微创技术在上颌窦内提升植骨中应用效果的影像学评价  

Minimally Invasive Sinus Augmentation Procedure Using a Sinus Crestal Approach:A Prospective Case Series Study on Radiologic Outcomes

作　　者：王智[1] 邹立东[1] WANG Zhi;ZOU Lidong(The Second Dental Center, Peking University School and Hospital of Stomotology, Beijing 100101, China)

机构地区：[1]北京大学口腔医院第二门诊部,北京100101

出　　处：《口腔医学研究》2020年第7期688-692,共5页Journal of Oral Science Research

摘　　要：目的:通过随访应用微创技术行上颌窦底内提升植骨并同期种植的病例,用锥形束CT(CBCT)及根尖片对植骨效果进行评价。方法:选取56例患者(68个上颌后牙区缺牙位点),可用骨高度4~9 mm,运用微创技术行上颌窦底内提升植骨并同期植入种植体,术后即刻、3个月和1年复查时拍摄CBCT和根尖片,测量上颌窦底提升的骨高度和种植体周围边缘骨水平的变化,并对提升植骨后的形态进行分类。结果:术前骨高度为(6.34±1.15)mm,术后骨高度为(11.57±1.28)mm,术前与术后即刻具有显著性差异。术后即刻的提升高度为(5.23±1.33)mm,术后1年的提升高度为(4.66±1.36)mm,两者具有显著性差异,P<0.05。对提升后窦底成骨形态分为四种,A型47例(69.1%),B型11例(16.2%),C型4例(5.9%),D型6例(8.8%),穿孔率为4.4%。术后1年种植体边缘骨吸收为(0.65±0.20)mm。结论:应用本研究中的微创方法进行上颌窦底内提升植骨,操作简便、安全有效,术后窦膜穿孔等并发症发生率低,推荐在临床推广使用。Objective:To evaluate radiologic outcomes and morphology of a novel device that allows simultaneous hydraulic sinus membrane elevation,bone grafting,and implant placement.Methods:56 patients with 68 lost teeth in the posterior maxilla with 4 to 9 mm of residual crestal height were operated by minimally invasive Sinus Crestal Approach(SCA)technology.They were analyzed by cone beam computed tomography(CBCT)pre and immediately post operation,three months post-operation,and one year post-operation.The parameters were measured:pre-operative bone height(H0),immediately post-operative bone height(H1),three-month post-operative height(H2),1 year post-operative height(H3),lift Height H'=H1-H0,three months of osteogenic height H1'=H2-H0,1 year post-operative osteogenesis height H2'=H3-H0,and post-operative bone tip height H3'.Sinus floor morphology was assessed one year post-operation.Marginal bone lost was measured.Results:The mean heights pre(H0)and immediately post-operation(H1)were(6.34±1.15)mm and(11.57±1.28)mm(P<0.01).The post-operative lift height(H')was(5.23±1.33)mm,and the 1 year post-operative lift height(H2')was(4.66±1.36)mm(P<0.05).According to the post-operative CBCT sagittal images,the morphology was divided into four types,47 cases of type A(69.1%),11 cases of type B(16.2%),4 cases of type C(5.9%),and 6 cases of type D(8.8%).A total of 3 cases had perforation,with perforation rate at 4.4%.MBL was(0.65±0.20)mm.Conclusion:The SCA technique was simple and easy to master,which achieved excellent results and low incidence of complications.Long-term clinical studies are needed to confirm these preliminary results.

关 键 词：上颌窦内提升 种植 微创 

分 类 号：R78[医药卫生—口腔医学]