柔性两阶段穿牙槽嵴上颌窦底提升术治疗上颌后牙区骨高度 严重不足1例报告及文献复习

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[中图分类号] R783.4 [文献标志码] B

ABSTRACT Transalveolar technique for sinus floor elevation（TSFE） offers the advantages of minimal invasiveness，reduced postoperative reaction，and shorter operative time for vertical bone augmentation in the maxillary posterior region.The clinical data of one patient with severe deficiency of residual bone height （RBH）in the maxillary posterior region，a blood vessel visible in the lateral wallof the maxillary sinus anda visible septum at the floor of the maxillary sinus were reported，and two-stage flexible TSFE was used to improve the vertical bone height of the operated area while reducing trauma，the risk of Schneiderian membrane rupture and maxilary sinus infection，etc.，and the relevant literatures were reviewed.The patient，male，26 years old，complained of missing left maxillary posterior teeth for more than 1 year and requested restoration. The patient had 27 missing teeth，normal keratinized gingiva，full alveolar ridge，no elongation of the opposing teeth，fair width of the proximal and normal occlusal distance.The results of cone beam CT（CBCT） showed that the distance between the sinus crests at the site of the 27 teeth was about 3mm ，thewidth of the alveolar bone was about 12.8mm ，the bone density was normal，and there were no residual roots or other abnormalities；no cyst-like lesions were seen in the wals of the maxillary sinuses bilaterally，and separation was seen at the floor of the maxillary sinus on the left sideand a blood vessel was seen in the lateral wall of the maxillary sinus.A diagnosis of Kennedy class II maxillary tooth defects was made.After two stages of TSFE，the Schneiderian membrane was intact and the bone height of the implant area was elevated to 9.6mm from 3mm preoperatively after the completion of the restoration，with stable bone augmentation，good osseointegration，and restoration of normal occlusal function.For the patients with severe bone height deficiency in the maxilary posterior region，flexible two-stage TSFE should be considered，whichcan help to reduce the risk of maxillary sinus infection and Schneiderian membrane rupture while minimizing the damage and obtaining the ideal bone augmentation results.

KEYWORDsSinus floor elevation；Transalveolar technique for sinus floor elevation；Schneiderian membrane；Bone regeneration；Dental implantation；Platelet-rich fibrin

上颌窦的过度气化以及牙槽骨吸收会使缺牙区的剩余骨高度（residualboneheight，RBH）降低，因此标准种植体在上颌后牙区的植入往往受到限制[1]。（剩余11496字）