超声骨刀在种植外科的应用效果评价

Clinical application and usefullness of piezosurgery in oral implant surgery

目的:介绍超声骨刀在种植手术中的应用及初步评价。方法:2012年2月—2012年6月期间,6例患者术前评估种植区剩余骨量不足,其中2例患者上颌后牙区牙槽嵴顶到窦底的剩余骨高度在4～6 mm,均行上颌窦侧壁开窗提升术;另外4例患者上颌或下颌前牙区骨宽度在3～6 mm,均行唇侧onlay植骨术。术中采用超声骨刀分别于上颌窦前壁开窗,进行上颌窦提升术和下颌支外斜线处块状骨取骨并行唇侧onlay植骨术。结果:6例患者均顺利完成手术,术中超声骨刀对骨皮质和骨松质都有良好的切割能力,并且精确性高,软组织保护好,出血少,手术视野清晰以及创伤小。术后无头晕、头痛等不适,切口均一期愈合。术后3、6个月复诊,全景片和CT检查显示上颌窦前壁开窗处及下颌支外斜线处骨切口愈合良好,骨材料成骨和块状骨成活良好。结论:超声骨刀对骨组织具有良好的切割能力,并对软组织有良好的保护作用,在种植外科领域具有广阔的前景。

PURPOSE： To introduce and evaluate the preliminary application of piezosurgery in oral implant surgery. METHODS： Six patients have been diagnosed as bone deficiency in implant sites through preoperative evaluation from Feb. 2012 to Jun. 2012. Two patients with residual bone height of 4 to 6 mm from the alveolar ridge crest to sinus floor in maxillary posterior region, were treated with lateral window technique of maxillary sinus. The other four patients with the residual bone width of 3-6 mm in maxillary or mandibular anterior region were treated with labial onlay bone graft technique. Piezosurgery was used for lateral window technique to finish maxillary sinus floor augmentation and mandibular ramus external oblique line graft to finish labial onlay bone graft in the operation. RESULTS： The operations were successfully completed for all six patients. During the operation, piezosurgery had a good capability to cut both cortical and cancellous bone, and had the advantage of high accuracy, soft tissue protection, less bleeding, clear operative vision and minimum trauma. Dizziness and headache didn＇t happen after operation, and all incisions healing primarily. Panoramic images and CT examinations showed that the incisions healing of anterior wall of maxillary anterior wall and mandibular ramus external oblique line were good, and the ossification of bone materials and block bone were also good after 3 and 6 months. CONCLUSION： Piezosurgery possesses favorable bone cutting ability, soft tissue protection,and thus has a broad prospect in oral implant surgery.