单纯脱蛋白牛骨用于开窗法延期种植前瞻性研究的三年以上临床效果评价  

Later approach sinus floor elevation using deproteinized bovine bone mineral with staged implant placement:follow-up for more than 3 years in a prospective clinical study

作　　者：王金 刘毅[1] 国正则 谢超[1] 曹彦泽 于卓 雷驰 李德华[1] Wang Jin;Liu Yi;Guo Zhengze;Xie Chao;Cao Yanze;Yu Zhuo;Lei Chi;Li Dehua(Department of Implantology,School of Stomatology,The Fourth Military Medical University&State Key Laboratory of Military Stomatology&National Clinical Research Center for Oral Diseases&Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture,Xi′an 710032,China;Department of Stomatology,The 81st Group Army Hospital of Chinese PLA,Zhangjiakou 075000,China)

机构地区：[1]第四军医大学口腔医学院口腔种植科,军事口腔医学国家重点实验室,口腔疾病国家临床医学研究中心,陕西省口腔生物工程技术研究中心,西安710032 [2]解放军陆军第八十一集团军医院口腔科,张家口075000

出　　处：《中华口腔医学杂志》2020年第6期378-382,共5页Chinese Journal of Stomatology

摘　　要：目的评价单纯脱蛋白牛骨用于经外侧壁入路的上颌窦底提升植骨术(开窗法)后延期种植的临床效果。方法本试验是一项前瞻性临床研究,纳入2011年5月至2015年2月就诊于第四军医大学口腔医学院口腔种植科的55例上颌后牙缺失区剩余牙槽骨高度不足5 mm的患者,其中女性21例,男性34例,年龄为(55.2±7.1)岁,共行62侧开窗法上颌窦底提升术,行临床及影像学检查,评价种植体存留率、并发症、周围软组织健康情况以及边缘骨吸收情况。结果完成3年以上随访的患者占74.5%(41/55),47侧开窗法上颌窦底提升,共82枚种植体,随访时间为(51.8±14.3)个月(36~78个月),上颌窦随访率为75.8%(47/62),种植体随访率为73.9%(82/111),种植体存留率为98.8%(81/82)。种植体边缘骨吸收结果近中为(0.64±0.63)mm(-0.28 mm,1.47 mm),远中为(0.49±0.73)mm(-0.51 mm,1.21 mm),改良出血指数为0.46±0.72,改良菌斑指数为0.60±0.87,角化黏膜宽度为(2.14±1.22)mm。种植体并发植体周黏膜炎发生率为28.4%(23/81),无植体周炎并发症,1例修复体出现机械并发症。结论在上颌后牙区窦嵴距不足的情况下,采用单纯脱蛋白牛骨进行开窗法上颌窦底提升术延期种植是可行的,临床效果可靠。Objective To evaluate clinical effect of deproteinized bovine bone for delayed implantation after fenestration.Methods This trial is a continuation of a prospective clinical trial.From May 2011 to February 2015 in Department of Implantology,School of Stomatology,The Fourth Military Medical University after planting division of 55 cases of maxillary teeth missing area of residual alveolar bone height≤5 mm patients.There were 21 female and 34 male patients,their average age were(55.2±7.1)years.A total of 62 side fenestration of maxillary sinus floor lift,clinical and imaging examination,evaluation of implant retention rate,complications,peripheral soft tissue health and marginal bone resorption.Results A total of 82 implants were followed up in 41 patients.The average follow-up time was(51.8±14.3)months(36-78 months).The follow-up rate of the maxillary sinus was 75.8%(47/62),the follow-up rate of the implant was 73.9%(82/111),and the implant survival rate was 98.8%(81/82).The bone resorption results at the implant margins were(0.64±0.63)mm(-0.28 mm,1.47 mm)in the near and(0.49±0.73)mm(-0.51 mm,1.21 mm)in the far,the improved hemorrhage index was 0.46±0.72,the improved plaque index was 0.60±0.87,and the keratinized mucosa width was(2.14±1.22)mm.The incidence rate of peri-implant mucositis was 28.4%(23/81)among 23 implants,and there was no complication of peri-implant inflammation.Conclusions This study shows that under the condition of insufficient sinus ridge spacing in the maxillary posterior area,it is feasible to use bovine bone alone to remove protein for delayed implantation of maxillary sinus floor elevation by windowing,and the clinical effect is reliable.

关 键 词：牙种植 上颌窦底提升术 开窗法 骨代用品 

分 类 号：R783[医药卫生—口腔医学]