改良上颌窦底内提升术的临床效果观察  

The Clinical Outcome of a Modified Technique in Transcrestal Sinus Floor Elevation

作　　者：楚德国[1] 宿玉成[2] 李永成 吕铁铭 王琳丹 CHU De-guo;SU Yu-cheng;LI Yong-cheng;LV Tie-ming;WANG Lin-dan(Department of Stomatology,Chuiyangliu Hospital affiliated to Tsinghua University,Beijing 100022;Department of Dental Impant,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,Beijing 100032;Beijing Chaoyang Integrative Medicine Emergency Medical Center,Beijing 100023,China)

机构地区：[1]清华大学附属垂杨柳医院口腔科,北京100022 [2]中国医学科学院北京协和医院口腔种植中心,北京100032 [3]北京朝阳中西医结合急诊抢救中心口腔科,北京100023

出　　处：《口腔颌面外科杂志》2019年第5期269-273,共5页Journal of Oral and Maxillofacial Surgery

摘　　要：目的:评估一种改良上颌窦底内提升术在口腔种植修复中的临床效果。方法:在2016-12—2018-07期间,于56例上颌后牙缺失患者共83个位点,行穿牙槽嵴顶四周剥离上颌窦底提升术。术前CBCT测量剩余骨高度(residual bone height,RBH),术中植骨,同期或延期植入种植体。术后即刻拍摄CBCT测量上颌窦底提升高度并观察窦底黏膜完整性。术后至少4个月完成修复,随访观察种植体存留率。结果:3个位点术中因上颌窦黏膜破裂改为侧壁开窗上颌窦底提升术,位点黏膜破裂率为3.61%。其余80个位点术后即刻CBCT显示其中5个位点上颌窦底黏膜破裂,位点黏膜破裂率为6.02%。80个位点中76个位点同期种植,3个位点延期种植,1个位点放弃种植。种植体直径为4.0~5.1 mm,平均(4.73±0.35)mm,长度为8.0~11.5 mm,平均(10.27±0.69)mm。上颌窦底黏膜未破裂的75个位点,术前RBH为0.88~9.27 mm,平均(5.57±1.91)mm;上颌窦底提升高度为4.54~15.14 mm,平均(8.09±1.99)mm。手术至修复时间为4~15个月,平均(7.14±2.06)个月,修复后随访时间为1~20个月,平均(9.36±4.60)个月。2枚种植体于修复前脱落,1枚种植体于修复后脱落,总体种植体存留率96.25%。结论:穿牙槽嵴顶四周剥离,行上颌窦底内提升创伤小,相对安全可靠,短期种植修复效果满意。Objective:To evaluate the clinical outcome of the modified transcrestal around detached sinus floor elevation technique(TADSFET)in the implant treatment.Methods:A total of 83 implant sites(56 patients)underwent TADSFET with bone grafting from December 2016 to July 2018.CBCT was used to measure the residual bone height(RBH)preoperatively.Implant was placed simultaneously or in a delayed phase according to the RBH.The elevated height and the integrality of the sinus membrane were evaluated by CBCT immediately postoperation.Restoration of the upper structures were performed at least 4 months after operation.The implant survival rate was evaluated during the follow-up.Results:Sinus membrane perforation was observed at 3 implant sites(3.61%)intraoperatively,followed by lateral window sinus floor elevation technique instead of TADSFET for these 3 implant sites.Membrane perforation(6.02%)were observed in 5 sites among the rest 80 implant sites from CBCT immediately postoperation.For the rest 80 implant sites,1 site was given up,76 were placed with implants simultaneously,and 3 were placed with implant in a 2-stage manner.The diameter of implants was from 4.0 to 5.1 mm,averaged(4.73±0.35)mm.The length of implants was from 8.0 to 11.5 mm,averaged(10.27±0.69)mm.The mean RBH for 75 implant sites without sinus membrane perforation was(5.57±1.91)mm,ranged from 0.88 to 9.27 mm,and the mean elevated height was(8.09±1.99)mm(ranged from 4.54 to 15.14 mm).Average time between operation and permanent restoration was(7.14±2.06)months(ranged from 4 to 15 months),and the average follow-up time after permanent restoration was(9.36±4.60)months(ranged from 1 to 20 months).A total of 3 implants were lost,including 2 before and 1 after permanent restoration,giving a survival rate of 96.25%.Conclusion:TADSFET is a minimally invasive,relatively safe,and reliable technique to elevate the sinus floor.Accepted short-term outcome was observed in the current study.

关 键 词：种植 上颌窦底提升 剩余骨高度 

分 类 号：R782[医药卫生—口腔医学]