Anteroinferior distraction of the atrophic subtotal maxillary alveolus for implant placement: a case report.
Anteroinferior distraction of the atrophic subtotal maxillary alveolus for implant placement: a case report.
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萎缩性上颌牙槽次全前下牵引以植入种植体：病例报告。
DOI：
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发表时间：
2002
期刊：
影响因子：
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通讯作者：
N. Hatano
中科院分区：
文献类型：
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作者：
K. Horiuchi;H. Uchida;Kazuhiko Yamamoto;N. Hatano
大多数关于牙槽骨牵张的报道都与下颌骨和上颌骨的垂直牵张有关。关于水平或斜向牙槽骨牵张的报道很少。一个病例的萎缩次全上颌牙槽骨牵引前方10毫米和5毫米垂直，然后放置9个种植体，提出。一位健康的55岁女性，主诉上颌牙松动。除上颌左第二磨牙外，其余11颗牙均被诊断为晚期边缘性牙周炎，并被认为是无望的，随后被拔除。拔牙后3个月，用骨锯在双侧第二前磨牙区域之间进行水平截骨术，垂直延伸至第二前磨牙远端，不涉及上颌窦。在确认牙槽骨的活动性后，使用钛微型螺钉和粘合树脂粘固剂将牵引装置固定在硬腭上。在7天的等待期后，上颌牙槽骨向前牵引0.25 mm，每天两次，连续25天。转移注意力的过程顺利完成。牵引后计算机断层扫描显示，上颌牙槽骨被充分牵引，将种植体放置在理想的位置。在固定牵引装置后4个月，放置了9个骨内种植体。所有种植体均具有良好的初期稳定性，并被浸没。所有种植体骨结合，尽管2个前部种植体由于临时可移除假体的跨粘膜过载导致的崩解而被替换。种植体植入后16个月，种植体周围未见明显的边缘骨吸收。结论：牙槽骨牵张术不仅在垂直方向上，而且在水平或倾斜方向上都能有效地扩大萎缩的牙槽骨。
Most reports on alveolar distraction have been related to vertical distraction in the mandible and the maxilla. There have been few reports on horizontal or oblique alveolar distraction. A case of an atrophic subtotal maxillary alveolus distracted 10 mm anteriorly and 5 mm vertically, followed by the placement of 9 implants, is presented. A healthy, 55-year-old woman presented with a chief complaint of mobility of all maxillary teeth. All remaining 11 teeth except the maxillary left second molar were diagnosed as being involved with advanced marginal periodontitis, and were considered hopeless and subsequently extracted. Three months after extraction, a horizontal osteotomy was performed with a bone saw between the bilateral second premolar regions, extending vertically distal to the second premolars, without involving the maxillary sinuses. After confirming mobility of the alveolar bone, a distraction device was seated with titanium miniscrews and adhesive resin cement over the hard palate. After a 7-day waiting period, the maxillary alveolus was distracted anteroinferiorly 0.25 mm twice a day for 25 consecutive days. The distraction process was completed uneventfully. Postdistraction computed tomography demonstrated that the maxillary alveolus was adequately distracted to place implants in an ideal position. Nine endosseous implants were placed 4 months after seating the distraction device. All implants had good primary stability and were submerged. All implants osseointegrated, although 2 anterior implants were replaced due to disintegration resulting from transmucosal overloading of the interim removable prosthesis. No significant marginal bone resorption was seen around the implants 16 months after implant placement. It was concluded that alveolar distraction can be very useful for augmenting the atrophic alveolus, not only vertically but also horizontally or obliquely.