在高度萎缩牙槽嵴中使用4.5毫米无负载种植体作为“临时种植体”的两步渐进式经牙槽嵴上颌窦增量术:病例报告

Two-Step Progressive Transcrestal Sinus Augmentation Using a 4.5 mm Unloaded Implant as a "Temporary Implant" in Highly Atrophic Ridge: Case Report.

作者信息

Anitua Eduardo

机构信息

Private Practice, Eduardo Anitua Clinic, Vitoria, Spain.

University Institute for Regenerative Medicine and Oral Implantology, UPV/EHU - Eduardo Anitua Foundation, Vitoria, Spain.

出版信息

Eur J Dent. 2023 May;17(2):560-566. doi: 10.1055/s-0042-1755557. Epub 2023 Jan 25.

Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6195/10329543/b04fdd94824e/10-1055-s-0042-1755557-i2252126-1.jpg

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