Jensen Ole T, Cottam Jared, Ringeman Jason, Adams Mark
ClearChoice Dental Implant Center, Greenwood Village, CO, USA.
J Oral Maxillofac Surg. 2012 Jan;70(1):141-8. doi: 10.1016/j.joms.2011.03.045. Epub 2011 Jul 28.
The aim of this study was to evaluate the clinical outcomes of trans-sinus dental implant placement by use of bone morphogenetic protein 2 (BMP-2) grafting and immediate functional loading by the all-on-4 scheme.
After bone reduction to create the all-on-4 shelf or because of severe maxillary atrophy and prominent sinus anatomy, 10 patients were selected to undergo trans-sinus implant placement and simultaneous BMP-2 sinus floor grafting for immediate provisional loading. Insertion torque was measured upon implant placement. Patients were followed up for at least 1 year after final restoration when either a computed tomography scan or panoramic radiograph was obtained and analyzed for the presence of trans-sinus peri-implant bone. Hounsfield units were recorded mid sinus graft.
Of 19 trans-sinus implants, 18 remained integrated at the 1-year follow-up, for a 5.2% failure rate. All sinus grafts formed bone, with a mean of 460 Hounsfield units. Final fixed prostheses were completed for all 10 patients.
Trans-sinus dental implant placement with BMP-2 grafting to gain anterior-posterior spread for immediate function by use of all-on-4 treatment appears to be a viable alternative to the use of zygomatic implants in the presence of severe maxillary atrophy.
本研究旨在评估采用骨形态发生蛋白2（BMP-2）植骨并通过全口4颗种植体方案进行即刻功能负载的经鼻窦种植体植入的临床效果。
在进行骨量减少以形成全口4颗种植体的平台后，或因严重上颌骨萎缩及鼻窦解剖结构突出，选择10例患者接受经鼻窦种植体植入及同时进行BMP-2鼻窦底植骨以进行即刻临时负载。在种植体植入时测量植入扭矩。在最终修复后至少随访1年，期间获取计算机断层扫描或全景X线片，并分析经鼻窦种植体周围骨的情况。记录鼻窦植骨中部的亨氏单位。
在19颗经鼻窦种植体中，18颗在1年随访时仍保持整合，失败率为5.2%。所有鼻窦植骨均形成了骨，平均亨氏单位为460。为所有10例患者完成了最终的固定修复体。
在存在严重上颌骨萎缩的情况下，采用BMP-2植骨的经鼻窦种植体植入以通过全口4颗种植体治疗获得前后向扩展以实现即刻功能，似乎是使用颧骨种植体的一种可行替代方法。
