骨移植とインプラント義歯による高度上顎歯槽堤萎縮症の治療

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Osseointegrated implants are currently recognized to be effective when used in preprosthetic surgery. Simultaneous bone grafting procedures to treat severely atrophic maxillae has, however, been little reported. Surgical procedures vary depending on the site and extent of bone resorption and bone quality; therefore, surgical planning should be carefully executed. We have simultaneously placed osseointegrated implants in conjunction with bone grafting in 9 of 10 extremely absorbed maxillae. In this report, the clinical course of alveolar bone resorption around the fixtures, survival rate of the installed fixtures, and masticatory efficiency in relation to surgical procedure were discussed. 1. The patients consisted of nine females and one male, ranging in age from 16 to 58 years. 2. A total of 59 fixtures were placed. In totally edentulous cases, six to eight fixtures were placed. In partially edentulous cases, two to five fixtures were placed. Four fixtures failed to achieve osseouintegration. Mean overall survival rate was 93.2% for a 1.5 year followup period. 3. The degree of bone resorption was 0.6 mm in 6 months, and 1.0 mm in one year after initial surgery. After the first year, bone resorption rate is stabilized at 0.2 mm per year. 4. Regarding masticatory efficiency assessed pre-and post operatively, all of the cases showed extreme improvement. The mean masticatory score in totally edentulous cases was 32 points preoperative and 92.5 points postoperative; that in partial edentulous cases was 44 points preoperative and 97.5 postoperative. These results indicate that osseointegrated implants in conjunction with bone grafting is a satisfactory procedure to restore masticatory function in patients with extreme atrophic maxillae.

骨移植とインプラント義歯による高度上顎歯槽堤萎縮症の治療

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