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在内窥镜辅助下,于根尖周病变部位即刻植入时使用富血小板纤维蛋白进行经牙槽嵴窦底提升术:一例报告。

The endoscopically assisted transcrestal sinus floor elevation with platelet-rich fibrin at an immediate implantation of periapical lesion site: A case report.

作者信息

Wang Hanchi, Wang Jia, Guo Tianqi, Ding Xinxin, Yu Wanqi, Zhao Jinghui, Zhou Yanmin

机构信息

School and Hospital of Stomatology, Jilin University, Department of Dental Implantology, Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Changchun, Jilin Province, China.

出版信息

Medicine (Baltimore). 2019 Jul;98(27):e16251. doi: 10.1097/MD.0000000000016251.

Abstract

RATIONALE

The traditional maxillary sinus floor elevation has serious postoperative complications and long healing periods, for patients with insufficient residual bone height (RBH). The endoscopic technique improves the blind nature of the sinus floor elevation procedure. Platelet-rich fibrin (PRF) can promote tissue healing and prevent perforation.

PATIENT CONCERN

A 25-year-old female with residual roots in the maxillary right second molar visited our hospital for dental implants.

DIAGNOSE

CBCT results showed a low-density shadow at the root tip, and the height of the periapical distance from the maxillary sinus floor was less than 1 mm.

INTERVENTION

Patient was immediately subjected to implant after root extraction. Two-step sinus floor elevation was performed under endoscopy. A 12 mm-long implant was installed.

OUTCOMES

At 10 months after surgery, the hard and soft tissues were stable, and a full-ceramic crown was placed.

LESSONS

Immediate implant and endoscope-guided sinus floor elevation through a transcrestal approach by using PRF as the only grafting material is viable in periapical infected sites with a RBH of less than 1 mm.

摘要

原理

对于剩余骨高度(RBH)不足的患者,传统的上颌窦底提升术术后并发症严重且愈合期长。内镜技术改善了窦底提升术的盲目性。富血小板纤维蛋白(PRF)可促进组织愈合并防止穿孔。

患者情况

一名25岁女性,上颌右侧第二磨牙有残根,来我院进行牙种植。

诊断

CBCT结果显示根尖处有低密度影,根尖距上颌窦底的高度小于1毫米。

干预措施

患者拔牙后立即进行种植。在内镜下进行两步法窦底提升。植入一枚12毫米长的种植体。

结果

术后10个月,软硬组织稳定,安装了全瓷冠。

经验教训

对于RBH小于1毫米的根尖感染部位,立即种植并通过经牙槽嵴入路在内镜引导下使用PRF作为唯一的移植材料进行窦底提升是可行的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ffb7/6635277/f357c60fb780/medi-98-e16251-g001.jpg

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