上颌窦底提升同期种植体植入术79例临床分析

Evaluation of clinical results of sinus floor elevation with simultenous dental implantation(report of 79 cases)

目的观察采用经牙槽嵴入路提升上颌窦底同期植入种植体的临床效果。方法对2009—2012年南京军区机关医院数字口腔中心接诊的79例上颌后牙缺失患者,行经牙槽嵴顶入路上颌窦底提升,选择性植入人工骨或富血小板纤维蛋白（PRF）,同时植入种植体。结果 79例患者平均提升上颌窦底高度3.8 mm（2.0~5.7 mm）。3例患者因上颌窦黏膜术中发生穿孔,遂关闭创口,未完成种植体植入。其余76例共植入87颗种植体,长度10~13 mm。Ⅱ期手术时,3颗种植体松动拔除。义齿修复后追踪12~36个月,2颗种植牙松动拔除,1颗有进行性骨吸收,种植体存留率为93.1%（81/87）。所有病例均无上颌窦并发症。结论经牙槽嵴顶入路上颌窦底提升术较开窗式上颌窦提升创伤小,操作简单,对窦底有适量剩余骨的上颌窦区种植是可行的;但由于窦底黏膜存在穿孔风险,技术要求较高,而且必须有专用的器械。

ObjectiveTo evaluate the clinical results of sinus floor elevation technique with simultaneous dental implantation in the posterior maxilla.MethodsA total of 79 patients underwent osteotome sinus floor elevation from 2009 to 2012. Bio-Oss and PRF were used as augmentation material,with simultaneous placement of implants.ResultsThe implant lengths ranged from 10 to 13 mm. The average height increase of the implant site was 3.8（2 to 5.7）. Sinus membrane perforation occurred in 3 cases and the dental implantation was abandoned. Totally 87 implants were placed. At second stage of surgery,3 failed implants were removed. Two implants were removed 18 months after prosthetic rehabilitation. One implant was lost due to progressive bone loss. The overall survival rate was 93.1%（81/87）. No clinical complications of the maxillary sinus area were observed during a follow-up period of 12 to 36 months.ConclusionOsteotome sinus floor elevation with bone graft was a predictable and safe technique. It simplifies the surgical process and can be taken predictably for implant placement with surgical technique.