不做窦底骨移植上颌窦内提升术2年疗效观察  

Osteotome sinus floor elevation without bone grafting:a 2-year prospective clinical study

作　　者：沈怡珉[1] 徐悠游[1] 徐爽[1] 徐培成[1] 

机构地区：[1]上海市徐汇区牙病防治所,上海200032

出　　处：《上海口腔医学》2009年第3期263-266,共4页Shanghai Journal of Stomatology

摘　　要：目的:研究不做骨移植的上颌窦内提升术(osteotome sinus floor elevation,0SFE)后的牙种植体留存率及周围骨组织变化规律,探讨种植体突入上颌窦内(≤3mm)病例中种植体周围有无新骨形成及其稳定性。方法:23例单个上颌后牙缺失患者,种植区剩余垂直骨高度(residual bone high,RBH)为5～8mm,接受OSFE+牙种植体植入术,控制种植体突入上颌窦内长度≤3mm,植入后3～4个月行种植体上部结构永久修复。通过牙种植体植入后2a连续临床观察,分析种植体留存率;通过X线测量(手术后及植入后3、6、12、24个月),观察种植体突入上颌窦内的长度变化及成骨规律。结果:2a种植体留存率为100%;X线测量显示,种植体突入上颌窦内部分,其近远中侧有成骨现象且2a内保持稳定。结论:在适当病例中进行不做窦底骨移植的OSFE是可行的。PURPOSE： The aim of this study was to evaluate the osteotome sinus floor elevation procedure with Straumann implants without bone grafting through observing the implant survival rate and the change of bone around the implant,and explored new bone formation and stability when the implants protruding in the sinus less than 3mm. METHODS： 23 patients with single upper maxillary molar lost were included in this study. The mean residual bone height （RBH） under the maxillary sinus was 5-8 mm and the distance of the implants protruding into the sinus was less than 3mm without bone grafting. A healing period of 3-4 months was allowed before abutment tightening at 35 N.cm. All the patients were followed up for 2 years to evaluate the implant survival rate. X-ray measurements （immediately after implant placement, after 3,6,12,24 months postoperatively） were performed to calculate the length of the implant protruding into the sinus and if the new bone formed near it. RESULTS： At the end of 2-year, the implant survival rate was 100% and the implants resisted the applied 35 N-cm torque and supported the definitive prosthesis well. The mesial and the distal sides of the implants protruding into the sinus had new bone formation. No hard tissue could be seen around the apical implant 3 months after inserting and the boundary between the new bone and the original sinus floor could not be seen 2 years after surgery. CONCLUSION： Elevation of the sinus membrane alone without addition of bone grafting could have the similar effect to the OSFE with bone grafting.

关 键 词：上颌窦内提升 Straumann种植体 骨移植 

分 类 号：R782[医药卫生—口腔医学]