Guided Bone Regeneration With Custom Made Meshes in the Dental Rehabilitation of Three Dimensional and Extended Defect of the Jaws.
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 20
- 主要终点
- Bone regeneration volumes
研究概览
简要总结
Twenty patients underwent a guided bone regenerative procedure with the application of a virtually projected customized mesh as containment and stabilizer of particulate bone graft. The entity of bone volume reconstructed after healing were digitally analysed on radiological imaging and expressed in volumetric data and in percentage of what planned before the operation. This datum was correlated with predictors variables potentially affecting the final results. As secondary outcome the implant results after the prosthetic loading was evaluated in terms of survival, success and complication.
详细描述
The implant-borne rehabilitation of three-dimensional and extended alveolar defects is not simple in any case: anatomic and prosthetic demands often require bone reconstructive procedures. Up to date, we can entirely virtually simulate our treatment .The design and printing of a customized mesh mimicking the ideal reconstruction eliminate the intra-operative handling and trimming, with reduced surgical timings and minimal stress for the soft tissues.
The aim is to verify if virtual planning with a customized scaffold could improve the predictability of a complex bone reconstruction in terms of bone reconstruction and implant results.
Twenty patients underwent a guided bone regenerative procedure with the application of a virtually projected customized mesh as containment and stabilizer of particulate bone graft. The entity of bone volume reconstructed after healing were digitally analysed on radiological imaging and expressed in volumetric data and in percentage of what planned before the operation. This datum was correlated with predictors variables potentially affecting the final result: six months at least after surgery, a new cone-beam CT was taken;the pre-and postoperative CT datasets were converted into three-dimensional models and digitally aligned; the reconstructed bone volumes (RBV) were calculated according to the planned bone volumes (PBVs), outlining the areas under the mesh. These values were correlated with complications, atrophies' location and the entity of virtually planned bone volume. As secondary outcome the implant results after the prosthetic loading was evaluated in terms of survival, success and complication.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •The presence of horizontal and vertical alveolar defects in both jaws, inadequate for the placement of at least two fixtures, even ≤6 mm long ones;
- •≥ 18 years;
- •informed consent signed.
排除标准
- •acute or chronic infections in the head and neck;
- •smoking >10 cigarettes per day;
- •uncontrolled diabetes (glycated hemoglobin level > 7 mg/dL);
- •a history of radiation therapy in the head or neck region;
- •current antitumor chemotherapy;
- •liver, blood, or kidney disease;
- •immunosuppression;
- •everyday corticosteroid use;
- •pregnancy;
- •inflammatory and autoimmune disease of the oral cavity;
- •poor oral hygiene and motivation
结局指标
主要结局
Bone regeneration volumes
时间窗: 6 months after surgery
The bone reconstruction was calculated comparing the pre-operative and postoperative volumes. The Reconstructed Bone Volume (RBV) derived by subtracting the Lacking Bone Volume (LBV) values from Planned Bone Volume (PBV) ones. The pre-and postoperative CT datasets were converted into 3D models using Amira imaging software, version 5.3.3. The segmentation regarded almost the entire jaw structure to have at least six precise anatomical points of matching for the superimposition. After that, the pre and postoperative models were digitally aligned with Geomagic Studio 12 software. After the alignment was verified at a minimum range of tolerance of error level of ±0.37 mm in the areas no involved by the surgery, the measurements were performed. In every single slice, the space between the mesh profile and the basal bone was virtually selected and rendered to obtain the PBV; the area representative for the empty space according to the gray-scale of pixels was rendered for the LBV.
次要结局
- Implant survival.(1 year after implant loading at least.)
- Complication rate(through study completion, an average of 2 years.)
- Implant success(1 year after implant loading at least.)
研究者
Giuseppe Lizio
research assistant
University of Bologna