经牙槽嵴顶上颌窦底骨块内嵌提升术的临床应用  

The Clinical Effect of the Inlay Osteotome Sinus Augmentation Technique for Sinus Floor Elevation

作　　者：吴东[1] 邹耿森 肖妍君[1] 杨进[1] 黄文秀[1] 

机构地区：[1]福建医科大学附属口腔医院种植科,福州350002

出　　处：《福建医科大学学报》2015年第5期322-325,共4页Journal of Fujian Medical University

基　　金：福建省科技厅重点项目(2013Y0039)

摘　　要：目的评价经牙槽嵴顶行上颌窦骨块内嵌技术在上颌后牙区垂直骨高度不足时种植治疗的应用及临床疗效。方法上颌后牙缺失患者34例,经牙槽嵴顶采用环形骨刀定位并制备窝洞,钻至距上颌窦底约1~2mm时,将内提升工具放入种植窝内轻轻敲击预备窝洞后的柱状骨块,造成窦底皮质骨骨折。将骨块内嵌,连同上颌窦底黏膜向上提升至所需要的高度,术中同期植入种植体,共49枚。术后4~6月后行种植体上部冠修复。术后、修复后定期复诊,检查上颌窦情况、种植体稳定性、种植体周围牙龈组织健康状况,拍摄X线片评价骨高度。结果 34例均未发生术后炎症及种植体松动、脱落等,种植体周围牙龈组织均无炎症,术后4~6月影像资料示种植体与周围组织已形成良好的骨性结合。缺牙区术前余留牙槽骨高度为5.2mm(3.7~7.1mm),术后上颌窦窦底垂直骨增量为3.8mm(2.0~6.9mm)。随访观察12月(3~24月),临床效果良好。对数据进行统计学分析,差别有统计学意义(P<0.05)。结论对于上颌后牙区垂直骨高度不足的病例,采用上颌窦骨块内嵌提升技术,并同期植入种植体,可以有效提高上颌后牙区垂直骨高度,方法可靠,具有良好的短期疗效,但长期疗效尚需进一步观察。Objective To study the Inlay Osteotome Sinus Augmentation Technique of floor ele- vation combined with simultaneous implant placement in treatment of posterior maxilla subject to insuffi- cient bone height, as well as to evaluate the technique＇s clinical effect. Methods Forty nine implants were installed in 34 patients in the severely atrophic posterior maxilla immediately after sinus floor eleva- tion. The Inlay Osteotome Sinus Augmentation Technique using a trephine was applied in the operation. With the purpose of bite training and soft tissue reforming, the final prostheses were fixed after 4~6 months. The stability and osseointegration of the implants were clinically evaluated, also the bone height gain around the implants was measured by X-rays. Results The survival rate was 100% during the study period with this procedure. Each of the implants, loaded without pain or any subjective sensation, was clinically stable. No implants had detectable sinus membrane perforation during operation. The mean residual bone height adjacent to or beneath the sinus was 5.2 mm, ranging from 3.7 to 7.1 mm. The radiographic results demonstrated that the bone height gain was 3.8 mm（2.0 -6.9 mm）after the surgery. Statistical analysis was carried out on the measurements, and the difference was statistically significant（P^0.05）. Conclusion Based on the results and within the limits of the present study, im- plant placement in conjunction with the Inlay Osteotome Sinus Augmentation Technique may yield predict able short-term clinical results for edentulous posterior maxillary region. Besides, from the clinical point of view, these techniques may simplify treatment in the posterior. However, long-term clinical results is needed from further observation.

关 键 词：上颌窦 牙槽突 牙种植 牙种植体 骨结合 

分 类 号：R783.6[医药卫生—口腔医学]