Wang Yu-Lan, Shao Wen-Jun, Wang Min
State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School and Hospital of Stomatology, Wuhan University, Wuhan 430079, Hubei Province, China.
Department of Oral Implantology, School and Hospital of Stomatology, Wuhan University, Wuhan 430079, Hubei Province, China.
World J Clin Cases. 2024 Apr 26;12(12):2109-2115. doi: 10.12998/wjcc.v12.i12.2109.
Lateral window approach for sinus floor lift is commonly used for vertical bone augmentation in cases when the residual bone height is less than 5 mm. However, managing cases becomes more challenging when a maxillary sinus pseudocyst is present or when there is insufficient bone width. In this case, we utilized the bone window prepared during the lateral window sinus lift as a shell for horizontal bone augmentation. This allowed for simultaneous horizontal and vertical bone augmentation immediately after the removal of the maxillary sinus pseudocyst.
A 28-year-old female presented to our clinic with the chief complaint of missing upper left posterior teeth. Intraoral examination showed a horizontal deficiency of the alveolar ridge contour. The height of the alveolar bone was approximately 3.6 mm on cone beam computed tomography (CBCT). And a typical well-defined 'dome-shaped' lesion in maxillary sinus was observed on CBCT imaging. The lateral bony window was prepared using a piezo-ultrasonic device, then the bony window was fixed to the buccal side of the 26 alveolar ridge using a titanium screw with a length of 10 mm and a diameter of 1.5 mm. The space between the bony window and the alveolar ridge was filled with Bio-Oss, covered with a Bio-Gide collagen membrane, and subsequently sutured. Nine months later, the patient's bone width increased from 4.8 to 10.5 mm, and the bone height increased from 3.6 to 15.6 mm. Subsequently, a Straumann 4.1 mm × 10 mm implant was placed. The final all-ceramic crown restoration was completed four months later, and both clinical and radiographic examinations showed that the implant was successful, and the patient was satisfied with the results.
The bone block harvested from the lateral window sinus lift can be used for simultaneous horizontal bone augmentation acting as a shell for good two-dimensional bone augmentation.
当剩余骨高度小于5mm时，上颌窦底提升的侧窗入路常用于垂直骨增量。然而，当存在上颌窦假性囊肿或骨宽度不足时，处理此类病例更具挑战性。在本病例中，我们利用侧窗上颌窦提升术中制备的骨窗作为水平骨增量的外壳。这使得在上颌窦假性囊肿切除后可立即同时进行水平和垂直骨增量。
一名28岁女性因左上后牙缺失为主诉前来我院就诊。口腔检查显示牙槽嵴轮廓存在水平不足。锥形束计算机断层扫描（CBCT）显示牙槽骨高度约为3.6mm。CBCT影像上观察到上颌窦内典型的边界清晰的“穹顶状”病变。使用压电超声设备制备外侧骨窗，然后用一枚长度为10mm、直径为1.5mm的钛螺钉将骨窗固定于26牙槽嵴的颊侧。骨窗与牙槽嵴之间的间隙用Bio-Oss填充，覆盖Bio-Gide胶原膜，随后缝合。9个月后，患者的骨宽度从4.8mm增加到10.5mm，骨高度从3.6mm增加到15.6mm。随后植入一枚4.1mm×10mm的Straumann种植体。4个月后完成最终的全瓷冠修复，临床和影像学检查均显示种植成功，患者对结果满意。
从侧窗上颌窦提升术中获取的骨块可用于同时进行水平骨增量，作为二维骨增量的良好外壳。
