Soardi Carlo M, Spinato Sergio, Bianchi Andrea Edoardo, Soardi Barbara, Zaffe Davide, Wang Hom-Lay
Int J Periodontics Restorative Dent. 2023 Jul-Aug;43(4):425-433. doi: 10.11607/prd.5987.
This evaluation correlates maxillary sinus 3D morphology with bone regeneration. In 39 patients with crestal bone ≤ 2 mm, mineralized human bone allografts were used to augment the sinus floor through the crestal window sinus elevation approach. CBCT was used to measure the buccopalatal diameter (BPD), mesiodistal diameter (MDD), and hemi-ellipsoidal volume (Vh) in all sinuses. A bone core biopsy sample was taken at implant placement (4 to 5 months after sinus augmentation). Microradiographs of methacrylate-embedded sections were used to evaluate the amounts of bone, residual graft, and soft tissue. All 51 implants placed in the 39 patients successfully osseointegrated. A linear regression analysis showed that as BPD, MMD, and Vh increased, the amount of bone gain decreased and the amount of soft tissue increased ( < .05). The amount of residual graft was little affected by sinus morphology. Microradiographic data were grouped into four different sinus types (from small to great) using BPD and Vh medians. The best amount of bone formation was achieved in the narrow and short sinus type, while no great differences were found in the remaining three sinus types. Understanding of 3D sinus cavity morphology, especially the buccopalatal diameter and mesiodistal dimensions, is fundamental for achieving the best possible sinus augmentation outcomes.
本评估将上颌窦三维形态与骨再生相关联。在39例牙槽嵴顶骨厚度≤2 mm的患者中，采用矿化人骨同种异体移植物通过牙槽嵴顶开窗上颌窦提升术来增高窦底。使用锥形束计算机断层扫描（CBCT）测量所有窦腔的颊腭径（BPD）、近远中径（MDD）和半椭球体体积（Vh）。在种植体植入时（上颌窦提升术后4至5个月）采集骨芯活检样本。对甲基丙烯酸酯包埋切片的显微放射照片用于评估骨量、残余移植物量和软组织量。39例患者植入的51枚种植体均成功实现骨整合。线性回归分析表明，随着BPD、MMD和Vh增加，骨增量减少，软组织量增加（P <.05）。残余移植物量受窦形态的影响较小。使用BPD和Vh中位数将显微放射照片数据分为四种不同的窦类型（从小到大）。在窄而短的窦类型中实现了最佳的骨形成量，而在其余三种窦类型中未发现显著差异。了解三维窦腔形态，尤其是颊腭径和近远中尺寸，是实现最佳上颌窦提升效果的基础。
