Gaspar João, Mazor Ziv, Bonfante Estevam A
Department of Oral Surgery, Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health and Science, Caparica, Portugal.
Private Practice, Tel Aviv, Israel.
Clin Implant Dent Relat Res. 2025 Feb;27(1):e13399. doi: 10.1111/cid.13399. Epub 2024 Oct 1.
Osseodensification is a novel approach that has significantly advanced the field of implant dentistry, particularly in the context of transcrestal maxillary sinus floor elevation. This technique involves the use of specially designed burs that compact and densify bone along the osteotomy walls, thereby enhancing implant primary stability and facilitating osseointegration in low-density bone. This article reviews the historical evolution of implant site preparation, and the biomechanical, histological, and clinical evidence of osseodensification with a special focus on its application in sinus floor augmentation. The integration of this technique into contemporary practice represents a paradigm shift, offering a minimally invasive and efficient solution for addressing the challenges of posterior maxilla, with improved patient-reported outcomes and low complication rate. Three different protocols for sinus lift and implant placement using osseodensification burs are proposed based on available literature, and risk factors for Schneiderian membrane perforation based on residual bone height are discussed, along with implant-related outcomes and patient-reported outcome measures. The potential for osseodensification to become a standard practice in sinus floor augmentation is emphasized, highlighting key aspects such as surgical protocol and patient selection.
骨致密化是一种新方法,在种植牙科领域取得了显著进展,尤其是在上颌窦底经嵴提升的情况下。该技术使用专门设计的车针,沿着截骨壁压实并致密化骨组织,从而增强种植体的初期稳定性,并促进在低密度骨中的骨整合。本文回顾了种植部位预备的历史演变,以及骨致密化的生物力学、组织学和临床证据,并特别关注其在上颌窦底提升中的应用。将该技术整合到当代临床实践中代表了一种范式转变,为解决上颌后牙区的挑战提供了一种微创且高效的解决方案,患者报告的结果有所改善,并发症发生率较低。基于现有文献,提出了三种使用骨致密化车针进行窦底提升和种植体植入的不同方案,并讨论了基于剩余骨高度的施耐德膜穿孔的风险因素,以及与种植体相关的结果和患者报告的结局指标。强调了骨致密化成为上颌窦底提升标准术式的潜力,突出了手术方案和患者选择等关键方面。