中国组织工程研究

中国组织工程研究 ›› 2026, Vol. 30 ›› Issue (4): 841-848.doi: 10.12307/2025.959

• 口腔组织构建 oral tissue construction • 上一篇    下一篇

外斜线Onlay植骨在上前牙骨缺损种植修复中的应用

徐沈聪1，方紫菲2，季明意1，徐诚睿1，李彬红3，曹佳雨1，徐俊峰1，2   

  1. 1浙江中医药大学口腔医学院，浙江省杭州市  310053；2浙江省立同德医院口腔科，浙江省杭州市  310012；3临平区第一人民医院口腔科，浙江省杭州市  310000
  • 收稿日期:2024-10-24 接受日期:2024-12-18 出版日期:2026-02-08 发布日期:2025-05-16
  • 通讯作者: 徐俊峰，主任医师，浙江中医药大学口腔医学院，浙江省杭州市 310053；浙江省立同德医院口腔科，浙江省杭州市 310012
  • 作者简介:徐沈聪，男，1999年生，浙江省金华市人，汉族，浙江中医药大学在读硕士，执业医师，主要从事口腔种植学相关研究。

Application of Onlay bone grafts from mandibular lateral oblique line in implant restoration of bone defects in upper anterior teeth

Xu Shencong1, Fang Zifei2, Ji Mingyi1, Xu Chengrui1, Li Binhong3, Cao Jiayu1, Xu Junfeng1, 2   

  1. 1School of Stomatology, Zhejiang Chinese Medical University, Hanzhou 310053, Zhejiang Province, China; 2Department of Stomatology, Zhejiang Tongde Hospital, Hangzhou 310012, Zhejiang Province, China; 3Department of Stomatology, The First People’s Hospital of Linping District, Hangzhou 310000, Zhejiang Province, China 
  • Received:2024-10-24 Accepted:2024-12-18 Online:2026-02-08 Published:2025-05-16
  • Contact: Xu Junfeng, Chief physician, School of Stomatology, Zhejiang Chinese Medical University, Hanzhou 310053, Zhejiang Province, China; Department of Stomatology, Zhejiang Tongde Hospital, Hangzhou 310012, Zhejiang Province, China
  • About author:Xu Shencong, Master candidate, Physician, School of Stomatology, Zhejiang Chinese Medical University, Hanzhou 310053, Zhejiang Province, China

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摘要：


文题释义：
Onlay植骨：即上置法Onlay植骨手术，将自体骨块移植至种植区的骨缺损部位，从而增加骨宽度、高度和体积的骨增量办法，是解决种植区严重骨缺损的方法之一。
上前牙骨缺损：上前牙区唇侧骨板通常由大量的束骨组成，在拔牙后唇侧骨板会有较为明显的骨吸收，进而造成复杂的垂直向、水平向和混合型的骨缺损。

背景：随着口腔种植学的发展，种植修复逐渐成为人们牙齿缺失后的首选修复方式。骨增量手术使得种植适应证不断扩大、种植修复成功率不断提高，但骨增量区术后骨高度、宽度及体积的长期稳定一直是临床难点之一。
目的：采用锥形束CT及自动图像配准程序测量骨增量区的牙槽骨宽度、高度及体积，分析性别及年龄因素对骨增量区牙槽骨体积变化差值的影响。
方法：选择浙江省立同德医院口腔科17例上前牙缺失患者，男10例，女7例，年龄(45.88±12.47)岁，均进行外斜线区Onlay骨块移植(骨增量手术)与种植修复手术，在植骨前、植骨后即刻、植骨后6个月以及种植后即刻、种植后6个月分别进行锥形束CT检查，分析骨增量区牙槽骨体积、高度与宽度，分析性别及年龄因素对骨增量区牙槽骨体积变化差值的影响。
结果与结论：①植骨后即刻、植骨后6个月的骨增量区牙槽骨体积大于植骨前(P < 0.05)，植骨后即刻的骨增量区牙槽骨体积大于植骨后6个月(P < 0.05)；植骨后即刻、植骨后6个月的骨增量区牙槽骨高度大于植骨前(P < 0.05)；植骨后即刻、植骨后6个月的骨增量区各位点牙槽骨水平宽度均大于植骨前(P < 0.05)；②男性植骨后即刻、植骨后6个月的骨增量区各位点的骨块吸体积与女性相比差异无显著性意义(P > 0.05)；Pearson 相关性分析显示，年龄与植骨后即刻、植骨后6个月的骨增量区体积变化值呈正相关，但差异无显著性意义(P > 0.05)；③种植后6个月，完成种植修复的25颗种植牙功能正常，种植体存活率为100%；④结果表明，外斜线区取骨于上前牙区行Onlay植骨种植修复可显著改善骨量不足的问题，效果良好，但Onlay植骨后6个月骨增量区存在一定量的骨吸收，需开辟第二术区，临床医师应结合具体情况选择不同的骨增量手术。
https://orcid.org/0009-0002-1799-2790(徐沈聪)

中国组织工程研究杂志出版内容重点：干细胞；骨髓干细胞；造血干细胞；脂肪干细胞；肿瘤干细胞；胚胎干细胞；脐带脐血干细胞；干细胞诱导；干细胞分化；组织工程

关键词: 外斜线, Onlay骨块, 骨增量, 上前牙骨缺损, 种植修复, 工程化口腔材料

Abstract: BACKGROUND: With the development of oral implantology, implant restoration has gradually become the first choice of restoration after missing teeth, and bone augmentation procedures have led to the expansion of implant indications and the improvement of the success rate of implant restoration. However, the long-term stability of bone height, width and volume after bone augmentation surgery has been one of the clinical difficulties for oral implantologists.
OBJECTIVE: To measure and analyze the bone width, height, and volume of different sites in the bone augmentation area at different time points using cone-beam CT and an automatic image alignment program.
METHODS: Seventeen patients with severe bone defects in the upper anterior region who underwent Onlay bone block grafting in the external oblique region were recruited from the Department of Stomatology, Zhejiang Tongde Hospital. There were 10 males and 7 females, with a mean age of (45.88±12.47) years. The cone-beam CT scans of the patients' Onlay bone grafts were taken at five time points: preoperatively, immediately postoperatively, 6 months postoperatively, immediately post implantation, and 6 months post implantation, and then were statistically analyzed for alveolar bone volume, width, and height in the bone augmentation area, as well as for the difference in the alveolar bone volume of the bone incremental area between patients of different sexes and age.
RESULTS AND CONCLUSION: (1) The alveolar bone volume in the bone augmentation area was higher immediately and 6 months after bone grafting than before bone grafting (P < 0.05) as well as was higher immediately after bone grafting than 6 months after bone grafting (P < 0.05). The alveolar bone height in the bone augmentation area was higher immediately and 6 months after bone grafting than before bone grafting (P < 0.05). The horizontal width of the alveolar bone at various sites in the bone augmentation area immediately and 6 months after bone grafting was higher than that before bone grafting (P < 
0.05). (2) There was no significant difference in the volume of bone graft resorption at various sites in the bone augmentation area between males and females immediately and 6 months after bone grafting (P > 0.05). Pearson correlation analysis showed a positive correlation between age and the change in bone augmentation area volume immediately and 6 months after bone grafting, but the difference was not statistically significant (P > 0.05). (3) Twenty-five dental implants with completed implant restorations functioned normally, and the survival rate of the implants was 100%. To conclude, Onlay bone graft implant restoration in the upper anterior region can significantly improve insufficient bone with favorable outcomes. However, there is some amount of bone resorption in the bone augmentation area at 6 months after Onlay bone grafting and it is necessary to open up the second surgical area. Clinicians should consider different bone augmentation procedures in accordance with the specific circumstances. 

Key words: external oblique line, Onlay bone grafts, bone augmentation, upper anterior bone defect, implant restoration, engineered tissue construction

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