Published online Dec 26, 2020. doi: 10.12998/wjcc.v8.i24.6408
Peer-review started: July 24, 2020
First decision: September 24, 2020
Revised: October 4, 2020
Accepted: October 13, 2020
Article in press: October 13, 2020
Published online: December 26, 2020
In this case study, a minimally invasive transalveolar approach using platelet-rich fibrin and bone substitute with simultaneous implantation was carried out in an elderly patient. We analyzed the cone-beam computed tomography (CBCT) findings to evaluate bone regeneration.
A 65-year-old female with no contraindications for dental implants and loss of maxillary bilateral molars is described. Examination by CBCT showed the available vertical bone height in the bilateral posterior maxilla was 0.5-6.8 mm in the left and 2.8-6.5 mm in the right. The patient underwent a transalveolar approach using platelet-rich fibrin and bone substitute with simulataneous placement of an implant 10 mm in length. Six months post-surgery, the implant showed excellent osseointegration with the bone graft. Thereafter, full-ceramic crowns were fitted. Follow-up at 2 years demonstrated satisfactory prognosis.
Platelet-rich fibrin and bone substitute can be used to augment the maxillary sinus with a vertical bone height less than 4 mm.
Core Tip: Insufficient height of residual bone in the posterior maxilla is commonly encountered after tooth loss in elderly people. When the vertical bone height is less than 5 mm, the lateral antrostomy approach is recommended. In this case, cone-beam computed tomography examination showed that the available vertical bone height in the bilateral posterior maxilla was 0.5-6.8 mm in the left and 2.8-6.5 mm in the right. We chose the crest approach with platelet-rich fibrin and bovine bone graft material and obtained a good outcome. This case demonstrates that minimally invasive implantation and repair in elderly patients can be achieved, with reduced surgical trauma, postoperative pain, swelling, surgical costs and significantly shortened the course of implantation and repair. Therefore, in elderly patients, based on the premise of strict mastery of surgical indications and operating skills, this minimally invasive method with simultaneous implantation in the maxillary sinus can be considered.