Periodontol 2000. 2017 Feb;73(1):103-120. doi: 10.1111/prd.12165.
Implant treatment in an atrophied edentulous posterior maxilla constitutes a challenge for the therapeutic team. The authors of the present study acknowledge that modern micro-rough surface implants in lengths of about 8-10 mm or longer and of different brands are similarly successful. Consequently, the authors propose that the use of different sinus floor elevation techniques should be considered when < 8 mm of bone is available below the maxillary sinus. The type of sinus floor elevation technique selected is mainly based on residual vertical bone height, marginal bone width, local intrasinus anatomy and the number of teeth to be replaced, although other factors (such as surgical training and surgical experience) may have an impact. It is proposed that a transcrestal sinus floor elevation approach can be considered as a first-choice method for single tooth gaps in situations with sufficient width for implant placement and a residual bone height of 5-8 mm, while lateral sinus floor elevation, with or without grafting materials, is indicated when < 5 mm of bone is available and when several teeth are to be replaced. With regard to time of implant placement, a one-stage procedure is preferred provided that high primary stability can be ensured.
在萎缩性无牙颌后上颌进行种植治疗对治疗团队来说是一个挑战。本文作者承认，现代微粗糙表面种植体的长度约为 8-10mm 或更长，且来自不同品牌，成功率也相似。因此，当上颌窦下的骨量不足 8mm 时，作者建议考虑使用不同的窦底提升技术。选择的窦底提升技术类型主要基于剩余垂直骨高度、边缘骨宽度、局部窦内解剖结构和要替换的牙齿数量，尽管其他因素（如手术培训和手术经验）也可能有影响。建议在有足够种植体放置宽度和 5-8mm 剩余骨高度的情况下，对于单个牙间隙，可以考虑经牙槽嵴窦底提升方法作为首选方法，而当骨量不足 5mm 且需要替换多颗牙齿时，可采用或不采用植骨材料的侧壁窦底提升方法。至于种植体放置的时间，如果能够确保较高的初始稳定性，作者更倾向于一期手术。
