| Objective The horizontal defect of alveolar bone not only affects implant implantation,but also may cause aesthetic problems after repair.Therefore,surgery is needed to increase the amount of alveolar bone.Common clinical methods are guided bone regeneration(GBR)and autologous bone block graft.conventional GBR scheme is xenogenic granular bone powder combined with absorbable collagen membrane.However,when the bone defect is severe,it may collapse at crest,resulting in poor effect of augmentation.autologous bone block graft has good space maintenance and osteogenesis effect,but it needs to open a second operation area and bone mass is limited.This study adopts an modified method: strip autologous bone block graft combined with GBR was applied in horizontal bone augmentation,Compared with the conventional GBR,the effect of bone augmentation in two groups after operation was evaluated,providing a reference for clinical treatment of severe horizontal bone defects.Methods 24 patients who met the inclusion criteria from January 2021 to April 2022 were randomly divided into 2 groups.Study group(group A): 11 patients had 27 tooth positions,with an average age of 36.0 ± 12.3 years,including 6 males and 5 females.The surgical method was strip autogenous bone block graft combined with GBR;The control group(group B): 13 patients had 28 tooth positions,with an average age of 32.5± 14.2 years,5 males and 8 females,and the surgical method was conventional GBR.The success rate,complication rate,secondary bone graft rate,VAS pain score,bone width increment,bone resorption and resorption rate of the two groups were evaluated.SPSS 26.0 software was used for statistical analysis,Fisher’s exact probability method was used for counting data,The measurement data conforms to the normal distribution and Variance homogeneity adopts the t-test,while non-conformance adopts the rank sum test.P<0.05 is statistically significant.Results The success rate of bone augmentation in both groups was 100%,the complication rate was 18.2% in Group A and 7.7% in Group B,with no significant difference(P>0.05).the secondary bone grafting rate in Group A was 18.2% and 53.8%in Group B,with no significant difference(P>0.05).The postoperative VAS pain score was 5.18 ± 0.87 in Group A and 4.46 ± 0.97 in Group B,with no significant difference(P>0.05).There was no significant difference of bone width Preoperative and width increment immediately after operation between the two groups(P>0.05).At 6 months after operation,the width of alveolar bone in both groups increased significantly,and the width increment in group A was more than that in group B.The difference was statistically significant at 2 mm below the crest(P<0.05),but there was no statistically significant difference at 6 mm and 10 mm below the crest(P>0.05).The absorption amount and absorption rate of group A were lower than that of group B at 2 mm below the crest,and the difference was statistically significant(P<0.05),but with no statistically significant difference at 6 mm and 10 mm below the crest(P>0.05).Conclusion For severe horizontal bone defects in the edentulous area,the application of strip autogenous bone block combined with GBR has lower absorption rate and more bone width increment at the crest than the conventional GBR in horizontal augmentation,which can obtain better crest contour. |
