大斜度上颌窦底侧方提升同期种植的临床探讨  

High Inclination Sinus Floor Lift Distally:A Case Report

作　　者：孙振宇[1] 陈光[1] 张明睿[1] 王道富[1] 冯颉[1] 刘慧[1] 

机构地区：[1]北京解放军305医院口腔科,北京100017

出　　处：《广东牙病防治》2010年第1期46-48,共3页Journal of Dental Prevention and Treatment

摘　　要：目的探索大斜度上颌窦底侧方提升并同期种植的方法。方法左上第一磨牙缺失1例,CT检查拟植入区上颌窦底坡度达60°,窦嵴距坡顶为14.4mm,坡底为9.2mm。利用快速成型技术加工个性化光敏树脂模型,在模型上行模拟种植术,制作导板。术中用先锋钻在导板引导下钻入13mm深,但不穿通上颌窦底,然后用专用上颌窦底开孔钻行上颌窦底侧方提升,植入种植体。结果上颌窦底向远中提升,黏膜完整,植入种植体长13mm,根尖端一半在骨皮质内,一半在上颌窦腔黏膜下,初期稳定性好。结论利用快速成型树脂模型模拟手术后制作导板进行种植导航手术能精确控制扩孔钻方向和深度,能胜任大斜度上颌窦底侧方提升的需要。Objective To report one successful surgery on a high clination sinus floor lift distally. Methods A 39 years-old male patient received sinus lift because of the first molar missing in the left upper jaw. CT scan based three-dimensional reconstruction analysis showed that the inclination of sinus floor was 60 degree and the distance between top of the alveolar bone and the sinus floor ranged from 14.4 mm to 9.2 mm. A simulating operation was done on the patient＇s rapid prototyping model and a surgical guide was fabricated. During the surgical guide aided operation a 2.2 mm twist drill was applied to drill the top of alveolar bone,stopping at a distance of 13 mm deep without penetrating the sinus floor. A Sinustech reamer was used to cut a hole in the sinus floor and the sinus membrane was lifted simultaneously. Finally the implant was introduced and its initial stability checked. Results No damage or laceration of the sinus membrane was observed. The sinus floor was lift distally. The half tip of the implant was tight imbedded to the alveolar bone and the other half root tip of the implant covered by intact membranes. Conclusion The angle and depth of twist drills and Sinustech reamers were controlled precisely by surgical guide. That is the key for the success of sinus lift in the patient who has a high inclination sinus floor.

关 键 词：牙种植 上颌窦提升 快速成型 导航手术 

分 类 号：R783.4[医药卫生—口腔医学]