利用塉頂鑿骨技術階段性處理上顎竇可利用齒槽骨嚴重不足之植體置放－病例報告

Implant Placement Using Staged Sinus Augm Entation with Crestal Approach in Severely Atrophic Posterior maxilla-case Reports

王研力(Yen-Li Wang) ； 陳雅怡(Ya-Yi Chen) ； 潘惠玲(Whei-Lin Pan) ； 陳朝寶(Chiu-Po Chan) ； 朱毓仁(Yuh-Ren Ju)

《中華民國牙周病醫學會雜誌》 12卷4期 (2007/12) Pp. 299-311

摘要

上顎竇植牙手術的成功與否，除個人手術技巧外，常取決於剩餘齒槽骨之高度(residual bone height, RBH)，如何得到初期穩定度是一重要之關鍵，當可利用之齒槽骨高度小於5mm或皮質骨寬度不足以支撐植體獲得理想初期穩定度時，分二階段先提高上顎竇高度再植牙，不失爲一理想，安全且可預期性高之植牙方法。本文提出二個病例，在可利用剩餘骨高度1~3mm的情況下，第一階段先用外徑6.lmm，內徑5.25mm之骨環鋸(trephine bur)將塉骨作記號並鑽開，再以推骨器(Bone condenser)輕敲慢慢將此骨栓往上推。當骨栓可以自由移動時填入PepGen P-15，數個月後進行第二階段的植體植入。最後利用可攜式植體穩定測量器(Osstell mentor)測量植體穩定商數，決定置放癒合接合體的時閒，術後追蹤已有一年以上的時間，情況穩定。

關鍵字

植體 ； 可利用齒槽骨高度嚴重不足 ； 塉頂鑿骨技術 ； 上顎竇墊高 ； 植體穩定商數測量

並列摘要

The most important factor influencing implant survival in sinus augmentation, besides individual surgical technique, is the preexisting bone height between the sinus floor and alveolar crest. The key factor for success is to achieve primary stability. When the available bone height is less than 5mm or the thickness of the cortical bone is inadequate, two stage protocol (elevating the sinus floor to create sufficient bone height first, and then placing the implant at the second stage) is a safe, predictable treatment modality. We present 2 case reports of which the residual bone height is 1~3mm in either case. After marking and drilling the alveolar ridge with trephine bur, the bone plug was intruded with gentle force using bone condensers. PepGen P-15 was then placed when the bone plug was freely movable. Implant placement was performed several months later. The time for healing abutment connection was determined by measuring the ISQ value with Osstell mentor. It has been more than one year postoperatively and the implants appeared healthy radiographically and were immobile clinically.

並列關鍵字

dental implants ； insufficient available alveolar bone height ； crestal approach ； sinus augmentation ； ISQ