or autologous
grafts: a study in dogs. Int J Oral Maxillofac Implants 1995,
10: 143-154.
Borstlap WA, Heidbuchel KLWM, Freihofer HPM, Kuijpers-
Jagtman AM: Early secondary bone grafting of alveolar cleft
defects: a comparison between chin and rib grafts. J Cranio-
Maxillofac Surg 1990, 18: 201-205.
Boyne PJ: Histologic response of bone to sectioning by high
speed rotary instruments. J Dent Res 1996, 45: 270-276.
Breine U, Branemark PL. Reconstruction of alveolar jaw bone.
Scand J Plast Reconstr Surg 1980, 14: 23.
Burchardt H: Biology of bone transplantation. Orthop Clin North
Am 1987, 18: 187-195.
Buser D, Dula K: Lateral ridge augmentation using autografts
and barrier membranes: a clinical study with 40 partially
edentulous patients. J Oral Maxillofac Surg 1996, 54: 420-
432.
Buser D, Dula K: Lateral ridge augmentation using autografts
and barrier membranes: a clinial study with 40 partially
edentulous patients. J Oral Maxillofac Surg 1996, 54: 420-
432.
Buser D, Hoffman B, Bernard JP: Evaluation of bone filling
materials in membrane protected defects. A comparative
histomorphometric study in the mandible of miniature pigs.
Clin Oral Impl Res 1998, 9: 137-150.
Dablin C, Linde A, Gottlow J: Healing of bone defects by guided
tissue regeneration. Plast Reconstr Surg 1988, 81: 672-676.
Dennis R: Auogenous bone harvesting: a chin graft technique for
particulate and monocortical bone blocks. Int J Periodontics
Restorative Dent 1999, 19: 165-173.
Donovan M, Dickerson N: Maxillary and mandiular
reconstruction using calvarial bone grafts and Branemark
implants. A preliminary report. J Oral Maxillofac Surg 1994,
52: 588-594.
Friedlander G: Current concepts review. Bone grafts: the basic
science rationale for clinical applications. J Bone Joint Surg
1987, 69: 786.
Garg AK: Grafting materials in repair and restoration. In: Lynch
SE, Genco RJ, Marx EX (eds). Tissue engineering.
Applications in maxillofacial surgery and periodontics.
Chicago; Quintessence, 1999: 83-101.
Hasha BC, Turvey TA: Use of autogenous cranial bone grafts in
maxillofacial surgery: a preliminary report. J Oral Maxillofac
Surg 1986, 44: 11-15.
Hoppenreijs T, Nijdam E, Freihoter H: The chin as a donor siote
in early secondary osteoplasty: a retrospective clinical and
radiological evaluation. J Craniomaxillogac Surg 1992, 20:
119-124.
Jensen J, Sindet-Pedersen S: Autogenous mandibular bone
grafts and osseointegrated implants for reconstruction of the
severely atrophied maxilla: a preliminary report. J Oral
Maxillofac Surg 1991, 48: 1277-1287.
Jovanovic SA, Nevins M: Bone formation utilizing titaniumreinforced
barrier membranes. Int J Periodontics Restorative
Dent 1995, 15: 57-69.
Kalk W, Jansma J: Morbidity from iliac crest bone harvesting. J
Oral Maxillofac Surg 1996, 54(1): 424-429.
Keller EE, Van Roeckel NB: Prosthetic-surgical reconstruction of
severely resorbed maxilla with iliac bone grafting and tissueintegrated
prostheses. Int J Oral Maxillofac Implants 1987, 2:
155-165.
Koole R, Bosker H: Late secondary autogenous bone grafting in
cleft patients comparing mandibular and iliac crest grafts. J
Cranio-Maxillofac Surg 1989, 17: 28-30.
Listrom RD, Symington JS: Osseointegrated dental implants in
conjunction with bone grafts. Int J Oral Maxillofac Surg
1988, 17: 116-118.
Misch C: Ridge augmentation using mandibular ramus bone
grafts for the placement of dental implants: presentation of a
technique. Pract Periodontics Aesthet Dent 1996, 8: 127-
135.
Misch CM, Misch CE, Resnik RR, Ismail YH: Reconstruction of
maxillary alveolar defects with mandibular symphysis grafts
for dental implants: a preliminary procedural report. Int J
Oral Maxillofac Implants 1992, 7: 360-366.
Misch CM, Misch CE: The repair of localized severe ridge defects
for implant placement using mandibular bone grafts. Implant
Dentistry 1995, 4: 261-267.
Misch CM: Compariston of intraoral donor sites for onlay grafting
prior to implant placement. Int J Oral Maxillofac Implants 1997, 12: 767-776.
Perel ML: Facilitating implant placement with sites with chin
grafts for maxillary bone augmentation. Part II. Dent
Implantol Update 1996, 6 (12): 1-4.
Raghoebar GM, Louwerse C, Kalk WW, Vissink A: Morbidity of
chin bone harvesting. Clin Oral Impl Res 2001, 12: 503-507.
Reintsema H: Augmentation of localized defects of the anterior
maxillary ridge with autogenous bone before insertion of
implants. J Oral Maxillofac Surg 1996, 54: 1180-1185.
Rissolo AR, Bennet J: Bone grafting and its essential role in
implant dentistry. Dent Clin North Am 1998, 42: 91-116.
Schenk RK: Biology of fracture repair. In: BrownerBD, Jupiter
JB, Levine AM, Traften PG (eds). Skeletal Trauma.
Philadelphia: Saunders 1992: 31-75.
Schwartz A, Melloning J: Ability of commercial demineralized
freeze-dried bone allograft to induce new bone formation. J
Periodontol 1996, 67: 918-926.
Simion M, Dablin C, Trisi P: Qualitative and quantitative
comparative study on different filling materials used in bone
regeneration: a controlled clinical study. Int J Period Rest
Dent 1994, 14: 199-215.
Simion M, Jovanovic SA: Vertical ridge augmentation around
dental in humans. Int J Periodontics Restorative Dent 1998,
18: 9-23.
Simion M, Misitano U, Gionso L: Treatment of dehiscences and
fenestrations around dental implants using resorbable and
nonresorbable membranes associated with bone autografts: a
comparative clinical study. Int J Oral Maxillofac Implants
1997, 12: 159-167.
Sindet-Pedersen S: Mandibular bone grafts for reconstruction of
alveolar clefts. J Oral Maxillofac Surg 1988, 46: 533-537.
Sindet-Pedersen S: Reconstruction of alveolar clefts with
mandibular bone grafts or iliac crest bone grafts. J Oral
Maxillofac Surg 1990, 48: 554-558.
Sindet-Pedersen S, Enemark H: Mandibular bone grafts for
reconstruction of alveolar clefts. J Oral Maxillofac Surg 1988,
46: 533-537.
Sindet-Pedersen S, Enemark H: Reconstruction of alveolar clefts
with mandibular or iliac crest bone grafts: a comparative
study. J Oral Maxillofac Surg 1990, 48: 554-558.
Tolman D: Reconstrutive procedures with endosseous implants
in grafted bone: a review of the literature. Int J Oral
Maxillofac Implants 1995, 10: 275-294.
Von Arx T, Hardt N: The TIME technique: a new method fro
localized alveolar ridge augmentation prior to placement of
dental implants. Int J Oral Maxillofac Implants 1996, 11:
387-394.
Von Arx T, Kurt B: Implant placement and simultaneous periimplant
bone grafting usin a micro titanium mesh for graft
stabilization. Int J Period Rest Dent 1998, 18: 117-127.
Zeiter DJ, Ries WL, Sanders JJ: The use of a bone block graft
from the chin for alveolar ridge augmentation. Int J
Periodontics Restorative Dent 2000, 20: 619-627.
Από την Κλινική της Στοματικής και Γναθοπροσωπικής Χειρουργικής, Οδοντιατρική Σχολή Πανεπιστημίου Αθηνών
(Διευθυντής: ο Καθ. Α.Π. Αγγελόπουλος).
1. Μεταπτυχιακή φοιτήτρια.
2. Λέκτορας.
3. Αναπληρωτής Καθηγητής.
Αρχεία Ελληνικής Στοματικής και Γναθοπροσωπικής Χειρουργικής 5(2): 86 - 93, 2004.
ΠΕΡΙΛΗΨΗ
Η έρευνα που λαμβάνει χώρα τις τελευταίες δεκαετίες γύρω από την ανάπτυξη τεχνικών και υλικών,
επιτρέπουν οτο χειρουργό να δημιουργηθεί υπόβαθρο ικανό να δεχθεί μία προσθετική αποκατάσταση. Η
χρήση μοσχευμάτων και μεμβρανών για την αύξηση του οστικού υποστρώματος αποτελεί πλέον καθημερινή
πρακτική. Από τη σύγχρονη βιβλιογραφία προκύπτει ότι τα καλύτερα αποτελέσματα επιτυγχάνονται με
τη χρήση αυτομοσχευμάτων λόγω της βιοσυμβατότητάς τους και της ικανότητας τους να δρουν ταυτόχρονα
οστεοκαθοδηγητικά, οστεοεπαγωγικά και οστεογενετικά. Εκ του συνόλου των δοτριών θέσεων, η γενεια-
κή σϋμφυση αποτελεί την επιλογή μας τις περισσότερες φορές που απαιτείται μέτρια ποσότητα οστού.
Σκοπός της εργασίας είναι η αναφορά στην τεχνική λήψης μοσχεύματος από τη γενειακή σύμφυση στα
πλαίσια διόρθωσης ανωμαλιών του οστικού υπόβαθρου που θα δεχθεί μία προσθετική αποκατάσταση και
παρουσίαση περιστατικών λήψης μοσχεύματος και τοποθέτησης τους σε διάφορες θέσεις της άνω και
κάτω γνάθου.
Λέξεις κλειδιά: Γενειακό μόσχευμα, αυτομόσχευμα, οστική αναγέννηση.
REFERENCES
Becker W, Schenk R, Higushi K: Variations in bone regeneration
adjacent to implants augmented with barrier membranes
alone or with demineralized freeze-dried bone or autologous
grafts: a study in dogs. Int J Oral Maxillofac Implants 1995,
10: 143-154.
Borstlap WA, Heidbuchel KLWM, Freihofer HPM, Kuijpers-
Jagtman AM: Early secondary bone grafting of alveolar cleft
defects: a comparison between chin and rib grafts. J Cranio-
Maxillofac Surg 1990, 18: 201-205.
Boyne PJ: Histologic response of bone to sectioning by high
speed rotary instruments. J Dent Res 1996, 45: 270-276.
Breine U, Branemark PL. Reconstruction of alveolar jaw bone.
Scand J Plast Reconstr Surg 1980, 14: 23.
Burchardt H: Biology of bone transplantation. Orthop Clin North
Am 1987, 18: 187-195.
Buser D, Dula K: Lateral ridge augmentation using autografts
and barrier membranes: a clinical study with 40 partially
edentulous patients. J Oral Maxillofac Surg 1996, 54: 420-
432.
Buser D, Dula K: Lateral ridge augmentation using autografts
and barrier membranes: a clinial study with 40 partially
edentulous patients. J Oral Maxillofac Surg 1996, 54: 420-
432.
Buser D, Hoffman B, Bernard JP: Evaluation of bone filling
materials in membrane protected defects. A comparative
histomorphometric study in the mandible of miniature pigs.
Clin Oral Impl Res 1998, 9: 137-150.
Dablin C, Linde A, Gottlow J: Healing of bone defects by guided
tissue regeneration. Plast Reconstr Surg 1988, 81: 672-676.
Dennis R: Auogenous bone harvesting: a chin graft technique for
particulate and monocortical bone blocks. Int J Periodontics
Restorative Dent 1999, 19: 165-173.
Donovan M, Dickerson N: Maxillary and mandiular
reconstruction using calvarial bone grafts and Branemark
implants. A preliminary report. J Oral Maxillofac Surg 1994,
52: 588-594.
Friedlander G: Current concepts review. Bone grafts: the basic
science rationale for clinical applications. J Bone Joint Surg
1987, 69: 786.
Garg AK: Grafting materials in repair and restoration. In: Lynch
SE, Genco RJ, Marx EX (eds). Tissue engineering.
Applications in maxillofacial surgery and periodontics.
Chicago; Quintessence, 1999: 83-101.
Hasha BC, Turvey TA: Use of autogenous cranial bone grafts in
maxillofacial surgery: a preliminary report. J Oral Maxillofac
Surg 1986, 44: 11-15.
Hoppenreijs T, Nijdam E, Freihoter H: The chin as a donor siote
in early secondary osteoplasty: a retrospective clinical and
radiological evaluation. J Craniomaxillogac Surg 1992, 20:
119-124.
Jensen J, Sindet-Pedersen S: Autogenous mandibular bone
grafts and osseointegrated implants for reconstruction of the
severely atrophied maxilla: a preliminary report. J Oral
Maxillofac Surg 1991, 48: 1277-1287.
Jovanovic SA, Nevins M: Bone formation utilizing titaniumreinforced
barrier membranes. Int J Periodontics Restorative
Dent 1995, 15: 57-69.
Kalk W, Jansma J: Morbidity from iliac crest bone harvesting. J
Oral Maxillofac Surg 1996, 54(1): 424-429.
Keller EE, Van Roeckel NB: Prosthetic-surgical reconstruction of
severely resorbed maxilla with iliac bone grafting and tissueintegrated
prostheses. Int J Oral Maxillofac Implants 1987, 2:
155-165.
Koole R, Bosker H: Late secondary autogenous bone grafting in
cleft patients comparing mandibular and iliac crest grafts. J
Cranio-Maxillofac Surg 1989, 17: 28-30.
Listrom RD, Symington JS: Osseointegrated dental implants in
conjunction with bone grafts. Int J Oral Maxillofac Surg
1988, 17: 116-118.
Misch C: Ridge augmentation using mandibular ramus bone
grafts for the placement of dental implants: presentation of a
technique. Pract Periodontics Aesthet Dent 1996, 8: 127-
135.
Misch CM, Misch CE, Resnik RR, Ismail YH: Reconstruction of
maxillary alveolar defects with mandibular symphysis grafts
for dental implants: a preliminary procedural report. Int J
Oral Maxillofac Implants 1992, 7: 360-366.
Misch CM, Misch CE: The repair of localized severe ridge defects
for implant placement using mandibular bone grafts. Implant
Dentistry 1995, 4: 261-267.
Misch CM: Compariston of intraoral donor sites for onlay grafting
prior to implant placement. Int J Oral Maxillofac Implants 1997, 12: 767-776.
Perel ML: Facilitating implant placement with sites with chin
grafts for maxillary bone augmentation. Part II. Dent
Implantol Update 1996, 6 (12): 1-4.
Raghoebar GM, Louwerse C, Kalk WW, Vissink A: Morbidity of
chin bone harvesting. Clin Oral Impl Res 2001, 12: 503-507.
Reintsema H: Augmentation of localized defects of the anterior
maxillary ridge with autogenous bone before insertion of
implants. J Oral Maxillofac Surg 1996, 54: 1180-1185.
Rissolo AR, Bennet J: Bone grafting and its essential role in
implant dentistry. Dent Clin North Am 1998, 42: 91-116.
Schenk RK: Biology of fracture repair. In: BrownerBD, Jupiter
JB, Levine AM, Traften PG (eds). Skeletal Trauma.
Philadelphia: Saunders 1992: 31-75.
Schwartz A, Melloning J: Ability of commercial demineralized
freeze-dried bone allograft to induce new bone formation. J
Periodontol 1996, 67: 918-926.
Simion M, Dablin C, Trisi P: Qualitative and quantitative
comparative study on different filling materials used in bone
regeneration: a controlled clinical study. Int J Period Rest
Dent 1994, 14: 199-215.
Simion M, Jovanovic SA: Vertical ridge augmentation around
dental in humans. Int J Periodontics Restorative Dent 1998,
18: 9-23.
Simion M, Misitano U, Gionso L: Treatment of dehiscences and
fenestrations around dental implants using resorbable and
nonresorbable membranes associated with bone autografts: a
comparative clinical study. Int J Oral Maxillofac Implants
1997, 12: 159-167.
Sindet-Pedersen S: Mandibular bone grafts for reconstruction of
alveolar clefts. J Oral Maxillofac Surg 1988, 46: 533-537.
Sindet-Pedersen S: Reconstruction of alveolar clefts with
mandibular bone grafts or iliac crest bone grafts. J Oral
Maxillofac Surg 1990, 48: 554-558.
Sindet-Pedersen S, Enemark H: Mandibular bone grafts for
reconstruction of alveolar clefts. J Oral Maxillofac Surg 1988,
46: 533-537.
Sindet-Pedersen S, Enemark H: Reconstruction of alveolar clefts
with mandibular or iliac crest bone grafts: a comparative
study. J Oral Maxillofac Surg 1990, 48: 554-558.
Tolman D: Reconstrutive procedures with endosseous implants
in grafted bone: a review of the literature. Int J Oral
Maxillofac Implants 1995, 10: 275-294.
Von Arx T, Hardt N: The TIME technique: a new method fro
localized alveolar ridge augmentation prior to placement of
dental implants. Int J Oral Maxillofac Implants 1996, 11:
387-394.
Von Arx T, Kurt B: Implant placement and simultaneous periimplant
bone grafting usin a micro titanium mesh for graft
stabilization. Int J Period Rest Dent 1998, 18: 117-127.
Zeiter DJ, Ries WL, Sanders JJ: The use of a bone block graft
from the chin for alveolar ridge augmentation. Int J
Periodontics Restorative Dent 2000, 20: 619-627.
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