유착된 상악 대구치 발치와 동시에 상악동 골이식술과 치조골 증대술 복합 시행 증례

Abstract

This is a case report of combined sinus floor augmentation and alveolar ridge augmentation using a titanium mesh simultaneously performed with extraction of an ankylosed maxillary molar. An 18-year-old male presented with discomfort in the upper right molar. The maxillary right first molar was diagnosed with chronic apical periodontitis, ankylosis, and secondary dental caries. It was determined as hopeless prognosis due to the extensive secondary caries so we planned extraction of the tooth. Due to the pneumatization of the maxillary sinus and the vertical defects of the alveolar ridge, the bone dimension was insufficient for future implant placement. Sinus floor augmentation and alveolar ridge augmentation were performed simultaneously with extraction. Buccal flap was elevated for approach to the ankylosed root and the sinus. Piezosurgery was used for atraumatic removal of ankylosed tooth and the sinus window formation without the Schneiderian membrane perforation. Demineralized bone matrix and bovine bone mineral were grafted into the sinus and on the defected ridge. The sinus window was covered with a collagen membrane and a titanium mesh was installed at the ridge. Primary closure was achieved with buccal advanced flap and palatal rotational flap. Though there was titanium mesh exposure during the healing process, but sufficient bone formation was achieved. And the implant placement and the restoration procedures were successfully completed.