移植材料を用いない上顎洞挙上術，インプラント同時埋入法

抄録

Boyne and Brånemark et al. have shown, since 1980, that it is possible to insert implants into sinuses after elevation of the sinus membrane.Conventionally, the floor of the sinus is filled with an autogenous bone graft, hydroxyapatite, or a demineralized freeze-dried bone allograft during this procedure.
The purpose of this study was to establish a procedure using simultaneous elevation of the sinus membrane and implant placement into the sinus,which involves no foreign body graft material and less surgical intervention. Three patients received surgery involving simultaneous sinus lift and implant placement into the sinus without graft material. Bone chips removed from the lateral wall of the maxilla were inserted between the apex of the implanted fixture and the sinus membrane,and they were secured to the membrane by biological tissue bond (Beriplast P^®). The augmented space under the sinus was filled with blood clot without the presence of graft material. We expected the blood clot to develop into new bone. In order to evaluate bone development around the fixture, tomographic analysis was performed before and after surgery (at six months and one year). Radiographic examination revealed that the augmented space under the sinus and around the apex of the implant fixture was filled with new bone. All three cases showed no mobility of the implant. Our findings suggest that this procedure increases the indication for implant therapy on posterior maxillary edentulous patients that have a sinus floor near the alveolar ridge.