改良小开窗上颌窦外提升同期种植体植入术的5年临床观察  

A clinical study of modified minimally invasive incision in maxillary sinus floor elevation with simultaneous placement of dental implants for 5 years

作　　者：张雯[1] 张庆元[1] 鲁洁[1] 程洁莉 ZHANG Wen;ZHANG Qing-yuan;LU Jie;CHENG Jie-li(Department of Stomatology,Guangdong Second Traditional Medicine Hospital,Guangzhou 510095,China)

机构地区：[1]广东省第二中医院口腔科,广州510095

出　　处：《岭南现代临床外科》2020年第2期193-199,共7页Lingnan Modern Clinics in Surgery

基　　金：广东省中医药局科研项目(20201031);广东省医学科研基金(B2019227)。

摘　　要：目的探讨改良小开窗在上颌窦外提升同期种植体植入术中的较长期临床效果。方法自2012年1月至2014年1月,收集上颌后牙缺失病例27例,剩余牙槽嵴高度(RBH)≤7 mm,平均(4.03±1.87)mm,在上颌窦前外侧壁行改良小开窗上颌窦外提升术,并同期植入种植体共42枚,术后半年行上部结构修复,所有病例观察时间均≥5年(即60个月以上)。结果42枚种植体5年存留率100%,共提升上颌窦31侧,其中1例发生窦膜小穿孔,穿孔率3.23%,2例机械并发症,经过修复均使用良好;术后即刻、半年、1年及5年的RBH均显著高于术前,且随着术后时间的延长逐渐减少(P<0.001);进一步比较,根据患者术前RBH水平,将其分为≤4 mm组和>4 mm组,两组间术后RBH变化量的差异无统计学意义(P=0.124);术后半年较术后即刻骨吸收量0.97 mm,术后1年较术后半年骨吸收量1.15 mm,术后5年较术后1年骨吸收量0.66 mm,可见术后1年之后上颌窦提升骨量逐渐减少并且趋于稳定。结论改良小开窗上颌窦外提升并同期种植体植入术可获得理想提升高度,减少患者创伤,较长期的临床效果稳定。Objective To discuss the long clinical effect of modified minimally invasive incision in maxillary sinus floor elevation with simultaneous placement of dental implants of patients.Methods Between January 2012 and January 2014,a total of 27 patients with maxillary posterior teeth missing were enrolled in this study.The residual alveolar bone height(RBH)was less than 7 mm,with an average of(4.03±1.87)mm.A modified minimally invasive fenestration was performed on the lateral wall of the maxillary sinus,and a total of 42 implants were implanted at the same time.The upper part was repaired half a year later,and all cases were observed for 5 years(that is more than 60 months).Results The 5-year survival rate of 42 implants was 100%,and a total of 31 sides of the maxillary sinus were elevated.One case had small perforation of the sinus membrane,and the perforation rate was 3.23%.RBH measured immediately after the operation,six months,one year and five years after the operation were significantly higher than that before the operation,and gradually decreased with the extension of postoperative time(P<0.001).Further,according to the preoperative RBH level,the patients were divided into two groups(RBH≤4 mm group and RBH>4 mm group).There was no statistically significant difference in postoperative RBH change between the two groups(P=0.124).The bone resorption was 0.97 mm six months after the operation compared with that immediately after the operation.Compared with half a year after the operation,the bone resorption was 1.15 mm at 1 year.Compared with 1 year after surgery,the bone resorption was 0.66 mm at 5 years after surgery.It can be seen that after 1 year,the elevated bone mass of maxillary sinus gradually decreases and tends to stabilize.Conclusion Modified minimally invasive incision in maxillary sinus floor elevation with simultaneous placement of dental implants can achieve ideal elevation,reduce trauma in patients,and achieve stable long-term clinical effect.

关 键 词：改良小开窗 上颌窦提升 种植体 临床效果 

分 类 号：R782[医药卫生—口腔医学]