Mazor Ziv, Mamidwar Sachin
Private practice, Ra'anana, Israel.
Orthogen, Springfield, NJ.
Clin Adv Periodontics. 2015 Feb;5(1):76-81. doi: 10.1902/cap.2013.130022.
Patients with an edentulous posterior maxillary segment frequently lack adequate bone mass to support dental implants. Implant placement into the posterior maxillary ridge can be complicated by limited quantity and poor quality of bone. Sinus lift and bone grafting result in bone regeneration as well as an increase in bone volume and hence help stabilize implants. The challenge of bone deficiency of this segment has been traditionally addressed by two approaches: 1) lateral maxillary window (hinge osteotomy) and 2) the crestal approach via osteotome technique.
A 70-year-old female patient presented needing a full maxillary rehabilitation. The osteotome-closed approach was used on the right side, which was grafted with nanocrystalline calcium sulfate (nCS) bone graft. The lateral window sinus elevation approach was used on the left side, which was grafted with nCS in combination with platelet-rich fibrin. Implants were placed simultaneously. Computed tomography scans showed bone formation in the augmented sites at 6 months. Implants were restored at this time. A 2-year follow-up showed satisfactory results with good implant stability.
This case demonstrates the effective use of nCS for sinus-augmentation cases.
上颌后牙区无牙患者常常缺乏足够的骨量来支持牙种植体。由于骨量有限且质量较差,在上颌后牙嵴植入种植体可能会很复杂。上颌窦提升和骨移植可实现骨再生并增加骨量,从而有助于种植体的稳定。传统上,针对该区域骨量不足的问题有两种解决方法:1)上颌外侧开窗术(铰链式截骨术)和2)通过骨凿技术的嵴顶入路。
一名70岁女性患者需要进行全上颌修复。右侧采用骨凿闭合入路,并植入了纳米晶硫酸钙(nCS)骨移植材料。左侧采用外侧开窗上颌窦提升入路,并植入了nCS与富血小板纤维蛋白的复合材料。同时植入种植体。计算机断层扫描显示,6个月时植骨部位有骨形成。此时进行种植体修复。2年随访结果显示效果满意,种植体稳定性良好。
本病例证明了nCS在上颌窦增量病例中的有效应用。