Anitua Eduardo
Private Practice, Eduardo Anitua Clinic, Vitoria, Spain.
University Institute for Regenerative Medicine and Oral Implantology, UPV/EHU - Eduardo Anitua Foundation, Vitoria, Spain.
Eur J Dent. 2023 May;17(2):560-566. doi: 10.1055/s-0042-1755557. Epub 2023 Jan 25.
Severe atrophic posterior maxillary ridge (residual bone height < 3 mm) could be a challenging situation to place dental implants. Several treatment options have been proposed, but some of them may require advanced surgical skills to achieve best results. In this article, we present a novel and easier technique to allow implant placing in localized areas of severe atrophy. In a first step, a 4.5-length extra-short (unloaded) implant is placed after a transcrestal maxillary sinus floor augmentation (MSFA). After the gained apical bone consolidation, this "temporary implant" is atraumatically removed and a longer and wider definitive implant is placed to support the definitive single restoration. The case of a 45-year-old female treated with this approach is also presented. The patient suffered a severe resorption in the upper right molar area after a tooth extraction. Four months after the "temporary implant" placement and MSFA grafting with plasma rich in growth factors and autologous bone, 3 mm of dense apical bone gain could be observed. In a second surgical time, the 4.5 mm-length "temporary implant" was removed, and a 5.5 mm-length "definitive implant" was placed. This second implant was placed in a denser type 1 (1,000 Hounsfield Unit) new formed apical bone. Four months later, the implant was loaded with a screw-retained crown over a transepithelial (intermediate abutment). After 1-year follow-up, the implant was in health and no mechanical or biological complications were noticed. The satisfactory results of this case encourage the realization of new studies to elucidate its reproducibility.
严重萎缩的上颌后牙嵴（剩余骨高度＜3mm）可能是种植牙植入的一个具有挑战性的情况。已经提出了几种治疗方案，但其中一些可能需要先进的手术技巧才能取得最佳效果。在本文中，我们提出了一种新颖且更简便的技术，以允许在严重萎缩的局部区域植入种植体。第一步，在经牙槽嵴上颌窦底提升术（MSFA）后植入一枚4.5长度的超短（未负重）种植体。在获得根尖骨巩固后，将这枚“临时种植体”无创伤地取出，然后植入一枚更长、更宽的最终种植体以支持最终的单冠修复。本文还介绍了一名采用此方法治疗的45岁女性患者的病例。该患者拔牙后右上磨牙区出现严重吸收。在植入“临时种植体”并使用富含生长因子的血浆和自体骨进行MSFA植骨四个月后，可观察到根尖部有3mm的致密骨生长。在第二次手术时，取出4.5mm长度的“临时种植体”，植入一枚5.5mm长度的“最终种植体”。这枚第二次植入的种植体被植入到密度更高的1型（1000亨氏单位）新形成的根尖骨中。四个月后，通过经上皮（中间基台）为种植体安装了一枚螺丝固位的牙冠。经过1年的随访，种植体状况良好，未发现机械或生物学并发症。该病例的满意结果促使开展新的研究以阐明其可重复性。
