上颌窦内提升术在上颌后牙区严重骨萎缩患者种植修复中的临床应用

Clinical application of maxillary sinus lift on the implant restoration in patients with severe bone atrophy in maxillary posterior region

目的研究上颌窦内提升术在上颌后牙区严重骨萎缩患者种植修复中的临床应用。方法对上颌后牙区牙缺损骨萎缩的患者共80例,行外科修复术且植入种植体90枚。随机分为两组：试验组采用上颌窦内提升术同期植入种植体;对照组通过口腔种植手术植入种植体。第12个月临床复查,同时并行口腔X线片检查,观察两组术后种植体成功率、骨结合情况（种植体周围骨吸收量、种植体周围垂直高度改变、平均愈合时间）及随访时软组织情况（出血指数、菌斑指数、探诊深度）。结果在术后12个月内,种植体获得了良好的初期稳定性,试验组种植体存留率为97.62%,对照组成功率为81.25%,差异有统计学意义（χ^2=14.18,P〈0.05）;术后12个月试验组种植体获得了良好的骨结合,试验组在骨吸收量和种植体提升高度明显高于对照组,且平均愈合时间短于对照组,差异均有统计学意义（t分别=7.80、18.52、-4.00,P均〈0.05）。随访时软组织情况显示,试验组在出血指数、菌斑指数和探诊深度均低于对照组,差异均有统计学意义（t分别=-23.86、-11.34、-11.12,P均〈0.05）。两组总的并发症发生率比较,差异无统计学意义（χ^2=3.46,P〉0.05）。结论上颌窦内提升术与传统口腔修复术相比,能更有效地解决上颌后牙区严重骨萎缩时的牙种植修复问题。

Objective To investigate the clinical application of maxillary sinus lift on the implant restoration in patients with severe bone atrophy in maxillary posterior region. Methods A total of 80 cases with severe bone atrophy in maxillary posterior region underwent surgical repair of maxillary teeth defect bone atrophy. The patients were randomly divided into ex-perimental group and control group. Experimental group implanted with maxillary sinus lift augmentation and control group with oral implant surgery. The implant success rate, bone combination（implant surrounding bone absorption, planted around the perpendicular height change, the average healing time） and soft tissue condition（bleeding index, plaque index, probing depth） were observed after 12 months clinical follow-up. Results Within 12 months after surgery, implant obtained the good initial stability. Implant retention rate of experimental group was 97.62%, the success rate of control group was 81.25%,and the difference was statistically significant（χ~2=14.18, P〈0.05）. Implant in experimental group obtained the good bone combination, and the bone absorption rate and plant body lifting were significantly higher than those in the control group, and the average healing time was shorter than that of control group, the differences were statistically significant（t=7.80,18.52,-4.00,P〈0.05）. The soft tissue after follow-up showed that the bleeding index, plaque index and probing depth of experimental group were lower than the control group, the differences were statistically significant（t=-23.86,-11.34,-11.12, P〈0.05）.There was no significant difference of the incidence of complications between the two groups（χ~2=3.46, P〉0.05）. Conclusion Compare to traditional oral repairation, maxillary sinus lift can more effectively solve the bone implant restoration of maxillary posterior region serious atrophy.