连续203例经牙槽嵴顶上颌窦提升的愈合期内并发症的研究  

A retrospective study of complications associated with osteotome sinus floor elevation

作　　者：杨博 陈明[1] 马攀[1] 孙静[1] 王瑶[1] 唐德争[1] 李贝贝 岳新新[1] FANG Bo;CHEN Ming;MA Pan;SUN .ling;WANG Yao;TANG De-zheng;LI Bei-bei;YUE Xin-xin(Department of Implantology Capital Medical University School of Stomatology,Beijing 100050,China)

机构地区：[1]首都医科大学口腔医学院种植中心,北京100050

出　　处：《北京口腔医学》2018年第6期327-330,共4页Beijing Journal of Stomatology

基　　金：北京市卫生系统高层次卫生技术人才培养计划(2015-3-094);北京市自然科学基金(7172088);首都医科大学附属北京口腔医院学科建设基金-临床专项(17-09-20)

摘　　要：目的探讨经牙槽嵴顶上颌窦提升术愈合期内相关的并发症以及解决方法。方法连续203例上后牙缺失并骨量不足的患者接受经牙槽嵴顶上颌窦提升术,其中170例已完成修复。术前测量上颌窦底剩余骨高度,记录所有愈合期内并发症,包括上颌窦黏膜损伤、感染、脱落、植入扭矩、窦底与种植体夹角,并统计种植体存留率。结果 203例患者中有18例出现上颌窦黏膜损伤,其中术中并发症发生17例,包括1例囊液漏,9例术后即刻出现上颌窦液面以及7例出现术中捏鼻鼓气试验阳性,术后黏膜损伤并发症发生1例,表现为术后3天手术侧鼻孔出现血性分泌物。术后有2枚出现松动脱落,有1枚植入位置出现偏斜。结论上颌窦黏膜损伤是经牙槽嵴顶上颌窦提升术愈合期内最常出现的并发症,通过术前详细询问病史,完善的术前检查、正确规范的手术操作、合理的种植设计以及术后抗生素的使用可以有效预防和处理相关并发症。Objective To discuss the complications and the solution in osteotome sinus floor elevation. Methods A total of 203 patients with upper posterior teeth loss and bone deficiency were treated by osteotome sinus floor elevation and170 patients have been finished. The residual bone height( RBH) of the maxillary sinus floor was measured before operation,and all complications during the healing period were recorded,including maxillary sinus mucosa perforation,infection,failure,implant torque,angle between the sinus floor and implant,and the implant retention rate was counted.Results Maxillary sinus mucosa perforations occurred in 18 patients. Among them,intraoperative complications occurred in17 cases,including 1 cystic fluid leakage,9 liquid surface after operation,and 7 positive pinch nose gas test. Postoperative complication occurred in 1 case which was bleeding on the surgical side of the nostril 3 days after the operation. Two implants failure occurred after the operation,and 1 implant skewed. Conclusion Maxillary sinus mucosa perforation was the most frequent complication through osteotome sinus floor elevation in the healing period. Perfect preoperative examination,standardized operation,reasonable implant design and postoperative use of antibiotics can be effective in the prevention and treatment of complications.

关 键 词：并发症 经牙槽嵴顶上颌窦提升 种植 

分 类 号：R783.4[医药卫生—口腔医学]