新型穿牙槽嵴顶上颌窦底提升骨凿临床应用研究  

The clinical analysis of a new type of osteotome for transcrestal around detached sinus floor elevation technique

作　　者：楚德国[1] 

机构地区：[1]清华大学附属北京市垂杨柳医院(北京微创医院),北京100022

出　　处：《现代口腔医学杂志》2016年第3期151-155,共5页Journal of Modern Stomatology

摘　　要：目的介绍一种新型穿牙槽嵴顶上颌窦底提升骨凿（Chu Deguo Osteotome）及穿牙槽嵴顶四周剥离上颌窦底提升术,初步评价该新型骨凿及术式应用于剩余牙槽骨高度〈6mm患者的临床效果。方法上颌后牙缺失患者6名（21-57岁,平均37.17±12.92岁）,术前CBCT测量种植位点剩余牙槽骨高度。应用新型穿牙槽嵴顶上颌窦底提升骨凿进行穿牙槽嵴顶四周剥离上颌窦底提升术,上颌窦底提升后的空间内植入Bio-Oss骨粉,同期或延期植入种植体。术后即刻拍摄曲面体层放射片或CBCT对上颌窦底提升效果进行评估。结果剩余牙槽骨高度2.90-5.99mm,平均4.55±1.15mm。6名患者7个上颌窦提升位点同期植入种植体6颗,延期植入1颗。植入种植体长度平均11.42±0.20mm。上颌窦底提升高度8.58-12.69mm,平均10.38±1.44mm。术后曲面体层放射片或CBCT显示所有种植位点上颌窦底提升区域均形成一外形连续界限清晰的＂帐篷状＂隆起,未发生上颌窦黏膜穿孔。结论新型穿牙槽嵴顶上颌窦底提升骨凿及穿牙槽嵴顶四周剥离上颌窦底提升术可应用于剩余牙槽骨高度〈6mm患者。与传统穿牙槽嵴顶上颌窦底提升术比较,穿牙槽嵴顶四周剥离上颌窦底提升术具有对上颌窦底黏膜提升面积大、提升幅度高、创伤小、更安全等优点,就提升幅度而言可以达到侧壁开窗上颌窦底提升术的效果。Objective To introduce a new type of osteotome（Chu Deguo Osteotome）for a transcrestal around detached sinus floor elevation technique（TADSFET）used in patients with less 6 mm residual bone height. Methods 6 patients（mean age ： 37.17±12.92 ys） treated with TADSFET were evaluated. All patients were examined by CBCT for residual bone height preoperatively. Bio-Oss was used as the augmentation material. Implant was placed simultaneously with sinus augmentation or delayed.Following the operation, panoramic tomography or CBCT were used to assess the bone height gained. Results The residual bone height in the posterior maxilla ranged from 2.90 to 5.99 mm（average 4.55±1.15 mm）. 6 implants were placed simultaneously with sinus augmentation and 1 implant was placed in 2-stage manner.Average length of implants was 11.42 ±0.20 mm. The mean height increase of the implant sites using the TADSFET was10.38 ±1.44 mm（ranged from 8.58 to 12.69 mm）. Panoramic tomography or CBCT pictures showed that there was a smooth and continuous tent-shaped apophysis on the lifting site and no signs of laceration on the membrane. Conclusion The new type of osteotome and the TADSFET can be recommended when less 6 mm residual bone height was present. Compared with traditional transcrestal sinus floor elevation technique the TADSFET has some advantages such as bigger lift area, higher lift height, less trauma and more secure. As for the gained bone height, the TADSFET can achieve the same results as the lateral window sinus floor elevation technique.

关 键 词：新型骨凿 穿牙槽嵴顶四周剥离上颌窦底提升术 剩余牙槽骨高度 

分 类 号：R783.6[医药卫生—口腔医学]