| The loss of mandibular continuity and maxillary deformity and functional and cosmetic problem often caused by the postoperation of oral and maxillofacial neoplasm, trauma or infection trauma. Autogenous bone graft in combination with dental implants, can repair the bone difficiency, reconstruct facial contour and restore occlusion function. Among them, autogenous nonvascular iliac bone graft and simultaneous implantation can reduce the times of operation and restore occlusion function in time. However, different reports can be seen about osseointegration, healing period and the clinical result.ObjectiveThe aim of this study is to observe the bone growth and osseointegration during healing process after autogenous nonvascular iliac bone graft and simultaneous implantation and supply proof of this type surgery in clinic by investigating the different results of jaw continuity recovery in animal experiment and clinical research.Materials and MethodsAnimal experiment: Twelve healthy and white adult male Japanese rabbits, with iliac bone loss imposed and bilateral iliac bone isolated, and then self-made column hydroxide phosphorite implanted simultaneously in the bilateral area of iliac bone with and without autogenous nonvascular bone graft, were randomly divided into 3 group and four rabbits in each group.the rabbits in every groups was sacrificed at 4,8,12 weeks poetoperation respectively and the dissected samples were used for general and histological observation, electron microscope scanning and reverse pushing out tests.Clinical research: Thirteen patients who suffered with teeth loss with the maxilla alveolar absorption or defect and want to repair with implantation were selected. They were given an operation of autogenous nonvascular iliac bone graft and HA coated dental implants(BLB Comp.)simultaneously,the abutments were set and porcelain tooth were repaired six months after the operation. Implant flexile degree, radial examination and sufferers' self feeling were investigated.Results1. Animal experiment shows: Implants were connected tightly with iliac bone and the implants weren't flexible in every group from general observation. Osseointegration between the implants and the iliac bone can be found and a thin fibrous tissue was observed only in some sample areas of four-week autogenous nonvascular iliac bone graft group by the naked eyes.Radial examination shows: There is no obvious x-ray transmission area around the implant in every group.The density of grafting bone area is a bit lower than that of non-grafting area at four-week group while at eight-week twelve week group there is basically no difference in both areas.Histological and scanning electron microscope examination shows: Implants in grafting bone and non-grafting bone group are both osseointegrated with bone while Osseointegration in non-graftting bone group is much better. Along with time, Osseointegration in every group is much better in turn.Mechanics test (reverse pushing out test) shows that the maximum load of grafting bonegroup in four, eight and twelve weeks is 143.9N/cm2, 194.6 N/cm2 248.3 N/cm2 respectively while it is 229.2 N/cm2. 307.1 N/cm2 377.6 N/cm2 in non-graftting bone group.2. Clinic research shows: The graft bones survived with excellent osseointegration. No obvious x-ray transmission area was observed between 29 implants and graft bones 6 months post-operation. Implants were fixed firmly when Mucosa was flaped. Grafted italic bones grew well. Comfortable self feeling and satisfactory reconstructed facial shapes were reported. One year follow-up observation shows that all implants were stable and functional, as well as patients' comfortable self feeling and satisfactory reconstructed facial shapes.ConclusionsThe method of autogenous nonvascular iliac bone graft and simultaneous implantation can reduce the times of operation and restore occlusion function in time. It's an effective way to repair the bone difficiency, reconstruct facial contour and restore occlusion functio...
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