在口腔种植上颌窦提升中植骨材料与影像学和器械应用的研究进展

Research progress of implant, imaging and instrument in maxillary sinus augmentation

背景:近年,上颌窦提升中是否使用及如何使用骨替代材料问题存在争议,器械及影像学的发展极大的推动了上颌窦提升的临床应用及术式的改良,新术式的不断报道也促进了上颌窦提升的成熟与发展。目的:总结上颌窦提升在材料研究库、牙颌面专用锥形束CT及超声骨刀在临床中的应用等方面的新进展。方法:由第一作者检索2000/2010 PubMed数据、SCI数据库、维普数据库及万方数据库有关上颌窦提升植骨材料、影像学应用及器械的应用、术式改良等方面的文献。结果与结论:上颌窦提升在材料学、影像学及设备学上的发展将为口腔种植在术前诊断测量、手术设计、预后分析等方面提供更为科学的服务。目前的不足及有待解决的问题有:在上颌窦提升中植骨材料的选择及应用方面,由于植骨后观察时间不足还未能得出较有效和有力的比较;不使用植骨材料的观点和效果需更多研究及实验的验证;牙颌面专用锥形束CT只是硬组织的三维成像,不能得到黏膜等软组织的状态及观察测量信息,还有待研究发展;超声骨刀的出现较新,今后在器械工作头的选择及操作技巧方面还有待做进一步的探讨改进和临床实践。

BACKGROUND： In recent years, the feasibility and the methods of applying bone substitute materials in maxillary sinus augmentation are in dispute, the developing instruments and imaging greatly facilitate the clinical application of maxillary sinus augmentation and modify surgical procedures, new surgical procedures have been reported to promote the maturation and development of maxillary sinus augmentation. OBJECTIVE： To summarize the research progress of materials research, clinical applications of maxillofacial cone CT and ultrasound bone knife in maxillary sinus augmentation. METHODS： PubMed database, SCI database, VIP database and Wanfang database from 2000 to 2010 were retrieved by the first author for articles about the maxillary sinus bone graft material, imaging and device applications, improved surgical procedures and other aspects. RESULTS AND CONCLUSION： The development of materials science, imaging science and instrument in maxillary sinus augmentation can provide scientific service for preoperative diagnosis and measurement, operation design, prognosis design of oral implant. Current deficiencies and unsolved issues are addressed as： the selection and application of bone graft material in maxillary sinus augmentation, more effective and powerful comparisons are not available due to shorter observations of the bone graft; abandonment of bone graft material requires more research and experimental verification; maxillofacial cone CT is only the three-dimensional imaging of hard tissue, it cannot observe the conditions and measurement information of mucosa and other soft tissues, needing further research and development; ultrasonic bone knife emerges recently, the selection and operating skills of instrument working head require further exploration and clinical improvement.