Monje Alberto, Urban Istvan A, Miron Richard J, Caballe-Serrano Jordi, Buser Daniel, Wang Hom-Lay
Int J Periodontics Restorative Dent. 2017 Sep/Oct;37(5):e279-e289. doi: 10.11607/prd.3228.
Regenerative therapies are commonly needed prior to implant placement in the posterior maxilla following tooth extraction. The aim of this study was to investigate the anatomical features of the atrophic posterior maxilla that might affect surgical approach selection and technique and risk of intra- and postoperative complications. Cone beam computed tomography files were screened to identify pristine atrophic maxillary ridges in need of bone augmentation (ridge height < 10 mm). Ridge height and width and lateral wall thickness (LWT) were measured at different levels, and palatonasal recess and lateral wall morphology were calculated. The influence of site was assessed using generalized estimation equations. The linear correlation between parameters was estimated with Pearson coefficient, and principal component analysis (PCA) was performed to establish patterns of multiple correlations. In the 433 edentulous sites and 6,062 measurements analyzed, the strongest correlations corresponded to LWT measurements at the different levels. Most of the parameters examined presented linearity (P < .001), allowing establishment of four main morphologic patterns according to anatomical features. The anatomical structures of the atrophic posterior maxilla follow linear patterns that might predict complications due to an anatomical feature and thus success in regenerative therapy.
在拔除上颌后牙后进行种植体植入之前，通常需要进行再生治疗。本研究的目的是调查萎缩性上颌后牙区的解剖特征，这些特征可能会影响手术入路的选择、技术以及术中和术后并发症的风险。筛选锥形束计算机断层扫描文件，以识别需要骨增量的原始萎缩性上颌牙槽嵴（牙槽嵴高度<10mm）。在不同水平测量牙槽嵴高度、宽度和侧壁厚度（LWT），并计算腭鼻隐窝和侧壁形态。使用广义估计方程评估部位的影响。用Pearson系数估计参数之间的线性相关性，并进行主成分分析（PCA）以建立多重相关性模式。在分析的433个无牙区和6062次测量中，最强的相关性对应于不同水平的LWT测量。所检查的大多数参数呈现线性（P<.001），根据解剖特征可建立四种主要形态模式。萎缩性上颌后牙区的解剖结构遵循线性模式，这可能会因解剖特征而预测并发症，从而预测再生治疗的成功。
