日本口腔外科学会雑誌
Online ISSN : 2186-1579
Print ISSN : 0021-5163
ISSN-L : 0021-5163
総説
上顎洞底挙上術 —側方アプローチと歯槽頂アプローチ—
菅井 敏郎
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ジャーナル フリー

2010 年 56 巻 3 号 p. 150-165

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The concept of osseointegration has allowed highly predictable result and the popular use of dental implant therapy. However, implant placement is often difficult in the posterior maxilla due to insufficient bone volume below the maxillary sinus. Boyne and James have developed a technique involving grafting of autogenous bone into the sinus floor by fenestration of the lateral maxillary sinus wall to access and elevate the sinus membrane based on the Caldwell-Luc procedure. In addition, Summers has developed the sinus floor elevation technique using an osteotome by alveolar crest approach. Subsequently, many modified procedures have also been reported. Methods based on the former are called “lateral approach” or “lateral window technique”, while those based on the latter are called “alveolar crest approach” or “osteotome technique”. The lateral approach allows elevation of the maxillary sinus membrane under direct vision, and it is applicable, even if the bone volume is too deficient to obtain primary stability. While the alveolar crest approach is a less-invasive surgical procedure, it has several limitations. It is applicable only when there is enough bone volume to provide primary stability of the implant, and it has to be performed blindly. Regardless of which method is used, the selection of indication, proper diagnosis, and treatment planning are extremely important.
The prognosis for implant treatment with maxillary sinus floor elevation is extremely favorable. Consequently, the maxillary sinus floor elevation has been widely accepted as a technique essential for implant treatment in the posterior maxilla.
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