Ahmed M, Abu Shama A, Hamdy R M, Ezz M
Department of Oral and Maxillofacial Surgery, Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt.
Department of Oral and Maxillofacial Surgery, Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt.
Int J Oral Maxillofac Surg. 2017 Sep;46(9):1178-1187. doi: 10.1016/j.ijom.2017.04.001. Epub 2017 May 2.
Maxillary sinus pneumatization limits implant placement in the edentulous posterior maxilla. Grafted sinus floor augmentation through Schneiderian membrane elevation and space obliteration with autogenous bone grafts, bone substitutes, or a combination of the two has often been used to resolve this problem. More recently, non-grafted sinus floor elevation has been established. This is based on the concept of membrane elevation and support either by tenting technique or using space-maintaining mesh. The aim of this study was to evaluate the predictability of new bone formation after sinus floor elevation using space-maintaining mesh without graft material and to illustrate the difference between the use of bioresorbable and titanium meshes. Eight patients with bilateral sinus pneumatization were selected for implant placement in the edentulous posterior maxilla. Pneumatized sinuses were approached through the lateral window technique; these were elevated and maintained with resorbable or titanium meshes. All patients were evaluated clinically and radiographically immediately and at 6 months postoperative. At 6 months, a core bone biopsy was obtained from the planned implant position using a trephine drill, and the bone formed was examined histologically. Healing was uneventful in all patients, and radiographic, clinical, and histological evidence of new bone formation was seen in both groups. Titanium and resorbable meshes were found to be reliable and predictable as space-maintaining devices.
上颌窦气化限制了无牙后上颌骨种植体的植入。通过上颌窦黏膜提升和使用自体骨移植、骨替代物或两者结合来闭塞空间进行植骨的上颌窦底提升术，常被用于解决这一问题。最近，非植骨上颌窦底提升术已确立。这基于通过帐篷技术或使用空间维持网片进行黏膜提升和支撑的概念。本研究的目的是评估使用无移植材料的空间维持网片进行上颌窦底提升后新骨形成的可预测性，并阐明生物可吸收网片和钛网片使用之间的差异。选择8例双侧上颌窦气化患者，在无牙后上颌骨植入种植体。通过侧窗技术进入气化的上颌窦；使用可吸收或钛网片将其提升并维持。所有患者在术后即刻及6个月时进行临床和影像学评估。在6个月时，使用环钻从计划种植部位获取骨芯活检标本，并对形成的骨进行组织学检查。所有患者愈合过程顺利，两组均可见新骨形成的影像学、临床和组织学证据。钛网片和可吸收网片作为空间维持装置被发现是可靠且可预测的。
