冲压法上颌窦底提升同期牙种植体植入术对上颌窦黏膜的影响研究  

Influence of osteotome sinus floor elevation in conjunction with implant placement on sinus membrane

作　　者：秦磊 林盛筱 赵宁波 谢超 宋应亮 李德华 

机构地区：[1]第四军医大学口腔医院口腔种植科,陕西西安710032 [2]中国人民解放军第461医院口腔科,吉林长春130000

出　　处：《中国实用口腔科杂志》2016年第4期214-217,223,共5页Chinese Journal of Practical Stomatology

基　　金：国家自然科学基金资助项目(81300918)

摘　　要：目的观察冲压法上颌窦底提升同期牙种植体植入术对上颌窦黏膜的影响。方法收集2012年1月至2015年8月于第四军医大学口腔医院口腔种植科就诊,因上颌后牙区垂直骨高度不足连续行冲压法上颌窦底提升术的患者100例(共100侧上颌窦),同期植入Straumann种植体126枚。于术前、术后1 d、术后6个月拍摄锥形束CT(CBCT),分析该术式对上颌窦黏膜的影响。结果上颌窦正常黏膜和增厚黏膜在术后1 d的CBCT上均观察到黏膜厚度的增加,与术前黏膜厚度的差异有统计学意义(P<0.05);术后1 d上颌窦鼻道开口阻塞发生率显著增加(0.09%),与术前差异有统计学意义(P<0.05)。不同时期上颌窦假性囊肿直径无明显变化(P>0.05)。结论从对上颌窦黏膜及生理功能的影响来看,上颌窦黏膜增厚和假性囊肿并非冲压法上颌窦提升术的绝对禁忌证。Objective To evaluate membrane change in osteotome sinus floor elevation in conjunction with dental im- plant placement. Methods One hundred and twenty seven implants were placed in 100 consecutive patients with an in- sufficient residual vertical height. All implants were placed following a one-stage osteotome sinus floor elevation（OSFE） protocol （elevating the sinus floor and placing the implant at the same time）. CBCT was performed prior to, one-day af- ter surgery and six months after surgery. The influence of osteotome technique in conjunction with implant placement on sinus membrane was evaluated. Results The schneiderian membrane exhibited significant swelling one day after surgery （P 〈 0.05）. The corresponding changes were also observed for ostium patency with a tendency of transient obstruction （0.09%）after surgery. Compared with pre-surgery CBCT scans, no difference was found in diameter of antral pseudo- cysts in different periods （P 〉 0.05）. Conclusion Thickened membranes and antral pseudocysts might not be contrain- dieations to OSFE from the standpoint of the surgical impact on the schneiderian membrane.

关 键 词：冲压法上颌窦底提升术 上颌窦黏膜 上颌窦假性囊肿 

分 类 号：R78[医药卫生—口腔医学]