Misch C E, Dietsh F
University Oral Implantology Center, University of Pittsburgh School of Dental Medicine, Pennsylvania 15261.
J Oral Implantol. 1994;20(2):100-10.
Autogenous grafts in conjunction with endosteal implants may be indicated in conditions of severe atrophy of the maxilla. From July, 1984, to December, 1990, 20 severely atrophic arches were restored with iliac crest onlay block grafts, subantral augmentation, and 148 endosteal root-form implants. Twenty-one implants were placed at the same time as the graft to stabilize a corticotrabecular bone block. Two implants were lost (90% implant survival). One hundred twenty-seven implants were placed after graft maturity, and one implant was removed (99% implant survival). Thirteen fixed restorations and 7 completely implant-supported overdentures were fabricated. Follow-up evaluation of prostheses and implants ranged from 26 to 97 months. All the implants used for initial prosthesis fabrication and all initial prostheses remain in function. The advantages of implant placement after graft maturity and subantral augmentation are addressed. One year after implant placement, the amount of additional bone lost around the implants placed in grafted bone is similar to the bone loss around maxillary implants inserted into non-grafted bone.
自体骨移植联合骨内种植体可用于上颌严重萎缩的情况。从1984年7月至1990年12月，对20例严重萎缩的牙弓采用髂嵴块状贴附移植、上颌窦底提升术以及148枚骨内根形种植体进行修复。21枚种植体在植骨同时植入以稳定皮质骨小梁骨块。2枚种植体脱落（种植体存留率90%）。127枚种植体在植骨成熟后植入，1枚种植体被取出（种植体存留率99%）。制作了13例固定修复体和7例完全种植支持的覆盖义齿。对修复体和种植体的随访评估时间为26至97个月。所有用于初始修复体制作的种植体及所有初始修复体均仍在使用。文中讨论了在植骨成熟及上颌窦底提升后植入种植体的优点。种植体植入1年后，植入植骨区种植体周围额外骨吸收量与植入未植骨区上颌种植体周围的骨吸收量相似。
