Oh Simon, Zelig David, Aalam Alexandre Amir, Kurtzman Gregori M
Private practice - Oral Surgery, Fair Hills, Pennsylvania.
Private practice - Oral Surgery, Clifton, New Jersey.
Ann Med Surg (Lond). 2023 Apr 11;85(5):1959-1965. doi: 10.1097/MS9.0000000000000520. eCollection 2023 May.
Severe bone loss in the anterior maxilla poses challenges to implant placement, especially when treating the entire arch. Utilization of zygomatic implants may not allow positioning of the implant platform anterior enough to properly support the full arch prosthesis, leaving an anterior cantilever in some clinical cases.
Placement of implants into the trans-nasal bone between the pneumatized maxillary sinus and nasal fossa allows utilization of an extralong implant in this residual bone to augment zygomatic implants placed distal to this for better support of a full arch prosthesis.
A typical case is presented with insufficient alveolar height for traditional implant placement in the anterior maxilla following extraction of the dentition related to bone loss resulting from periodontal disease. Review of the anatomy and technique for placement of implants into the Z-point area for trans-nasal implants.
This article discusses the utilization of trans-nasal implants into the Z-point and the technique for placement in this residual bone with a case example.
The Z-point implant aids in the elimination of the anterior cantilever that may be present due to the most anterior the platform for the zygomatic implant can be placed. Trans-nasal implants should be considered as part of the treatment plan in severely resorbed maxillary arches to allow better implant to spread and load management during functioning.
上颌前部严重骨量流失给种植体植入带来挑战,尤其是在治疗整个牙弓时。使用颧骨种植体可能无法将种植体平台放置得足够靠前,以妥善支撑全牙弓修复体,在某些临床病例中会留下前部悬臂。
将种植体植入气化上颌窦和鼻窝之间的经鼻骨内,可在这块剩余骨中使用超长种植体,以增强位于其远中的颧骨种植体,从而更好地支撑全牙弓修复体。
呈现一个典型病例,因牙周病导致骨质流失,拔除上颌前部牙齿后,传统种植体植入的牙槽嵴高度不足。回顾将种植体植入Z点区域以进行经鼻种植体植入的解剖结构和技术。
本文通过一个病例示例,讨论了经鼻种植体在Z点的应用以及在这块剩余骨中的植入技术。
Z点种植体有助于消除因颧骨种植体平台放置最靠前而可能出现的前部悬臂。在严重吸收的上颌牙弓治疗计划中,应考虑经鼻种植体,以便在功能期间更好地分散种植体并进行负荷管理。