超短种植体植入结合上颌窦内提升治疗上颌后牙骨量严重不足的疗效观察

Observation of the therapeutic effect of ultra short implant implantation combined with maxillary sinus elevation in the treatment of severe bone deficiency in maxillary posterior teeth

目的探讨超短种植体植入结合上颌窦内提升治疗上颌后牙骨量严重不足的近远期疗效。方法选择84例上颌后牙骨量严重不足患者,根据手术方式分为对照组(上颌窦内提升并同期种植体修复)和观察组(上颌窦内提升结合超短种植体植入)。比较两组患者牙槽骨高度(RBH)、龈乳头高度、骨质增量高度、边缘骨丧失高度,以及种植体周围骨量和留存率、牙菌斑指数(PLI)、出血指数(BI)、牙周袋探诊深度(PD)、附着丧失(CAL)和并发症发生情况。结果与术前比较,术后两组RBH均明显升高(P<0.05),但术后两组比较差异无显著性(P>0.05)。与术后1周比较,术后6个月两组种植体周围骨量均降低,而观察组高于对照组(P<0.05)。术后6个月观察组龈乳头高度低于对照组(P<0.05)。两组术后骨质增量高度、边缘骨丧失高度和种植体留存率以及并发症发生率比较差异无显著性(P>0.05)。与术后1周比较,术后6个月两组PLI、BI、PD、CAL升高,观察组低于对照组(P<0.05)。结论超短种植体植入结合上颌窦内提升治疗上颌后牙骨量严重不足疗效好,值得临床推广。

Aim To explore the short-term and long-term efficacy of ultra short implant implantation combined with maxillary sinus elevation in the treatment of severe bone deficiency in maxillary posterior teeth.Methods 84 patients with severe bone deficiency in the maxillary posterior teeth were selected and divided into a control group(maxillary sinus elevation combined with simultaneous implant repair)and an observation group(maxillary sinus elevation combined with ultra short implant implantation)according to the surgical methods.The residual bone height(RBH),papilla height,bone increment height,marginal bone loss height,as well as peri implant bone mass and retention rate,plaque index(PLI),bleeding index(BI),periodontal pocket probing depth(PD),clinical attachment level(CAL),and incidence of complications between two groups of patients were compared.Results Compared with the parameters before operation,RBH levels were significantly increased in both groups after surgery(P<0.05),but there was no significant difference between the two groups after surgery(P>0.05).Compared with the situations one week after surgery,the bone mass around the implants in both groups were decreased at 6 months after surgery,while the observation group was higher than the control group and the gingival papilla height was lower than the control group(P<0.05).There was no significant difference in the postoperative bone increment height,marginal bone loss height,implant retention rate,and incidence of complications between the two groups(P>0.05).Compared with one week after surgery,PLI,BI,PD,and CAL were significantly increased in both groups at 6 months after surgery,with the observation group being lower than the control group(P<0.05).Conclusion The combination of ultra short implant implantation and maxillary sinus elevation has a good therapeutic effect in the treatment of severe insufficient bone mass in maxillary posterior teeth,and is worthy of clinical promotion.