Department of Periodontology, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel.
J Periodontol. 2011 Jan;82(1):41-51. doi: 10.1902/jop.2010.090682. Epub 2010 Aug 23.
The crestal core elevation (CCE) technique is reportedly a less invasive procedure than the lateral window elevation technique. We retrospectively evaluated long-term outcomes of CCE procedures over an 11-year time period.
Core preparations were made after extractions of 57 upper molars in 45 patients. Extraction sites were drilled with a calibrated trephine bur to an estimated distance of 1 mm from the sinus membrane. The trephined interradicular bone and underlying sinus membrane were imploded into the sinus. The surgical crater and residual extraction socket were filled with deproteinized bovine bone mineral or freeze-dried bone allograft, stabilized, and protected with an absorbable collagen membrane and fully covered with coronally positioned flaps. Implants were placed 4 months later. Success was defined if ≥9 mm available bone height was available. Where the available bone height varied between 7 and 9 mm, implant placement was complemented using the bone-added osteotome sinus floor elevation technique; those sites were defined as a "partial success."
The CCE technique was successful in 31 (68.9%) out of 45 sites, and partially successful in six (13.3%) out of 45 sites. Eight sites failed (17.8%). Surgical failures were caused by core detachment resulting in large tears of the sinus membrane. Implants placed in successful sites presented a 100% survival rate during the study duration.
CCE implemented simultaneously with molar extractions provided therapeutic benefits and clinical limitations. The subsequent implant placement using CCE revealed an excellent survival rate in the study population evaluated.
据报道，相较于侧壁开窗提升术，牙冠顶提升（CCE）技术是一种侵袭性更小的手术。我们对该技术在 11 年时间跨度内的长期效果进行了回顾性评估。
在 45 名患者的 57 颗上颌磨牙拔除后进行核心预备。使用校准的环钻以估计距离窦膜 1mm 的距离在拔牙窝处进行钻孔。然后将环钻所取的根间骨和下方的窦膜一起压入窦腔。手术凹陷和残留的拔牙窝用脱蛋白牛骨矿物质或冻干骨移植物填充，用可吸收胶原膜固定和保护，并完全用冠向定位瓣覆盖。4 个月后放置种植体。如果有≥9mm 的可用骨高度，则认为手术成功。如果可用骨高度在 7 至 9mm 之间，使用加骨骨凿窦底提升技术补充种植体放置；这些部位被定义为“部分成功”。
在 45 个部位中，31 个（68.9%）部位的 CCE 技术成功，6 个（13.3%）部位部分成功。8 个部位失败（17.8%）。手术失败是由于核心分离导致窦膜大撕裂。在研究期间，成功植入部位的种植体存活率为 100%。
与磨牙拔除同时实施的 CCE 提供了治疗益处和临床限制。在本研究人群中，使用 CCE 进行后续种植体放置显示出了极好的存活率。
