珊瑚羟基磷灰石与Bio-Oss骨代用品联合闭合式上颌窦提升术同期种植的比较

A clinical comparative study on coralline hydroxyapatite versus Bio-Oss bone substitute for osteotome-mediated maxillary sinus augmentation

目的评价可吸收珊瑚羟基磷灰石和Bio-Oss两种骨移植材料在闭合式上颌窦提升术同期种植的临床应用效果。方法采取随机对照临床试验研究方法,将40例上颌后牙区缺失牙患者分为两组:(1)Bio-Oss组行闭合式上颌窦提升术+植入Bio-Oss+同期种植;(2)羟基磷灰石组行闭合式上颌窦提升术+植入可吸收性珊瑚羟基磷灰石+同期种植,5～6个月后行上部结构修复。结果随访所有种植体平均负载23个月,两组种植体存留率均为100%。X线片显示,Bio-Oss组术前、术后即刻、负重1年后平均窦底高度分别为5.8、11.5、10.9mm,羟基磷灰石组3个时间点平均窦底高度为5.3、11.2、10.3mm,术后即刻两组骨提升高度未见明显差异,负重1年后可吸收珊瑚羟基磷灰石组骨吸收大于Bio-Oss组,且差异有统计学意义(P<0.05)。结论可吸收性珊瑚羟基磷灰石和Bio-Oss人工骨用于上颌窦闭合式提升术成骨效果理想,种植体存留率无明显差异。

Objective To evaluate the clinical outcomes of osteotome-mediated maxillary sinus augmentation and implant placement with Bio-Oss or eoralline hydroxyapatite bone substitute. Methods Forty patients with edentulous area in the posterior maxilla were divided into 2 groups, using a method of randomized controlled trial. The patients in Group A received osteotome-mediated maxillary sinus augmentation using Bio-Oss and simultaneous implantation; patients in Group B received osteotome- mediated maxillary sinus augmentation using coralline hydroxyapatite and simultaneous implantation. After a six-month healing period, the final fixed prostheses were fabricated. Results A 100% implant survival rate was observed for both two groups after 23 months follow-up. X-ray showed that the average height of the remaining alveolar bone before the surgery, immediately after surgery, and I year after the surgery was 5.8 mm,ll.5 mm,10.9 mm, respectively in Group A. In Group B, the average height of the remaining alveolar bone was 5.3 mm, 11.2 mm, 10.3 mm before the surgery, immediately after the surgery, and 1 year after the surgery, respectively. The bone resorption in Group B was more than Group A after 1 year of loading. Conclusion It was concluded that grafting of the maxillary sinus with Bio-Oss or coralline hydroxyapatite alone is a reliable procedure for bone healing and implant stability.