两次经牙槽嵴顶上颌窦提升联合CGF在上颌后牙区骨量极度不足种植的临床应用

Clinical application about two-stage closed sinus lift combined with CGF for severe bone deficiency in the posterior maxillary

目的:评价经牙槽嵴顶两次上颌窦提升联合CGF在上颌后牙区骨量极度不足情况下种植的临床效果。方法:选择2014年2月至2018年2月在长沙市口腔医院修复科后牙区剩余骨高度仅为1-2mm的患者应用经牙槽嵴顶两次上颌窦提升联合CGF种植病例23例,共植入种植体41枚,并完成固定修复。通过临床观察、X线片检查评估种植体2年存留率。结果:在观察期内,41枚种植体均获得良好骨结合;X线片显示种植体颈部骨组织稳定,种植体存留率100%。结论:在2年观察期内,经牙槽嵴顶两次上颌窦提升联合CGF应用于上颌后牙区骨量极度不足情况下的种植临床效果良好,为临床医生提供了一种更便捷微创简单的方法,同时缩短了手术操作时间,减小患者术后反应,特别对于张口受限及颊肌肥厚的患者,侧壁开窗比较困难,此方法无疑是一种更好的选择。

Objective:To evaluate the long-term clinical outcomes of two-stage closed sinus lift for the maxillary sinus combined with CGF for severe bone deficiency in the posterior maxillary.Methods:Twenty-three patients with maxillary posterior tooth loss(1 mm≤RBH≤2 mm)were treated with two-stage closed sinus lift combined with CGF at the prosthodontics department of our hospital between February,2014 and February,2018,with 41 implants implanted.And implant-supported fixed prostheses were restored.According to the clinical observation and x-ray examination to assess the survival rates of the implant within 2 years.Results:Among the 41 implants placed,all implants showed well-osseointegrated to the alveolar bones,no implants were failed.The cervical alveolar bone surrounding the implants were stable at the end of the two years.The survival rate was 100%.Conclusions:In the 2-year follow up clinical study,favorable long-termclinical outcomes can be achieved by two-stage closed sinus lift for the maxillary sinus combined with CGF for severe bone deficiency in the posterior maxillary with less trauma and less clinical time,and provide a simpler and more convenient method to solve the problem of severe alveolar bone height deficiency in the maxillary posterior region,especially for the patients with severe limitation of mouth opening and thickening check muscle.