残余骨高度不足1 mm行经牙槽嵴上颌窦内提升联合即刻种植1例

Immediate Implant Placement with Sinus Floor Elevation in a Case with Residual Bone Height Less than 1 mm: A Case Report

摘要: 上颌后牙区骨量不足时，当残余骨高度(RBH)低于1 mm，即刻种植风险显著增加。本文报告1例41岁男性患者，16牙缺失伴慢性根尖周炎，影像学示RBH仅约0.93 mm。采用经牙槽嵴冲顶法行上颌窦内提升，联合自体牙骨粉植骨并同期植入短种植体。随访6年结果显示，种植体骨结合良好，窦底提升区新生骨稳定。本病例提示，在严格病例选择及规范操作前提下，经牙槽嵴上颌窦内提升联合自体牙骨粉即刻种植可能为一例成功的探索性尝试，为极端骨量不足的微创种植策略提供了初步的临床参考。其远期安全性与有效性仍需更大样本量的研究予以验证。

Abstract: When there is bone deficiency in the posterior maxilla, and the residual bone height (RBH) is less than 1 mm, the risk of implantation increases significantly. When the residual bone height (RBH) is less than 1 mm, immediate implant placement risks increase significantly. This article reports a 41-year-old male with a missing tooth 16 and chronic apical periodontitis, presenting an RBH of only 0.93 mm. The tooth was extracted and processed into autogenous tooth bone graft. Transcrestal sinus floor elevation was performed using the osteotome technique, followed by simultaneous grafting and placement of a short implant. The 6-year follow-up results showed favorable osseointegration of the implant and stable new bone formation in the elevated sinus floor area. This case suggests that, under strict case selection and standardized procedures, transcrestal sinus floor elevation combined with autogenous tooth bone graft and immediate implant placement may represent a successful exploratory attempt, providing a preliminary clinical reference for minimally invasive implant strategies in cases with extreme bone deficiency. However, its long-term safety and efficacy still need to be verified by larger-scale studies.