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