关键词: 牙槽突扩张术, 引导骨再生植骨术, 种植牙, 牙槽骨宽度不足, 固位功能, 咀嚼功能

Abstract: PURPOSE: To explore the influence of alveolar process expansion, guided bone regeneration (GBR) and bone grafting for simultaneous dental implantation therapy on bone resorption volume, retention and masticatory function in patients with severe deficiency of alveolar bone horizontal width. METHODS: Eighty patients with severely insufficient alveolar bone width who received dental implantation therapy in Hangzhou Stomatology Hospital were selected from January 2021 to January 2023. Totally 40 patients (55 teeth) who received alveolar process expansion combined with GBR bone grafting were included in the experimental group, while 40 patients (51 teeth) with traditional alveolar bone splitting were enrolled as the control group. Both groups were treated with dental implantation at the same time. The repair effect [bone healing time, diameter and implant stability quotient (ISQ)], occurrence of complications and subjective feeling scores (retention, pain and tooth aesthetics) 1 year after surgery, alveolar bone resorption volume (mesial and distal), periodontal related indicators [gingival sulcus depth (SPD), gingival sulcus bleeding index (SBI) and gingival index(GI)] and masticatory function (masticatory efficiency, occlusal force) before surgery and 1 year after surgery were compared between both groups. RESULTS: The bone healing time in the experimental group was significantly less than that in the control group(P<0.05). The total incidence rate of complications was significantly lower in the experimental group than that in the control group(P<0.05). At 1 year after surgery, the alveolar bone resorption volume, SPD, SBI and GI in both groups were significantly reduced than those before surgery, and the indicators in the experimental group were much lower(P<0.05). The masticatory efficiency and occlusal force in the experimental group were significantly enhanced compared to before surgery(P<0.05), and the two indicators were significantly higher than those in the control group(P<0.05). At 1 year after surgery, the retention function and pink esthetic score(PES) in the experimental group were significantly higher (P<0.05) while the visual analogue scale(VAS) score was significantly lower than the control group (P<0.05). CONCLUSIONS: Simultaneous dental implantation with alveolar process expansion combined with GBR bone grafting has good repair effect and safety for patients with severe bone width deficiency. It can help to reduce bone resorption volume, enhance retention stability after bone grafting, relieve pain and improve tooth aesthetics.

Key words: Alveolar process expansion, Guided bone regeneration and bone grafting, Dental implantation, Alveolar bone width deficiency, Retentive function, Masticatory function