Guillemant H, Mouigha A, Vienne A, Libersa J-C, Ferri J
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Rev Stomatol Chir Maxillofac. 2012 Dec;113(6):448-54. doi: 10.1016/j.stomax.2012.07.009. Epub 2012 Nov 28.
Implanting on an atrophic maxilla alveolar ridge may require bone augmentation. Screwed expanders may sometimes be used, thus avoiding a more invasive bone graft. It allows bone density to increase and results in alveolar ridge expansion, by using bone elasticity and adaptation, allows the optimization of the available bone volume, with low morbidity.
Despite its apparent simple implementation, the technique should be adapted to each type of bone so as to optimize results. We present two clinical cases, use of screwed expanders, their action on the crestal bone, and the limitations of this technique depending on ridge configuration.
Screwed expanders are non-traumatic easy-to-use tools. They can be inserted like implants because they have a good self-tapping effect. Their use is more secure in narrow spaces; they are more comfortable for the patient than impacted expanders use. They allow increase of cancellous bone density, which improves primary stability in case of low density bone. Bone volume preservation and avoiding bone grafts can shorten the implant treatment procedure and decrease costs for the patient. Unfortunately, this technique does not allow alveolar ridge height increase. If this is required, onlay graft or guided tissue generation are the best alternatives.
在萎缩的上颌牙槽嵴上植入种植体可能需要进行骨增量。有时可使用螺纹扩张器，从而避免更具侵入性的骨移植。通过利用骨弹性和适应性，它能使骨密度增加并导致牙槽嵴扩张，进而优化可用骨体积，且发病率较低。
尽管该技术表面上实施起来较为简单，但应根据每种骨类型进行调整以优化效果。我们展示两个临床病例，介绍螺纹扩张器的使用、其对嵴顶骨的作用以及根据牙槽嵴形态该技术的局限性。
螺纹扩张器是无创且易于使用的工具。由于具有良好的自攻效果，它们可以像种植体一样植入。在狭窄空间使用时更安全；与冲击式扩张器相比，患者使用起来更舒适。它们能增加松质骨密度，在骨密度较低的情况下可提高初期稳定性。保留骨体积并避免骨移植可缩短种植治疗过程并降低患者费用。不幸的是，该技术无法增加牙槽嵴高度。如果需要增加牙槽嵴高度，覆盖植骨或引导组织再生是最佳选择。
