Cruz Mauro, Cruz Gustavo, Cruz Fernando, Morales-Vadillo Rafael, Cruz-Pierce Silvia
Int J Oral Maxillofac Implants. 2018 Mar/Apr;33(2):412-418. doi: 10.11607/jomi.5941.
To present a technique to rehabilitate atrophied alveolar ridges in the posterior maxilla and mandible using bone lateral to the maxillary sinus and to the inferior alveolar nerve and to present a retrospective study of the technique.
Severe resorption of the posterior region of the maxilla and mandible was treated following a conservative approach. Patients who presented this bone crest condition that impeded the placement of implants and had an anatomy that allowed the inferior alveolar nerve or the maxillary sinus to be approached laterally were treated. The bone ridge thickness lateral to the maxillary sinus and the inferior alveolar nerve was measured by computed tomography, and implants with a wedge-shaped design were placed in the available bone. A retrospective review of clinical records of these patients, treated between 1998 and 2012 at the Clinest - Clinical Center of Research in Stomatology, was conducted. The studied variables were surgical and prosthetic complications, the implant survival rate, and the difference between the remaining bone ridge measurement in the ridge center and the implant length placed laterally.
Fifty-six patients met the inclusion criteria. These patients received 208 implants according to the aforementioned technique. The mean implant length gain was 6.9 mm, varying from 0.5 to 12 mm. The cumulative survival rate was high for both maxillaries. For the implants placed beside the inferior alveolar nerve, none were lost at 2 years, two were lost at 5 years, and four were lost at 10 years. For the implants placed beside the maxillary sinus, only four implants were lost at 10 years. Nerve injuries and surgical/prosthetic complications occurred but were not significant.
The use of available bone alongside the maxillary sinus and inferior alveolar nerve to place implants is a surgical possibility, and a predictable, safe approach, albeit delicate and experience-dependent.
介绍一种利用上颌窦外侧及下牙槽神经外侧的骨组织修复上颌后牙区和下颌后牙区萎缩牙槽嵴的技术，并对该技术进行回顾性研究。
采用保守方法治疗上颌和下颌后牙区的严重吸收。治疗那些出现这种妨碍种植体植入的牙槽嵴情况且解剖结构允许从外侧接近下牙槽神经或上颌窦的患者。通过计算机断层扫描测量上颌窦外侧和下牙槽神经外侧的骨嵴厚度，并将楔形设计的种植体植入可用骨中。对1998年至2012年在Clinest - 口腔医学研究临床中心接受治疗的这些患者的临床记录进行回顾性分析。研究变量包括手术和修复并发症、种植体存活率以及牙槽嵴中心剩余骨嵴测量值与外侧植入种植体长度之间的差异。
56例患者符合纳入标准。这些患者根据上述技术接受了208颗种植体植入。种植体平均长度增加6.9mm，范围为0.5至12mm。上颌的累积存活率都很高。对于植入在下牙槽神经旁侧的种植体，2年时无一丢失，5年时丢失2颗，10年时丢失4颗。对于植入在上颌窦旁侧的种植体，10年时仅4颗种植体丢失。发生了神经损伤以及手术/修复并发症，但不显著。
利用上颌窦和下牙槽神经旁侧的可用骨组织植入种植体是一种手术可行的、可预测的、安全的方法，尽管操作精细且依赖经验。
