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严重上颌骨萎缩患者采用髂骨块移植进行双侧上颌窦底提升术中早期种植体植入:一项临床、组织学和影像学病例报告

Early implant placement in bilateral sinus floor augmentation using iliac bone block grafts in severe maxillary atrophy: a clinical, histological, and radiographic case report.

作者信息

Acocella Alessandro, Sacco Roberto, Niardi Paolo, Agostini Tommaso

机构信息

Department of Odontostomathology, Faculty of Medicine, University of Florence, Italy.

出版信息

J Oral Implantol. 2009;35(1):37-44. doi: 10.1563/1548-1336-35.1.37.

Abstract

Effectively restoring a grossly atrophic maxilla can be difficult for the implant surgeon. The placement of dental implants in patients who are edentulous in the posterior maxilla can present difficulties because of deficient posterior alveolar ridge and increased pneumatization of the maxillary sinus, resulting in a minimal hard tissue bed. Implant placement requires adequate quality and quantity of bone, especially in the posterior maxilla. Insufficient bone height and width in this area of the maxilla, because of expansion of the maxillary sinus and atrophic reduction of the alveolar ridge, represents a contraindication for conventional insertion of dental implants. The reconstruction of edentulous patients with adequate bone volume and density by the use of bone graft and, subsequently, the placement of dental implants has become a viable treatment option with high predictability. It is commonly shared that autologous bone graft is the gold standard grafting method in the augmentation of Higmoro antrum and in any kinds of guided bone regeneration. In this article, the authors report a case of severe maxillary atrophy that is augmented by block bone graft harvested from iliac crest. An early placement of implants is possible due to the quick healing of the site, as proven by histologic examinations.

摘要

对于种植外科医生而言,有效恢复严重萎缩的上颌骨可能具有挑战性。由于上颌后牙槽嵴不足以及上颌窦气化增加,导致硬组织床减少,在上颌后牙区无牙患者中植入牙种植体可能会遇到困难。种植体植入需要足够质量和数量的骨组织,尤其是在上颌后部。由于上颌窦扩张和牙槽嵴萎缩性减少,上颌骨该区域的骨高度和宽度不足,这是常规植入牙种植体的禁忌证。通过使用骨移植材料重建具有足够骨量和密度的无牙患者,随后植入牙种植体,已成为一种具有高可预测性的可行治疗选择。人们普遍认为,自体骨移植是上颌窦增高术和任何类型引导骨再生中骨移植的金标准方法。在本文中,作者报告了一例严重上颌萎缩病例,该病例通过取自髂嵴的块状骨移植进行了增高。组织学检查证明,由于手术部位愈合迅速,早期植入种植体是可行的。

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