Andreasi Bassi M, Lopez M A, Andrisani C, Ormanier Z, Gargari M
Private Practice, Rome, Italy.
Private Practice, Matera, Italy.
Oral Implantol (Rome). 2016 Nov 13;9(3):115-122. doi: 10.11138/orl/2016.9.3.115. eCollection 2016 Jul-Sep.
The edentulous severely atrophic maxilla, as consequence of alveolar bone resorption and pneumatisation of the maxillary sinus, represents a serious limitation to the implant rehabilitation. Implants insertion via palatal approach (PA), in combination with relatively minimally invasive techniques aimed at increasing bone volume without the use of autologous bone harvesting is a valid alternative among the options for the rehabilitation of the upper jaw.
In a 70-year-old female, with a severe maxillary atrophy, 6 spiral taper implants were placed with the PA, combined with the bilateral transcrestal elevation of both the sinus floors and nasal cavities; a further GBR, with resorbable pericardium membrane covering a termoplastic allograft associated to a xenograft, was performed. The second stage was performed after 6 months. Implant prosthetic functionalization was carried out in 4 months by placing the removable prosthesis in direct contact with the healing cup screws. After that period the case was finalized with a hybrid prosthesis. Clinical and radiographic follow-ups were carried out at 6 months and at one year after prosthetic finalization, during which no pathological signs were recorded.
The PA implant insertion described by the Authors, combined with bone augmentation procedures, performed in the same stage, may represent a valid and reliable solution to rehabilitate maxillary edentulous patients.
由于牙槽骨吸收和上颌窦气化，无牙的严重萎缩性上颌骨对种植修复构成严重限制。通过腭侧入路（PA）植入种植体，结合相对微创的技术以增加骨量且无需自体骨采集，是上颌骨修复方案中的一种有效替代方法。
在一名70岁的严重上颌骨萎缩女性患者中，通过PA植入了6枚螺旋锥形种植体，并结合双侧上颌窦底和鼻腔的经嵴顶提升；进一步进行了引导骨再生（GBR），使用可吸收心包膜覆盖与异种移植物相关的热塑性同种异体移植物。6个月后进行了二期手术。4个月后通过将可摘义齿直接与愈合帽螺钉接触进行种植体修复功能化。在此之后，该病例最终采用混合义齿完成修复。在修复完成后的6个月和1年进行了临床和影像学随访，期间未记录到病理迹象。
作者描述的PA种植体植入方法，结合同期进行的骨增量手术，可能是修复上颌无牙患者的一种有效且可靠的解决方案。
