Better Hadar, Chaushu Liat, Nissan Joseph, Xavier Samuel, Tallarico Marco, Chaushu Gavriel
Int J Periodontics Restorative Dent. 2018 July/August;38(4):601–606. doi: 10.11607/prd.2950. Epub 2017 Dec 18.
Hydraulic sinus lift and augmentation may be successfully performed using a dedicated implant device designed according to residual bone height (RBH). The aim of this study was to evaluate whether a flapless surgical approach might negatively influence the outcome. A total of 40 consecutive patients (16 men and 24 women) were included in the study, 20 in each group (minimal flap/control versus flapless/study). Inclusion criteria were ≥ 3 mm RBH, ≥ 6 mm width of the residual alveolar ridge according to preoperative cone beam computerized tomography, and ≥ 8 mm buccopalatal keratinized gingiva for the flapless group. Primary outcome parameters included intraoperative membrane perforation. Secondary outcome parameters included postoperative infection, soft tissue healing, bone gain, and short-term dental implant survival. Mean RBH was 4.6 mm. No intraoperative membrane perforations and no postoperative infections were observed. Mean bone gain height was similar for both groups, at 11 mm. Soft tissue healing was observed within 2 months. In all cases, second-stage surgery allowed generation of at least 2 mm of keratinized gingiva buccally. All implants were osseointegrated at second-stage surgery. The use of a flapless approach to maxillary sinus augmentation using an implant device based on RBH yields predictable results.
使用根据剩余骨高度（RBH）设计的专用种植体装置可成功进行水压式上颌窦提升和骨增量术。本研究的目的是评估无瓣手术方法是否会对结果产生负面影响。共有40例连续患者（16例男性和24例女性）纳入研究，每组20例（最小瓣/对照组与无瓣/研究组）。纳入标准为RBH≥3mm，根据术前锥形束计算机断层扫描，剩余牙槽嵴宽度≥6mm，无瓣组的颊腭角化龈≥8mm。主要结局参数包括术中膜穿孔。次要结局参数包括术后感染、软组织愈合、骨增量和短期牙种植体存留率。平均RBH为4.6mm。未观察到术中膜穿孔和术后感染。两组的平均骨增量高度相似，均为11mm。在2个月内观察到软组织愈合。在所有病例中，二期手术可在颊侧产生至少2mm的角化龈。所有种植体在二期手术时均实现骨整合。使用基于RBH的种植体装置对上颌窦进行无瓣提升术可产生可预测的结果。
