ISPRD レポート クリストファーヘンメル教授
2019年06月8日
ITI Scholarでこの教授のもとで学びたいと思っていた方です。思いは叶わずロンドン留学になってしまいましたが、歯周病学に関われることができたのでそれはそれでよかった。
University of Zurich
独自のGBR難易度分類
それに対してどのように対応するか?
中等度の造成にはバイオマテリアル
難易度に高いものには自家骨かPTFEメンブレンを用いた造成
結局、Khoury????
Bio-Oss Collagenの宣伝かと思ったデータだったけど、納得感はあった。
PTFEサイトプラスとは敷居が高い。オープンバリアメンブレンで3次元行けたらいいのに。行けるものか?
サイトプラストでグラフトレスオープンバリアで垂直できたら。。。。夢すぎる。
Dream above dream…
自家骨はどこからでもとるけど、このデータを見るとオトガイからの感覚異常はかなり高頻度の模様。下顎前歯が生活歯の場合は根せんより5mm話してブロック採取とKhoury先生には習ったが、感覚異常のことは常に頭にありどう部位からのブロックに踏み切ったことはほとんどない。
Ref )
Alveolar Ridge Contouring with Free Connective Tissue Graft at ImplantPlacement: A 5-Year Consecutive Clinical Study.
Abstract
This study evaluated volume stability after alveolar ridge contouring with free connective tissue grafts at implantplacement in single-tooth gaps. A total of 52 single-tooth gaps with labial volume deficiencies in the maxilla (incisors, canines, and premolars) were consecutively treated with implants and concomitant free palatal connective tissue grafts in 46 patients between 2006 and 2009. Implants had to be covered with at least 2 mm peri-implant local bone after insertion. At implant placement, a free connective tissue graft from the palate was fixed inside a labial split-thickness flap to form an existing concave buccal alveolar ridge contour due to tissuevolume deficiency into a convex shape. Standardized volumetric measurements of the labial alveolar contour using a template were evaluated before connective tissue grafting and at 2 weeks, 1 year, and 5 years after implantprosthetic incorporation. Tissue volume had increased significantly (P < .05) in all six reference points representing the outer alveolar soft tissue contour of the implant before connective tissue grafting to baseline (2 weeks after implant-prosthetic incorporation). Statistically, 50% of the reference points (P > .05) kept their volume from baseline to 1 year after prosthetic incorporation and from baseline to 5 years after prosthetic incorporation, respectively, whereas reference points located within the area of the implant sulcus showed a significant (P < .05) decrease in volume. Clinically, 5 years after prosthetic incorporation the originally concave buccal alveolar contour was still convex in all implants, leading to a continuous favorable anatomical shape and improved esthetic situation. Intraoral radiographs confirmed osseointegration and stable peri-implant parameters with a survival rate of 100% after a follow-up of approximately 5 years. Implant placement with concomitant freeconnective tissue grafting appears to be an appropriate long-term means to contour preexisting buccal alveolarvolume deficiencies in single implants.
Simultaneously CTGはできるだけやろうぜ!ってことか。
塩谷先生も東京医科歯科大学の春日井教授とディスカッションしていた内容です。
ITI 万歳!
永田浩司