口腔医学 ›› 2024, Vol. 44 ›› Issue (4): 287-291.doi: 10.13591/j.cnki.kqyx.2024.04.009

• 病案分析 • 上一篇    下一篇

钛网植骨联合上颌窦底提升术改善上颌磨牙区严重骨缺损病例1例

田野1,石晓璐1,王济朋2,翟少博1,刘洋1,杨征1,吴毓川1,储顺礼1()   

  1. 1 吉林大学口腔医院种植科,吉林长春(130021)
    2 法兰克福大学牙医学院口腔种植外科,德国美因河畔法兰克福(60596)
  • 收稿日期:2023-10-10 出版日期:2024-04-28 发布日期:2024-04-25
  • 通讯作者: 储顺礼 Tel:(0431)88796025 E-mail:chusl@jlu.edu.cn
  • 基金资助:
    吉林省科技厅科学研究项目(20230203065SF);吉林省教育厅科学研究项目(JJKH20231291KJ)

Titanium mesh bone grafting combined with maxillary sinus floor elevation to improve severe bone defect in maxillary molar area: A case report

TIAN Ye1,SHI Xiaolu1,WANG Jipeng2,ZHAI Shaobo1,LIU Yang1,YANG Zheng1,WU Yuchuan1,CHU Shunli1()   

  1. Department of Oral Implantology, School of Stomatology, Jilin University, Changchun 130021, China
  • Received:2023-10-10 Online:2024-04-28 Published:2024-04-25

摘要:

目的 面对上颌磨牙区偏离牙弓曲线水平向严重缺损伴骨高度不足,本病例尝试选用钛网作为支架,联合上颌窦底提升术实现局部区域的水平向和垂直向骨增量。方法 患者术前CBCT显示,26牙位处剩余骨宽度约3.3 mm,高度约4.9 mm,27牙位处剩余骨宽度约5.2 mm,高度约5.1 mm。病例治疗采用了钛网维持颊侧水平向成骨空间,采集自体骨混合人工骨植骨,并应用富血小板纤维蛋白,同时联合侧壁开窗上颌窦底提升术改善垂直向骨量。结果 术后5个月,取出钛网,CBCT显示,26牙位处较术前骨宽度增加了2.0 mm,高度增加了3.2 mm;27牙位处较术前骨宽度增加了1.2 mm,高度增加了4.0 mm,获得了理想的骨增量效果。术后6个月,进行经牙槽嵴顶上颌窦底提升术和种植体植入术,种植体初期稳定性良好。术后1年,种植修复完成,CBCT显示,26牙位处较术前骨宽度增加了2.9 mm,高度增加了4.5 mm;27牙位处较术前骨宽度增加了0.9 mm,高度增加了6.6 mm,结果显示骨增量效果稳定,恢复了正常的咬合功能,并取得一定的美学效果改善。结论 该病例结果表明,钛网植骨联合上颌窦底提升术可以获得较为充分稳定的骨增量效果,是一种可靠的用来改善上颌磨牙区骨量不足的方法。

关键词: 钛网, 上颌窦底提升术, 骨增量, 口腔种植

Abstract:

Objective To handle severe horizontal defect of maxillary molar area deviating from dental arch curve with insufficient bone height, this case tried to use titanium mesh as a scaffold and combine maxillary sinus floor elevation to realize horizontal and vertical bone increment in local area. Methods Preoperative CBCT showed that the residual bone in 26 teeth was about 3.3 mm in width and 4.9 mm in height, and that in 27 teeth was about 5.2 mm in width and 5.1 mm in height. The patient was treated with titanium mesh to maintain buccal horizontal osteogenic space, and autogenous bone mixed with artificial bone was collected for bone grafting. At the same time, platelet-rich fibrin was applied, and the vertical bone mass was improved by lateral maxillary sinus floor elevation. Results Five months after operation, the titanium mesh was removed. CBCT showed that the bone width and height of 26 teeth were respectively increased by 2.0 mm and 3.2 mm compared with those before operation. The bone width and height of 27 teeth increased by 1.2 mm and 4.0 mm, and the ideal bone increment effect was obtained. Six months after operation, transalveolar maxillary sinus floor elevation and implant implantation were performed and the initial stability of the implant was good. One year after operation, the implant restoration was completed. CBCT showed that the bone width and height of 26 teeth were respectively increased by 2.9 mm and 4.5 mm compared with that before operation. The bone width and height of 27 teeth were respectively increased by 0.9 mm and 6.6 mm. The results showed that the bone increment effect was stable; the normal occlusal function was restored, and the aesthetic effect was improved to some extent. Conclusion Results of this case show that titanium mesh bone grafting combined with maxillary sinus floor elevation can obtain a relatively sufficient and stable bone increment effect, and it is a reliable method to improve the bone deficiency in maxillary molar area.

Key words: titanium mesh, maxillary sinus floor elevation, bone augmentation, dental implantation

中图分类号: