环形骨块内嵌式窦底提升与常规上颌窦外提升术式的比较研究  

Comparative study between annular bone block embedded in maxillary sinus lift and conventional maxillary sinus lift

作　　者：赵继刚 梁景章 黄艳阳 张磊涛[2] 潘文仪 钟小强 ZHAO Ji-gang;LIANG Jing-zhang;HUANG Yan-yang;ZHANG Lei-tao;PAN Wen-yi;ZHONG Xiao-qiang(Department of Stomatology, Foshan Nanhai District People′s Hospital, Foshan 528000, China;Department of Stomatology, Stomatology Hospital, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China)

机构地区：[1]佛山市南海区人民医院口腔科,广东佛山528000 [2]南方医科大学附属南方医院,广东广州510515

出　　处：《口腔疾病防治》2016年第10期582-588,共7页Journal of Prevention and Treatment for Stomatological Diseases

基　　金：佛山市科技局科技攻关项目(2015AB000422);广东省自然科学基金(S2011040003469)

摘　　要：目的探讨牙槽嵴顶入路环形骨块内嵌式窦底提升与常规上颌窦外提升术式的优缺点。方法将骨量严重缺失(窦嵴距离≤4 mm)患者80例共120个上颌窦,随机分为2组,每组60个上颌窦。分别通过牙槽嵴顶入路(牙槽嵴顶入路组)和上颌侧壁开窗入路(上颌侧壁开窗入路组)2种不同入路途径进行上颌窦底提升植骨。半年后植入种植体,植入种植体半年后行永久修复。比较2组上颌窦窦膜穿孔情况、手术时间、患者痛苦指数、上颌窦底提升高度。结果牙槽嵴顶入路组术后无一例出现鼻孔流血现象,窦膜穿孔率为0,上颌侧壁开窗入路组有2例术后鼻孔少量流血,窦膜穿孔率为3.33%;牙槽嵴顶入路组手术时间为(42.82±3.46)min,明显少于上颌侧壁开窗入路组的(88.38±4.37)min,差异具有统计学意义(t=35.237,P=0.001);牙槽嵴顶入路组痛苦指数4.20±0.68,低于上颌侧壁开窗入路组6.34±0.45,2组差异具有统计学意义(t=3.056,P=0.003);牙槽嵴顶入路组平均提升高度为(12.44±2.48)mm,上颌侧壁开窗入路组平均提升高度为(12.28±2.87)mm,2组差异无统计学意义(t=0.908,P=0.390);牙槽嵴顶入路组种植牙成功率为100%,上颌侧壁开窗入路组为99.03%(102/103)。结论牙槽嵴顶入路环形骨块内嵌式窦底提升术式相比常规上颌窦外提升术式手术时间明显缩小,患者痛苦指数明显减少,并发症少;而在上颌窦底提升高度、种植牙成功率及窦膜穿孔率方面2组无明显差异。Objective To investigate the advantage and disadvantage between annular bone block embedded inmaxillary sinus lift and conventional maxillary sinus lift. Methods One hundred and twenty sinuses from 80 patientsof serious insufficient of bone quantity (0?4 mm height of residual bone in the posterior maxilla) were divided into twogroups randomly. Each group contained 60 sinuses. By preparing annular bone block at the alveolar ridge crest, 60 si?nuses augmentation were carried out by repetitive knocking annular bone block under light force in the group of routefrom the crest of alveolar bone and 60 mucosa of maxillary sinuses were lifted up by routine fenestration operation onthe maxillary lateral wall in the conventional sinus lifting group. Implants were implanted after six months. The perpetu?al prosthesis was made in 6 months. Misery index of patients, lifting height of sinus floor, the perforating rate of sinus mucosa and the success rate of implantation were compared between two methods. Lifting height of sinus floor was exam?ined through x?ray imaging. Results No nostril hemorrhage was found in the group of route from crest sinus liftingwhereas two patients occurred nostril hemorrhage in the conventional group; the mean operation time of route groupfrom the crest of alveolar bone and the route group form the lateral wall was (42.82 ± 3.46) min, (88.38 ± 4.37) min, thedifference was statistically significant (t = 35.237, P = 0.001) ; misery index of route group from the crest of alveolarbone and the route group form the lateral wall was (4.20 ± 0.68), (6.34 ± 0.45), the difference was statistically signifi?cant (t = 3.056, P = 0.003) ; lifting height of sinus floor of route group from the crest of alveolar and the route groupform the lateral wall was (12.44 ± 2.48) mm, (12.28 ± 2.87) mm , and there was no statistical significance (t = 0.908,P = 0.390). Conclusion The route from the crest of alveolar bone could obviously reduce operative wound and postop?erative complications, shorten operative time, lesse

关 键 词：牙槽嵴顶 上颌窦底提升 植骨术 入路途径 穿孔 

分 类 号：R783.4[医药卫生—口腔医学]