*Professor, Department of Oral and Maxillofacial Surgery, School of Dentistry, Lebanese University, Beirut, Lebanon. †Clinical Assistant, Department of Oral and Maxillofacial Surgery, School of Dentistry, Lebanese University, Beirut, Lebanon. ‡Professor, Laboratory of Cancer Biology and Molecular Immunology, Department of Biology, Faculty of Science I, Lebanese University, Beirut, Lebanon. §Professor, Department of Pathology, Faculty of Medicine, Lebanese University, Beirut, Lebanon. ¶Assistant Professor, Department of Ear Nose and Throat, Faculty of Medicine, Lebanese University, Beirut, Lebanon.
Implant Dent. 2017 Oct;26(5):674-681. doi: 10.1097/ID.0000000000000631.
The aim of this study was to clinically, radiologically, and histologically evaluate a sinus augmentation technique using a resorbable collagen sponge to maintain space between the Schneiderian membrane and the residual crestal bone.
Patients with partially edentulous maxillae were clinically and radiographically evaluated for implant placement. A total of 10 consecutive patients with the bone height for implant placement (<4.0 mm) were enrolled in the study. The lateral maxillary wall was surgically exposed and the Schneiderian membrane was carefully elevated. A collagen wound dressing was placed in the antral area between the sinus floor and the raised membrane. The vertical sinus floor height was calculated using cone-beam computed tomography before the surgical procedure (baseline) and at 6 months postoperative. Immediately after the second scan, a core biopsy was removed for histological evaluation. The biopsy site was then further prepared for implant placement in the same location.
Biopsies showed mature cancellous bone with a predominantly lamellar structure. Well-vascularized intertrabecular spaces were filled with connective tissue and bone marrow. Analysis of bone height changes showed significant mean (SD) differences before and after procedures in anterior (2.67 ± 0.62 mm and 11.15 ± 1.1 mm), medial (2.98 ± 0.55 mm and 10.96 ± 0.77 mm), and posterior (3.17 ± 0.91 mm and 10.63 ± 0.51 mm) maxillary jaw locations (P = 0.005).
The collagen sponge provided an effective substrate for osseous regeneration of the sinus floor.
本研究旨在通过使用可吸收胶原海绵对窦腔提升技术进行临床、放射学和组织学评估，以维持硬脑膜和剩余牙槽嵴骨之间的空间。
对部分无牙上颌骨患者进行临床和放射学评估以进行种植体放置。共有 10 名连续的患者（骨高度适合植入物放置<4.0 毫米）被纳入本研究。手术暴露上颌骨外侧壁，并小心抬起硬脑膜。在窦底和抬起的硬脑膜之间的窦腔区域放置胶原伤口敷料。在手术前（基线）和术后 6 个月使用锥形束计算机断层扫描（CBCT）计算垂直窦底高度。在第二次扫描后立即取出核心活检进行组织学评估。然后在同一位置进一步准备活检部位以进行植入物放置。
活检显示成熟的松质骨，具有主要的板层结构。血管丰富的骨小梁间空间充满结缔组织和骨髓。骨高度变化分析显示，在前部（2.67 ± 0.62 毫米和 11.15 ± 1.1 毫米）、内侧部（2.98 ± 0.55 毫米和 10.96 ± 0.77 毫米）和后部（3.17 ± 0.91 毫米和 10.63 ± 0.51 毫米）上颌骨位置，术前和术后有显著的平均（SD）差异（P = 0.005）。
胶原海绵为窦底的骨质再生提供了有效的基质。
