Teng Minhua, Liang Xing, Yuan Quan, Nie Jing, Ye Jun, Cheng Qian, Zhai Junjiang, Liao Jian, Sun Xu, Wen Cai, Mo Anchun
State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Dental Implant Center, West China College of Stomatology, Sichuan University, Chengdu, China.
Clin Implant Dent Relat Res. 2013 Dec;15(6):918-26. doi: 10.1111/cid.12088. Epub 2013 May 24.
To display an inlay technique of osteotome sinus floor elevation using a trephine combined with simultaneous short implant placement where the residual bone height (RBH) is less than 5 mm, as well as to evaluate the clinical effect in a prospective study.
Fifty short implants were installed in 32 patients in the severely atrophic posterior maxilla immediately after sinus floor elevation between January 2010 and October 2012. An inlay osteotome sinus augmentation technique using a trephine was applied in the operation. The mean residual bone height adjacent to or beneath the sinus was 3.34 mm, ranging from 0.96 mm to 4.96 mm. It was rarely necessary to add graft material from bovine sources in this therapy. With the purpose of bite training and soft tissue reforming, the temporary crowns were fixed after 6 months. The final prostheses were restored 3 months later. The stability and osseointegration of the implants were clinically evaluated, also the bone height gain around the implants was measured.
The survival rate was 100% during the study period with this procedure. Each of the implants, loaded without pain or any subjective sensation, was clinically stable. No implants had detectable sinus membrane perforation during operation. The radiographic results demonstrated that the bone height gain was 5.38 mm after the surgery.
Based on the results and within the limits of the present study, it can be suggested that short implant placement in conjunction with this inlay osteotome sinus augmentation technique could yield predictable clinical results for edentulous posterior maxillary region with RBH less than 5 mm. Besides, from the clinical point of view, these techniques may reduce the indication for complex invasive procedures and simplify treatment in the posterior.
展示一种在剩余骨高度(RBH)小于5毫米时使用环钻联合同期短种植体植入的骨凿上颌窦底提升嵌体技术,并在前瞻性研究中评估其临床效果。
2010年1月至2012年10月期间,在32例严重萎缩的上颌后牙区患者的上颌窦底提升后立即植入50颗短种植体。手术中采用环钻进行骨凿上颌窦扩大技术。上颌窦邻近或下方的平均剩余骨高度为3.34毫米,范围为0.96毫米至4.96毫米。在该治疗中很少需要添加牛源移植材料。为了进行咬合训练和软组织重塑,6个月后固定临时冠。3个月后修复最终修复体。对种植体的稳定性和骨结合进行临床评估,同时测量种植体周围的骨高度增加情况。
在此过程中,研究期间的生存率为100%。每个种植体在加载时均无疼痛或任何主观感觉,临床稳定。手术中没有种植体出现可检测到的上颌窦膜穿孔。影像学结果显示,术后骨高度增加了5.38毫米。
基于本研究结果并在其限制范围内,可以认为短种植体植入结合这种骨凿上颌窦扩大技术可为RBH小于5毫米的无牙上颌后牙区产生可预测的临床结果。此外,从临床角度来看,这些技术可能会减少复杂侵入性手术的适应症,并简化后部治疗。