アブストラクト(36巻4号:神奈川歯学)

神奈川歯学

Japanese

Title : サイナスリフトに関するヒト上顎洞隔壁の解剖学的研究
Subtitle :
Authors : 関芳彦, 渡辺孝夫*, 高橋常男
Authors(kana) : せきよしひこ, わたなべたかお, たかはしつねお
Organization : 神奈川歯科大学口腔解剖学教室, *鶴見大学歯学部口腔外科学第一講座
Journal : 神奈川歯学
Volume : 36
Number : 4
Page : 215-227
Year/Month : 2001 / 12
Article : 原著
Publisher : 神奈川歯科大学学会
Abstract : 上顎臼歯部は上顎洞の存在によりインプラント植立のための骨量を十分に確保できないことがあり, そのため, インプラント治療の適応範囲が狭められる結果となっている. その解決法として, 上顎臼歯部における歯槽骨増大術, 骨誘導再生術, 上顎洞底骨造成術(以下, サイナスリフトと称する)などがある. サイナスリフトとは上顎骨側壁の骨を開窓, 洞底部の粘膜を挙上し, その下の空隙に骨補填材を填塞, インプラント植立のための骨造成を図るもの1~4)で, 組織学的にも挙上洞粘膜下空隙に新生骨が形成されたとする報告が出されている5~7). 本法の特徴は, 上下顎間距離を保ちつつ洞底歯槽頂間距離を増加できること3), および洞粘膜を保存することで粘膜機能への影響8, 9)を極力押さえられる点にある. 挙上洞粘膜下空隙に補填する材料としては, 自家骨10~21), 吸収性ヒドロキシアパタイト(HA)8), 非吸収性HA8), TCP8, 22), 吸収性ポリマー8), 非吸収性ポリマー8), ウシ焼成骨4, 8, 23~25), 生体活性ガラス26), 天然珊瑚顆粒8, 23, 27), ヒト乾燥凍結脱灰骨8, 23, 28, 29), ガンマー線照射骨1, 8, 23), 軟骨8, 23)など, 種々の材料が単材, あるいは混合8, 21, 23, 30~32)して用いられている.
Practice : 歯科学
Keywords : 上顎洞, 隔壁, サイナスリフト, 頬骨下稜線, ヒト解剖体

English

Title : An Anatomical Study of the Human Maxillary Sinus Septa with Reference to Sinus Lift Surgery
Subtitle :
Authors : Yoshihiko SEKI, Takao WATANABE*, Tsuneo TAKAHASHI
Authors(kana) :
Organization : Department of Oral Anatomy, Kanagawa Dental College, *The First Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Tsurumi University
Journal : Kanagawa Shigaku
Volume : 36
Number : 4
Page : 215-227
Year/Month : 2001 / 12
Article : Original article
Publisher : Kanagawa Odontological Society
Abstract : The aim of this study was to investigate anatomical structures of the maxillary sinus septa that cause the sinus membrane to break, using instruments to lift it in sinus lift surgery (maxillary sinus subantral bone augmentation) for implant placement. In this study, 132 hemi-maxillary bone blocks from 75 Japanese cadavers used for student's education (topographical dissection anatomy) in Kanagawa Dental College were investigated. The size of the sinuses averaged 31.6 mm in anterior-posterior length at the level of the horizontal plane where it was located at a height of 25.0 mm from the crest of the alveolar ridge and 19.3 mm in width on the zygomaticoalveolar crest (jugal ridge) line positioning at the central site of the zygomatic crest. 1. The incidence of sinuses with septa in the bottom of the maxillary sinuses was 45 sinuses (34.1%) in 132 blocks. The total number of septa was 70 and the average was 1.6 for each sinus. 2. Concerning the location of septa, 34 septa in 28 sinuses were observed in front of the zygomaticoalveolar crest line, 34 in 29 sinuses behind and 2 in 2 sinuses on the line. 3. The zone between the zygomaticoalveolar crest line and 10 mm anterior to the lateral wall, had the fewest, 9 septa in 9 sinuses (6.8% of 132 blocks), compared with the anterior area which had 21 sinuses (16.0%) and the posterior area, 29 sinuses (22.0%). 4. Regarding the direction of septa, 49 septa (70% of 70 septa) spread out from the medial wall to the lateral wall. Of them, the septa in front of the zygomaticoalveolar crest line spread out toward the anteriolaterally from the inner wall, and the ones behind it toward the posteriolaterally. 5. The height of septa was 4.2 mm on average ranging from 0.5 mm to 12.0. The maximum height was 25.7 mm. 6. There was no relationship between the number of the missing teeth and the incidence of sinuses with septa. In conclusion, it was surmised that location, shape, height and direction of septa in this study are very useful findings in helping to make the bone window accessible to the sinus and to manipulate instruments during sinus lift procedures.
Practice : Dentistry
Keywords :