[1]周震,王亚敏,孟文霞,等.经牙槽嵴顶上颌窦底二次提升术可改善上颌后牙区骨高度严重不足[J].南方医科大学学报,2019,(06):731.[doi:10.12122/j.issn.1673-4254.2019.06.16]
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经牙槽嵴顶上颌窦底二次提升术可改善上颌后牙区骨高度严重不足()
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《南方医科大学学报》[ISSN:1673-4254/CN:44-1627/R]

卷:
期数:
2019年06期
页码:
731
栏目:
出版日期:
2019-06-16

文章信息/Info

Title:
Two-stage closed sinus lift for severe bone deficiency in the posterior maxilla imrpoves long-term clinical outcomes
作者:
周震王亚敏孟文霞杨熙刀俊峰
关键词:
上颌窦提升术植骨种植体骨缺损骨增量
Keywords:
maxillary sinus floor augmentation bone graft dental implants bone defect bone augmentation
DOI:
10.12122/j.issn.1673-4254.2019.06.16
摘要:
目的评价上颌后牙区骨高度严重不足即上颌窦底剩余牙槽嵴垂直骨高度(RBH)≥1 mm且≤3 mm时行经牙槽嵴顶上颌 窦底二次提升术的长期临床效果。方法选取南方医科大学口腔医院种植中心2012年3月~2014年12月就诊的上颌后牙缺失 拟行上颌窦提升种植修复的患者78例,符合RBH≥1 mm且≤3 mm,牙槽嵴宽度≥5 mm,采用经嵴顶二次提升法,共植入种植体 148枚,术后6个月行上部结构修复,随访1~5年,行临床及影像学检查,评价患者满意度、种植体稳定性、种植体存留率、软组织 情况、窦底骨高度变化及种植体周边缘骨吸收情况。结果术中发生3 例上颌窦底黏膜破裂,穿孔率为3.85%(3/78)。23 例 (30.67%)存在轻微疼痛,52例(69.33%)无头痛发热,无明显疼痛及肿胀反应。种植体稳定性系数ISQ值术后即刻和术后半年 分别为58.39±1.39,81.88±1.22,两组差异有统计学意义(P<0.05)。随访率100%,愈合期及随访过程中无一种植体脱落,种植体 存留率为100%。比较随访时间1年和5年的种植体周探诊深度,改良龈沟出血指数,差异均无统计学意义(P>0.05)。平均上颌 窦底提升高度及种植体周边缘骨吸收术后1年和术后5年差异均有统计学意义(P<0.05)。结论与侧壁开窗式上颌窦提升术相 比, 经牙槽嵴顶上颌窦底二次提升术植骨手术创伤小、患者不适感明显减轻,有效解决上颌后部牙槽骨高度严重不足的问题并 取得良好的长期临床效果。
Abstract:
Objective To evaluate the long-term clinical outcomes of two-stage closed sinus lift for the maxillary sinus with residual bone height (RBH) of 1-3 mm in the posterior maxillary. Methods Seventy-eight patients with maxillary posterior tooth loss (1 mm≤RBH≤3 mm and alveolar ridge width ≥5 mm) were treated with two-stage closed sinus lift at the Dental Implantation Center of our hospital between March, 2012 and December, 2014. Coral hydroxyapatite powder and 148 implants were implanted. The superstructure was fixed within 6 months after the operation and the patients were followed up for 1-5 years for assessing the patients’ satisfaction, postoperative response, stability and survival rates of the implant, soft tissue condition, bone height of maxillary sinus floor elevation and the marginal bone loss. Results Perforation of the maxillary sinus floor occurred in 3 (3.85%) of the cases. Twenty-three (30.67%) patients complained of mild pain, and 52 (69.33%) did not experience headache or fever or reported obvious pain or swelling after the operation. The overall response to the operation was favorable. The ISQ value was 58.39±1.39 immediately after the operation, and increased significantly to 81.88±1.22 at 6 months (P<0.05). During the healing period and the follow-up, none of the implants fell off, and the implant survival rate was 100%. The peri-implant probing depth and modified sulcus bleeding index at 1 year after sinus lifting were similar to those at 5 years after the operation (P>0.05), but the sinus floor elevation and marginal bone resorption at the two time points differed significantly (P<0.05). Conclusion Compared with lateral wall lifting, two-stage close lifting of the maxillary sinus floor is associated with less trauma and less discomfort, and effectively solves the problem of severe alveolar bone height deficiency in the maxillary posterior region to achieve favorable long-term clinical outcomes.
更新日期/Last Update: 1900-01-01