Individualizirani koštani blokovi za augmentaciju alveolarnih grebena

master's thesis

• Title (english): Individualized bone blocks for the alveolar ridge augmentation
• Author: Elvira Babić
• Mentor: Ivan Zajc (mentor)
• Committee member: Ivan Zajc (predsjednik povjerenstva)
• Committee member: Marko Granić (član povjerenstva)
• Committee member: Davor Illeš (član povjerenstva)
• Granter: University of Zagreb; School of Dental Medicine; (Department of Oral Surgery); Zagreb
• Defense date and country: 2020-09-11, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Dental Medicine; Oral Surgery

Abstract

Gubitak volumena alveolarnoga grebena koji može biti uzrokovan razvojnim defektima, bolestima
parodonta, gubitkom zuba, traumom ili infekcijom otežava protetsku sanaciju te iziskuje potrebu
za nadomještavanjem resorbirane kosti. Autologna kost i dalje predstavlja zlatni standard u
augmentaciji alveolarnoga grebena, ali nosi potrebu za drugim operacijskim mjestom te rizik od
njegovog morbiditeta kao i dugo trajanje operacije koje može uzrokovati nelagodu pacijentu.
Posljednjih godina se, uz autologne koštane presatke, počinju koristiti individualizirani alogeni
koštani blokovi uzeti iz glava femura provjerenih donora. Na temelju CBCT snimka pacijenta,
izradi se 3D model čeljusti te se u CAD sustavu dizajnira budući koštani nadomjestak. Kada
liječnik odobri dizajn odobren, digitalni podatci učitaju se u CAM sustav te se iz suhosmrznutoga
alogenoga koštanoga bloka izgloda koštani blok oblika koji točno odgovara koštanome defektu
pacijenta. Korištenjem individualiziranih koštanih blokova izostaje potreba za dodatnim
pripasavanjem koštanoga presatka tijekom zahvata, što smanjuje trajanje istoga te rizik od
infekcije. Komplikacije koje se javljaju gotovo su isključivo povezane s kontaminacijom do koje
može doći kliničarevim nestručnim baratanjem koštanim blokom i mekim tkivom tijekom
operacije. Nakon razdoblja cijeljenja prisutna je novonastala kost, koštani presadak djelomično se
resorbira, ali ostaje dovoljno kosti za ugradnju dentalnih implantata.

Abstract (english)

The loss of alveolar ridge volume that is caused by developmental defects, periodontal disease,
tooth loss, trauma or infection aggravates the prosthetic rehabilitation and demands the replacement
of the resorbed bone. Autologous bone is still considered the golden standard in the alveolar ridge
augmentation, but it requires an additional surgical site and the risk of its morbidity as well as
longer operating time that can lead to patient’s discomfort. In recent years, individualized allogenic
bone blocks harvested from the femur heads of tested donors are used instead of autologous bone
grafts. A 3D model of the jaw is made based on the patient's CBCT scan and using the CAD
software the future graft is designed. When the design is approved by the clinician, the digital data
is uploaded into the CAM system where the freeze-dried allogenic bone block gets milled into the
shape that precisely fits the patient’s bone defect. Manual adaptation of the block graft can be
avoided by the application of the individualized bone blocks, which also saves time and reduces
the risk of infection. The reported complications are almost exclusively related to contamination,
which can occur due to the clinician’s improper manipulation of the bone block and soft tissue
during the surgery. After the healing period, a newly formed bone is observable and a limited
resorption of the bone graft with enough bone volume for a successful dental implant placement.

• Keywords: alverolarni greben povećanje; kosti; računalom vođeno oblikovanje
• Keywords (english): Alveolar ridge Augmentation; Bone and Bones; CAD/CAM
• Language: croatian
• URN:NBN: urn:nbn:hr:127:063184
• Study programme: Title: dental medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica dentalne medicine (doktor/doktorica dentalne medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2021-01-15 12:47:28