Hori M, Okaue M, Kaneko K, Harada D, Ohki H, Matsumoto M, Tanaka H
Department of Oral and Maxillofacial Surgery, Nihon University School of Dentistry, Tokyo, Japan.
J Oral Sci. 1998 Sep;40(3):123-8. doi: 10.2334/josnusd.40.123.
A case is reported of a 21-year-old Japanese man examined for unerupted molar teeth on the left side of both jaws. Intraoral examination revealed edentulous regions from the second premolar to the molar, with moderate atrophy of the upper alveolar ridge. A panoramic X-ray revealed eight impacted teeth. The impacted mandibular teeth were extracted through decortication and bone replacement. The impacted maxillary teeth were extracted following reflection of a mucoperiosteal flap. The large defects caused by the extractions in both jaws were filled with autogenous cancellous marrow and bone chips. Eleven months later, in the first stage of the Branemark implant procedure, fixtures were placed in the edentulous regions of both jaws, with simultaneous additional corticocancellous block onlay bone grafting in the maxilla to correct slight resorption. After another seven months, second-stage abutment surgery was performed. Occlusion was then restored through a prosthetic procedure. Next, orthodontic treatment was commenced, using the implant supported teeth as an anchor. Despite the slight resorption in the maxilla, implantation was successful and occlusion was restored in the previously edentulous regions. This suggests that application of a simultaneous corticocancellous block onlay bone graft is a valuable basis for implant procedures in the maxilla.
报告一例21岁日本男性病例，该患者因双侧下颌左侧磨牙未萌出而接受检查。口腔内检查发现双侧从第二前磨牙到磨牙区域无牙，上颌牙槽嵴中度萎缩。全景X线片显示有8颗阻生牙。通过去皮质和骨置换术拔除下颌阻生牙。翻起黏骨膜瓣后拔除上颌阻生牙。上下颌拔牙后造成的大的骨缺损用自体松质骨髓和骨屑填充。11个月后，在Branemark种植手术的第一阶段，在上下颌无牙区植入种植体，同时对上颌进行额外的皮质松质骨块覆盖植骨以纠正轻微的骨吸收。再过7个月后，进行二期基台手术。然后通过修复程序恢复咬合。接下来，以种植体支持的牙齿为支抗开始正畸治疗。尽管上颌有轻微骨吸收，但种植成功，先前无牙区恢复了咬合。这表明同时应用皮质松质骨块覆盖植骨是上颌种植手术的重要基础。
