Postgraduate Program, Dental School, Pontifical University Catholic of Rio Grande do Sul, Porto Alegre, Brazil.
Department of Biological and Materials Sciences and Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, MI, USA.
J Oral Implantol. 2023 Aug 1;49(4):365-371. doi: 10.1563/aaid-joi-D-22-00198R2.
A sinus floor elevation via lateral window (LSFE) is one of the most widely used bone augmentation procedures for implant therapy in the posterior area of the maxilla. Locating and preparing a correct opening window on the lateral sinus wall is a key step of this procedure. Conventionally, the surgeon designs and locates the window after the flap is reflected based on the information obtained from cone-beam computed tomography (CBCT) images or other diagnostic aids. Nevertheless, in spite of the advancements in CBCT imaging, clinicians may still experience hardships in situating and procuring meticulous access to the maxillary sinus by using CBCT alone. Therefore, in cases requiring an LSFE simultaneous to implant placement, a maxillary sinus surgical guide has been tested and reported to be the amiable method to be utilized as a conjunct to prevent unpredictable consequences according to its application in implying both the direction for the implant and the location of the lateral window. This article presents 3 clinical cases with a fully digital approach to guide the opening of the lateral wall of the maxillary sinus as well as the simultaneous placement of a single implant in an ideal 3D position. Based on the CBCT images and intraoral scan, a surgical guide was fabricated based on 3D software. During surgery, this teeth-supported template can be placed intraorally, guiding sinus window opening preparation. This technique makes the sinus window opening procedure simple and predictable, reduces surgical time and the risk of complications, and allows the placement of the implant in the ideal 3D position.
经侧壁开窗（LSFE）提升上颌窦底是上颌后牙区种植治疗中最常用的骨增量方法之一。在上颌窦侧壁找到并准备一个合适的开窗是该手术的关键步骤。传统上，外科医生根据 CBCT 图像或其他诊断辅助工具获得的信息，在翻瓣后设计和定位窗口。然而，尽管 CBCT 成像有了进步，临床医生在单独使用 CBCT 定位和获取对上颌窦的精细通道时仍然可能遇到困难。因此，在需要同时进行 LSFE 和种植体植入的情况下，上颌窦外科导板已被测试并报道为一种可行的方法，可作为一种联合方法来预防根据其在植入物方向和侧壁开窗位置的应用而产生的不可预测的后果。本文介绍了 3 例完全数字化方法引导上颌窦侧壁开窗和同时以理想的 3D 位置植入单个种植体的临床病例。基于 CBCT 图像和口内扫描，使用 3D 软件制作了手术导板。手术中，这个基于牙齿的模板可以放置在口腔内，引导窦窗开口的准备。该技术使窦窗开口过程简单且可预测，减少了手术时间和并发症的风险，并允许将种植体放置在理想的 3D 位置。
