上颌窦底提升术同期种植体长期存活率的影响因素分析  

Analysis on the influencing factors of long-term survival of implants during lateral maxillary sinus floor elevation

作　　者：陈文渊 陈翔 林晓炜 徐亮 CHEN Wen-yuan;CHEN Xiang;LIN Xiao-wei;XU Liang(Department of Stomatology,Zhangye People's Hospital Affiliated to Gansu Hexi University.Zhangye 734000,Gansu Province,China)

机构地区：[1]河西学院附属张掖人民医院口腔科,甘肃张掖734000

出　　处：《上海口腔医学》2020年第5期539-543,共5页Shanghai Journal of Stomatology

摘　　要：目的:探讨剩余垂直骨量/剩余牙槽骨高度(residual bone height,RBH)、上颌窦膜穿孔和空洞存在对上颌窦底提升术(maxillary sinus lifting,MSFA)植入种植体存活率的长期影响。方法:选择2005—2009年行MSFA并随访至2019年的56例患者(98颗种植体)作为研究对象。使用全景片和根尖周X线片评估RBH。根据RBH、窦膜穿孔和空洞的存在,采用对数秩检验和种植体失败危险比例评估累积生存率(cumulative probability of survival,CSR),采用SPSS 21.0软件包对数据进行统计学分析。结果:无窦膜穿孔的种植体的剩余垂直骨量显著大于窦膜穿孔的种植体,存活的种植体的剩余垂直骨量显著大于植入失败的种植体(P<0.05),但性别、吸烟、空洞对剩余垂直骨量无显著影响(P>0.05)。MSFA手术植入种植体后10年总CSR为94.5%,其中,女性种植体的CSR显著高于男性,非吸烟组CSR显著高于吸烟组,RBH≥3 mm的种植体CSR显著高于RBH<3 mm的种植体;但窦膜穿孔与无窦膜穿孔间CSR无显著差异。结论:RBH<3 mm植入的种植体的CSR较低,在适当的口腔卫生维持条件下,其存活率可被接受。窦膜穿孔和空洞存在,不会影响侧向MSFA植入种植体的存活率。PURPOSE:To investigate the long-term effects of residual bone height(RBH),maxillary sinus membrane perforation,and cavities on survival of implants with lateral maxillary sinus lifting(MSFA).METHODS:Fifty-six patients(98 implants)who underwent MSFA from 2005 to 2009 and followed up till 2019 were enrolled.RBH was assessed using a series of panoramic and periapical X-ray films.Based on the presence of RBH,sinus membrane perforation,cavities,the cumulative survival rate(CSR)were evaluated using log-rank test and risk ratio of implant failure,SPSS 21.0 software package was used to analyze the data.RESULTS:The residual bone height of implants with sinus membrane perforation was significantly larger than those without sinus membrane perforation.The residual bone height of the survival implants was significantly larger than that of the failed implants(P<0.05),but there was no significant difference in the residual bone height between gender,smoking and cavities(P>0.05).The total CSR of 10 years after implantation by MSFA was 94.5%,of which the females was significantly higher than that of males,non-smokers was significantly higher than that of smokers,and RBH≥3 mm was significantly higher than that of RBH<3 mm(P<0.05).However,there was no significant difference in CSR between sinus membrane perforation and non-sinus membrane perforation.CONCLUSIONS:Implants with RBH<3 mm have lower CSR,and the survival is acceptable under proper oral hygiene maintenance conditions.Sinus perforation and cavity do not affect the survival of lateral MSFA implants.

关 键 词：上颌窦底提升术 骨再生 生存率 窦膜穿孔 空洞 

分 类 号：R782.1[医药卫生—口腔医学]