上颌窦底提升自体骨与异种骨移植延期种植的临床疗效评价  

Clinical and radiographic outcomes of delayed implant placements after maxillary sinus floor augmentation with different grafting materials

作　　者：张晓[1] 孙凤[1] 张峰[1] 张智勇[1] 

机构地区：[1]北京大学口腔医学院·口腔医院第一门诊部,100034

出　　处：《中华口腔医学杂志》2012年第10期584-587,共4页Chinese Journal of Stomatology

摘　　要：目的评价经上颌骨前外侧壁的上颌窦底提升植骨延期种植术的长期临床效果，并比较两种不同的骨移植材料在种植修复不同时期的变化。方法对2002年1月至2008年12月牙列缺损患者18例（21侧）上颌窦行经上颌骨前外侧壁的上颌窦底提升植骨延期种植术。延期（6～8个月）植入共46枚种植体。将牙列缺损区域剩余牙槽骨高度〈4mm的患者分为两组：①混合材料组（自体骨＋异种骨）5例6侧；②单纯异种骨组（Bio—Oss）13例15侧。在3个时间点（植骨术后即刻、种植体负荷即刻、〉12个月随访）拍摄曲面体层X线片，评估骨吸收率及种植体存留率。结果在植入的46枚种植体中，除1枚因感染取出外，其余种植体骨结合良好并完成修复。在平均54个月随访期内，种植体存留率为98％（45／46）。3个时间点的X线片测量比较，移植骨量两组均减少，混合材料组（10．88％和7．77％），总吸收率18．65％；单纯异种骨组（4．40％和-2．47％），总吸收率1.93％。骨量变化的差异有统计学意义。结论上颌窦底提升植骨的临床效果是可以预期的；单纯异种骨移植的骨吸收率低于自体骨十异种骨混合材料的骨吸收率。Objective To evaluate the long-term clinical outcome of delayed implant placements after maxillary sinus floor augmentation with autologous bone or Bio-Oss grafting. Methods Eighteen patients underwent maxillary sinus floor augmentation and delayed implant placements from January, 2002 to December, 2008. Bone grafting and sinus floor augmentation were performed in 21 sides of maxilla and 46 implants were placed 6-8 months later. Residual bone height was less than 4 mm. The cases were divided to 2 groups and different materials （autologous bone ＋ Bio-Oss and Bio-Oss alone ） were grafted relatively. The bone resorption was assessed by panoramic X-ray and the stability of the implant was reviewed postoperatively. Results The average follow-up time was 54 months. Only one implant was lost and the implant survival rate was 98%. X-ray showed that the bone resorption was observed in both groups. The absorption ratio of autologous bone ＋ Bio-Oss group was 18. 65% and that of the Bio-oss group was 1.93%. The difference was significantly different. Conclusions The result of maxillary sinus floor augmentation with bone grafting was predictable. More bone absorption occurred in the Bio-Oss than in autologous bone ＋ Bio-Oss.

关 键 词：牙种植 上颌窦底提升术 骨吸收率 

分 类 号：R783.6[医药卫生—口腔医学]