Xu Jing
Department of Oral and Maxillofacial Surgery, Stomatological Hospital, Southern Medical University (Guangdong Provincial Stomatological Hospital), Guangzhou 510280, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2019 Jan 30;39(1):100-105. doi: 10.12122/j.issn.1673-4254.2019.01.16.
To explore the feasibility of immediate implantation after tooth extraction in the maxillary molar socket with poor bone quality beneath the sinus.
We collected the data from the patients undergoing extraction of maxillary molars with poor bone quality between the sockets and sinuses. Sinus lifting and immediate implant following the extraction were performed simultaneously in these cases, and the primary stability of the implants, wound healing, and changes of the sinus were observed. At 6 months after the operations, the crowns were installed on the implants. The masticatory function was observed, and the growth of the alveolar bones and their changes after the operations were examined using microcomputed tomography (MCT).
We analyzed 32 extraction cases with immediate implantation in the maxillary molar sockets with poor bone quality beneath the sinus. The average age of the patients was 59.8 years, and the length and diameter of the implant ranged from 8.5 to 10 mm and from 4.5 to 5.5 mm, respectively. The torque force of the implants varied from the minimum (in which cases the implants remained fixed after insertion with fingers) to the maximum of 30 N·cm. The postoperative recovery was uneventful in all the cases and no failed or movable implants were found. At 6 months after the operation, none of the patients showed abnormalities in the sinus, and in all the cases the crowns were successfully installed on the implants with good recovery of the masticatory functions. Follow-up of the patients for 12 to 96 months after the operation showed successful immediate implantation in all the cases. After the operation, the changes of the mean alveolar ridge heights on the buccal, palatal, mesial, and distal sides of the patients were 0.8069±0.6253 mm (=1.2904, >0.1), 0.5272± 0.3331 mm (=1.5836, >0.05), 0.5416±0.4048 mm (=1.3379, >0.05), and 0.5172±0.3874 mm (=1.3351, >0.05), respectively; the change of the alveolar ridge width was 0.5522±0.4381 mm (=1.2604, >0.1) mm. The dimension of the alveolar bone underwent no significant changes after the operation in these patients.
Immediate implantation in the maxillary extraction socket with a poor bone quality can avoid damages to the sinus and achieve good outcomes with such advantages of less trauma, full use of the innate gingiva and alveolar ridge, and well preserved morphology of the alveolar ridge as compared with delayed implantation.
探讨在上颌磨牙拔牙窝窦底骨质较差的情况下即刻种植的可行性。
收集上颌磨牙拔牙窝与窦底间骨质较差患者的数据。对这些病例在拔牙同时行上颌窦提升和即刻种植，观察种植体的初期稳定性、伤口愈合情况及上颌窦的变化。术后6个月在种植体上安装牙冠，观察咀嚼功能，并使用微型计算机断层扫描（MCT）检查牙槽骨的生长及术后变化。
分析32例上颌磨牙拔牙窝窦底骨质较差的即刻种植病例。患者平均年龄59.8岁，种植体长8.5至10 mm，直径4.5至5.5 mm。种植体的扭矩力从最小（插入后用手指即可固定）到最大30 N·cm不等。所有病例术后恢复顺利，未发现种植体失败或松动。术后6个月，所有患者上颌窦均无异常，所有病例牙冠均成功安装在种植体上，咀嚼功能恢复良好。术后对患者随访12至96个月，所有病例即刻种植均成功。术后患者颊侧、腭侧、近中侧和远中侧牙槽嵴平均高度变化分别为0.8069±0.6253 mm（=1.2904，>0.1）、0.5272±0.3331 mm（=1.5836，>0.05）、0.5416±0.4048 mm（=1.3379，>0.05）和0.5172±0.3874 mm（=1.3351，>0.05）；牙槽嵴宽度变化为0.5522±0.4381 mm（=1.2604，>0.1）mm。这些患者术后牙槽骨尺寸无明显变化。
在上颌拔牙窝骨质较差的情况下即刻种植可避免对上颌窦的损伤，与延期种植相比，具有创伤小、充分利用天然牙龈和牙槽嵴、较好保留牙槽嵴形态等优点，效果良好。
