Private practice, Prosthesis and Dental implant surgery, Rome, Italy.
Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 6. Caserta St., 00161, Rome, Italy.
BMC Oral Health. 2020 Oct 7;20(1):273. doi: 10.1186/s12903-020-01268-3.
The insertion of dental implants in the atrophic posterior maxilla can be a challenge. One option is to modify the residual native bone in preparation for proper, prosthetically-driven implant placement. The procedure presented in this study is called Navigated Antral Bone Expansion (N.A.B.E). This procedure employs the use of a navigation system to plan and guide the initial pilot drilling, bone expansion, final site preparation, and implant insertion. The aim of this study was to compare the distance between the alveolar ridge and the sinus floor measured before and after the surgery performed using the N.A.B.E.
Thirty-seven partially edentulous patients who were candidates for implant supported restoration in the posterior maxilla, with a bone height ranging from 4 to 7 mm were enrolled. The N.A.B.E procedure was used to increase the bone height. Paired-samples t-test evaluated the distance between the alveolar ridge and the sinus floor measured before and after surgery. The occurrence of post-surgical complications, and the angular deviation between the planned osteotomy and the actual placed implant trajectories were evaluated.
Out of the 37 consecutive patients enrolled in the study, 35 were considered in the data analyses. Patients' bone height after surgery compared to the bone height before surgery showed a statistically significant increase (p < .0005) of 3.96 mm (95% CI, 3.62 mm to 4.30 mm). No post-operative complications were observed in the 35 patients. The mean angular deviation between the planned osteotomy trajectory and the placed implant trajectory ranged between 12.70 to 34.90 (mean 25.17 ± 5.10).
This study provides evidence that N.A.B.E. technique is able to provide a significant bone increase, and could be considered an alternative method to the management of the atrophic posterior maxilla with a minimally invasive approach.
在上颌后牙区牙槽嵴萎缩的情况下植入种植体具有挑战性。一种选择是对残留的天然骨进行处理，为适当的、基于修复体的种植体植入做好准备。本研究中介绍的程序称为经导航的窦底扩展（N.A.B.E.）。该程序使用导航系统来规划和引导初始导钻、骨扩展、最终位点准备和种植体植入。本研究的目的是比较使用 N.A.B.E. 前后手术中牙槽嵴和窦底之间的距离。
纳入 37 名上颌后牙区部分缺牙、骨高度为 4-7mm 并适合植入物修复的患者。采用 N.A.B.E. 程序增加骨高度。采用配对样本 t 检验评估手术前后牙槽嵴和窦底之间的距离。评估术后并发症的发生情况，以及计划截骨线与实际植入体轨迹之间的角度偏差。
在连续纳入的 37 名患者中，有 35 名患者纳入数据分析。与术前相比，术后患者的骨高度增加了 3.96mm（95%CI，3.62mm 至 4.30mm），差异有统计学意义（p<0.0005）。35 名患者均未出现术后并发症。计划截骨线与实际植入体轨迹之间的平均角度偏差在 12.70°至 34.90°之间（平均 25.17°±5.10°）。
本研究表明，N.A.B.E. 技术能够显著增加骨量，可作为一种微创方法治疗上颌后牙区牙槽嵴萎缩的替代方法。
