改良小开窗在低位上颌窦底外提升术中的应用  

Application of modified micro fenestration in lower maxillary sinus floor elevation

作　　者：李文超 阮宁 李昊轩 田媛 俎威 李森浩 LI Wen-chao;RUAN Ning;LI Hao-xuan;TIAN Yuan;ZU Wei;LI Sen-hao(Department of Oral Implantology,Affiliated Hospital of Chifeng University,Inner Mongolia Autonomous Region,Chifeng024000,China)

机构地区：[1]赤峰学院附属医院口腔种植科,内蒙古赤峰024000

出　　处：《中国当代医药》2020年第26期12-16,23,F0003,共7页China Modern Medicine

基　　金：内蒙古自治区赤峰市自然科学科研课题(SZR2019184);内蒙古自治区大学生创新创业训练计划项目(201710138008)。

摘　　要：目的探讨改良小开窗在低位上颌窦底外提升术中的临床应用效果。方法选取2015年1月~2019年9月我院口腔种植科收治的30例上颌后牙区种植修复患者作为研究对象(种植位点70个,锥形束CT测量上颌窦底下方的剩余牙槽骨高度为1~3 mm),随机分为实验组(15例)和对照组(15例)。实验组患者采用改良小开窗提升上颌窦,对照组患者采用常规开窗提升上颌窦,两组均植入Bio-Oss骨粉后应用引导骨再生技术,同期或延期植入种植体。比较两组患者的开窗口直径和面积、手术时间、开窗时间、黏膜剥离和充填骨粉时间、术后3 d和7 d疼痛与面部肿胀程度以及手术前后窦底骨高度、术后窦底种植体周冠状骨宽度。结果实验组患者的开窗口直径和面积均小于对照组,差异有统计学意义(P<0.05)。两组患者的手术时间比较,差异无统计学意义(P>0.05);在骨开窗过程中,实验组患者所用时间短于对照组,差异有统计学意义(P<0.01);在上颌窦底黏膜剥离和充填骨粉过程中,实验组患者所用时间长于对照组,差异有统计学意义(P<0.01)。术后3 d和7 d,两组患者的疼痛程度比较,差异无统计学意义(P>0.05)。术后3 d,实验组患者的面部肿胀程度低于对照组,差异有统计学意义(P<0.05)。两组患者术后的窦底骨高度均高于术前,差异有统计学意义(P<0.05);术后即刻和术后6个月,两组患者的窦底种植体周冠状骨宽度比较,差异无统计学意义(P>0.05)。结论对于上颌磨牙区牙槽骨严重萎缩的患者,采用改良小开窗上颌窦底提升术能够有效增加上颌磨牙区骨高度,降低手术并发症的发生风险。Objective To investigate the clinical application effect of modified micro fenestration in lower maxillary sinus floor elevation.Methods From January 2015 to September 2019,30 patients admitted to the oral implantology department of our hospital were selected as the research subjects(70 implantation sites,the remaining alveolar bone height below the maxillary sinus measured by cone beam CT was 1-3 mm).Patients were randomly assigned to the experimental group(15 cases)and the control group(15 cases).The experimental group used modified micro fenestration to elevate the maxillary sinus floor,and the control group used conventional micro fenestration to elevate the maxillary sinus floor.Guided bone regeneration technology was applied in both groups after Bio-Oss bone powder was implanted at either the same period or at different periods.The diameter and area of open windows,operation time,post-operation pain,time of maxillary sinus bottom mucosa dissection and bone meal filling,degree of pain and facial swelling on 3 and 7 days after operation,bone height at the bottom of the maxillary sinus before and after operation,and the width of coronal bone around the sinus floor implants after operation were compared between the two groups.Results The diameter and area of the open windows in the experimental group were smaller than those in the control group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the operation time between the two groups(P>0.05).In the process of bone window opening,the time used in the experimental group was shorter than that in the control group,and the difference was statistically significant(P<0.01).In the process of maxillary sinus bottom mucosa dissection and bone meal filling,the time used in the experimental group was longer than that in the control group,and the difference was statistically significant(P<0.01).There was no statistically significant difference in the degree of pain between the two groups at 3 and 7 days after op

关 键 词：锥形束CT 低位上颌窦 上颌窦侧壁 引导骨再生 

分 类 号：R782.13[医药卫生—口腔医学]