Leblebicioglu B, Ersanli S, Karabuda C, Tosun T, Gokdeniz H
Section of Periodontology, College of Dentistry, The Ohio State University, Columbus, OH 43218, USA.
J Periodontol. 2005 Mar;76(3):385-90. doi: 10.1902/jop.2005.76.3.385.
The osteotome technique has been successfully used for implant placement when a limited vertical height is available at posterior maxilla. However, it is not clear if new bone is formed at the apical portion of the implant placed by this technique without any bone graft. The aim of this study was to radiographically evaluate bone formation around dental implant surfaces exposed to the space created at the sinus floor without the presence of any graft material.
Forty patients (21 male, 19 female; mean age 46.7 years) who received a total of 75 dental implants together with indirect sinus lifting procedure were included. Initial and 6-month postoperative panoramic films were scanned and analyzed using a commercially available software program. Implants were divided into two groups: initial alveolar bone height <9 mm or > or =9 mm. This helped determine the effect of available bone and exposed implant surface on bone formation in a system where the shortest implant was 8 mm.
The mean implant length placed at locations with <9 mm initial bone height (mean 7 +/- 1.3 mm, N = 29 implants) was 11 +/- 1.7 mm; gain in bone height was 3.9 +/- 1.9 mm. At locations where minimum bone height was 9 mm (mean 10.4 +/- 0.7 mm), 44 implants were placed with a 13.5 +/- 1.06 mm mean length. Mean gain in bone height was 2.9 +/- 1.2 mm at these sites. Two implants were lost at stage 2 surgery. The success rate after 25 months of loading was 97.3%.
It is possible to radiographically observe a gain of approximately 3 to 4 mm of bone from the sinus floor to the implant apex. The amount of initial alveolar bone height, presence of sinus membrane perforation, and the amount of exposed implant surface appear to play a role in the presence or absence of radiopacity within the elevated sinus floor, following 6 months of healing.
当在上颌后牙区垂直高度有限时，骨凿技术已成功用于种植体植入。然而，尚不清楚通过该技术植入的种植体根尖部分在未进行任何骨移植的情况下是否会形成新骨。本研究的目的是通过影像学评估在无任何移植材料的情况下，暴露于上颌窦底所形成空间的种植体周围的骨形成情况。
纳入40例患者（男性21例，女性19例；平均年龄46.7岁），这些患者共接受了75颗种植体及间接上颌窦提升术。使用商用软件程序对初始和术后6个月的全景片进行扫描和分析。种植体分为两组：初始牙槽骨高度<9 mm或≥9 mm。这有助于确定在最短种植体为8 mm的系统中，可用骨量和暴露的种植体表面对骨形成的影响。
初始骨高度<9 mm的部位植入的种植体平均长度（平均7±1.3 mm，N = 29颗种植体）为11±1.7 mm；骨高度增加量为3.9±1.9 mm。在最小骨高度为9 mm（平均10.4±0.7 mm）的部位，植入了44颗种植体，平均长度为13.5±1.06 mm。这些部位的骨高度平均增加量为2.9±1.2 mm。在二期手术时有2颗种植体丢失。负重25个月后的成功率为97.3%。
通过影像学可以观察到从窦底到种植体根尖大约有3至4 mm的骨量增加。愈合6个月后，初始牙槽骨高度、上颌窦膜穿孔情况以及种植体暴露表面的量似乎对提升的上颌窦底内是否存在不透射线影像有影响。
