上颌窦内提升术同期种植体植入术在修复上颌后牙缺失伴颌骨骨量不足病例中的应用

Application of maxillary sinus floor elevation and dental implantation in repairing maxilla posterior teeth loss and bone insufficiency

目的探讨上颌窦内提升术同期牙种植术修复剩余牙槽骨高度(RBH)的上颌后牙缺失颌骨骨量不足的临床疗效。方法选择上颌骨骨量不足行种植修复患者45例(85颗种植体)均行上颌窦内提升术同期牙种植术,其中RBH<5 mm患者加用骨挤压并植入骨粉。分别于术后1、3、6、12个月复查X线检查种植体保留情况,并观察骨改建骨小梁形成及骨吸收情况。结果患者均无上颌窦炎症,种植体周围边缘骨稳定,均获良好骨结合。A组、B组种植体的留存率分别为100.0%和95.6%,差异无统计学意义(χ2=0.51,P>0.05);上颌窦底不同提升高度之间的窦底改建程度比较,差异无统计学意义(χ2=4.49,P>0.05)。结论上颌窦内提升术同期牙种植术可有效修复上颌后牙缺失,颌骨骨量不足,对RBH<5 mm的患者有较好的留存率。

Objective To explore the clinical effect of applying maxillary sinus floor elevation and dental implantation in repairing maxillary posterior teeth loss and maxilla bone insufficiency. Methods 45 patients with 85 implants undergoing implant prosthesis for maxilla bone insufficiency were given maxillary sinus floor elevation combined with simultaneous dental implantation, and the cases whose residual bone height （RBH） 〈 5 mm were given osteotome and bone meal additionally. Patients were followed up alter 1,3,6, and 12 months,the survival rate of implants was checked,and bone trabecula formation and bone resorption were measured. Results All the cases gained good ossteointegration peri-implant bone was stable,and no maxillary sinus inflammation was found. There was no significant difference in the survival rate of implants in Group A （ 100.0% ） and Group B （95.6%） （ X^2 = 0. 51 , P 〉 0.05 ）. There was no significant difference in sinus floor remodeling among different implant elevation heights （ X^2 = 4.49, P 〉 0.05 ）. Conclusions Maxillary sinus floor elevation with simultaneous dental implantation is an effective way for the restoration of maxilla posterior teeth loss and bone insufficiency,and it also can achieve good survival rate of implants in patients with RBH less than 5 mm.