Juodzbalys Gintaras
Department of Maxillofacial Surgery, Faculty of Odontology, Medical Academy Lithuanian University of Health Sciences, KaunasLithuania.
Dental implant centre 'Stilus Optimus', KaunasLithuania.
J Oral Maxillofac Res. 2022 Sep 30;13(3):e5. doi: 10.5037/jomr.2022.13305. eCollection 2022 Jul-Sep.
Focal osteoporotic bone marrow defect is asymptomatic radiolucent area usually discovered incidentally during radiographic examination of the jaws. This bone condition can lead to clinical complications during dental implant placement or during osseointegration process.
A 54-year-old woman was referred to private dental implant centre for a dental implant rehabilitation treatment in May 17, 2016. Oral examination revealed a healthy mucosa with no visible pathology. Adentia of tooth #46 and moderate atrophy of the edentulous alveolar process were found. Panoramic radiography of the jaws showed 2 cm x 2 cm radiolucency with irregular borders located in tooth #46 region. The margins of the bone defect were uneven, single trabeculae were visible, and the cortical layer was not deformed. In the absence of signs of pathology, it was decided to perform a dental implant surgery in the edentulous jaw segment #46.
The osteoporotic focus was filled with natural bovine bone substitute Cerabone. The granules were gently condensed to the sides - to the buccal and lingual walls until they filled the entire cavity. A 10 mm long, 4.1 mm diameter Straumann Tissue Level implant was surgically placed with the shoulder of the implant resting on the margins of the osteotomy. It was proposed six steps protocol for surgical dental implant installation in focal osteoporotic bone marrow defect in mandible.
A six-step protocol for surgical placement of dental implants in focal osteoporotic bone marrow defects may be a useful tool for clinicians in implant dentistry.
局灶性骨质疏松性骨髓缺损是一种无症状的透射区，通常在颌骨影像学检查中偶然发现。这种骨质情况在牙种植体植入或骨整合过程中可能导致临床并发症。
一名54岁女性于2016年5月17日被转诊至一家私立牙种植中心进行牙种植修复治疗。口腔检查显示黏膜健康，无明显病变。发现46号牙缺失，无牙牙槽突中度萎缩。颌骨全景片显示在46号牙区域有一个2 cm×2 cm边界不规则的透射区。骨缺损边缘不平整，可见单小梁，皮质层未变形。在无病变迹象的情况下，决定在无牙颌的46号牙段进行牙种植手术。
骨质疏松灶用天然牛骨替代物Cerabone填充。颗粒被轻轻挤压到颊侧和舌侧壁，直至填满整个腔隙。手术植入一枚10 mm长、4.1 mm直径的Straumann软组织水平种植体，种植体肩部位于截骨边缘。提出了下颌局灶性骨质疏松性骨髓缺损中牙种植手术植入的六步方案。
局灶性骨质疏松性骨髓缺损中牙种植手术植入的六步方案可能是种植牙科临床医生的一个有用工具。
