上颌窦底提升术

Maxillary sinus floor elevation: an overview

目前,种植手术已成为一种常规的技术应用于临床,随着种植体设计的改进和植入技术的日趋成熟,成功率不断提高,适应证也不断扩大,但是剩余骨高度不足仍是影响上颌后牙区种植手术的主要因素。临床上多采用上颌窦底提升术,主要包括上颌窦侧壁开窗术和冲压式上颌窦底提升术,这2种术式有效解决了上颌后牙区剩余骨高度不足的问题。本文主要介绍上颌窦的解剖结构、底壁分嵴等情况,以及口腔影像学检查方法的应用;归纳总结上颌窦底提升术的基本原则,上颌窦侧壁开窗提升术的切口设计、手术方法,以及3种改良冲压式上颌窦底提升术的比较,骨挤压器和骨冲顶器的应用,初步探讨植骨材料的选择,辅助上颌窦底提升术的特殊器械(超声骨刀和内镜)的特点,伴发上颌窦囊肿和术后并发症的处理方法。

Recently, implant surgery has become a common clinical technique. As the improvement of implant design and surgery, the success rate of implant surgery has been increased and the indication has also been widened. However, the inadequate height of residual bone is still the main factor influencing implant surgery in maxillary posterior region. Lateral window technique of maxillary sinus floor and the transalveolar maxillary sinus floor elevation are used to solve the problem of bone inadequacy and widen implant indication in related region. This paper mainly introduced the structure of sinus and septa,the application of oral radiology examination; summarized the basic principle of maxillary sinus floor augmentation,incision design and operative method of the lateral window technique, comparison of three different advanced technique of transalveolar elevation, the characters of osteotomes, and investigated bone materials, special equipments （piezosurgery and endoscopic）, treatment options of implant surgery with maxillary sinus cyst and postoperative complications.