微创技术在上颌窦底内提升术中的临床应用

The Clinical Application of Minimally Invasive Technique in Transalveolar Sinus Floor Elevation

目的:探讨微创技术在上颌窦底内提升同期种植体植入术中的临床应用效果。方法:26例上颌后牙缺失患者,术前通过锥形束CT评估种植区剩余骨高度为4.5~8.5mm,附着龈充足,通过微创环切进行上颌窦底内提升,同期植入种植体过程中,根据牙龈厚度及测量杆指示深度,确定备孔深度与上颌窦底距离,精确到达窦底安全距离,行上颌窦底提升术,减少软组织翻瓣带来的损伤。3个月后行永久修复,术后定期复查,检查种植体稳定性、种植体周牙龈组织健康状况,拍摄X线片观察种植体根方新生骨高度。结果:26例患者共计植入32枚种植体,平均提升高度为(3.5±2.0)mm,术后反应较传统术式明显减轻。追踪观察6~36个月,均未见种植体松动或上颌窦炎发生,种植体周龈组织健康;X线片检查种植体骨结合良好,种植体周围骨高度稳定,上颌窦黏膜连续性完整,患者对修复效果满意。结论:上颌窦底内提升同期不翻瓣微创种植体植入术,创伤小、患者易接受,近期临床效果满意,长期效果尚需进一步观察。

Objective The aim of this study is to evaluate the clinical research of minimally invasive technique in transalveolar sinus floor elevation. Methods 26 patients with maxillary posterior teeth missing were chosed to be stuty. Before the implant surgery, we uesd cone beam computed tomography（CBCT） to measure residual bone height was 4.5 to 8.5mm, the attached gingiva was enough.They used minimally invasive technique to elevate the floor of maxillary sinus and finish the implant surgery. During the elevation,we measured gingival thickness and the depth of mearuring rod to calculate the distance between the depth of the prepared hole and the maxillary sinus. Then they finished the transalveolar sinus floor elevation precisely and reduced the injury of soft tissue.After 3 months,the permanent restorations were finished. Patients were followed up clinically, to mearure implants＇stablity, peri-implant＇s gingival tissue＇s health and panoramic radiographs were taken to measure height of new bone. Results 26 patients were included 32 implants. The average height of elevation was （3.5±2.0）mm. The postoperative reaction was significantly reduced. The clinical followed up of these patients during 6 to 36 months, the implants＇ stablity, peri- implant＇s gingiva＇s health were well, there was no inflammation around the implants. Panoramic radiographs also showed the well-integration between the bone and implant. The membrane of maxillry sinus was complete continuously and the patients were satisfied with the restorations. Conclusion The combination of minimally invasive technique and transalveolar sinus floor elevation may decrease pain and the occurrence of post-surgery complications. The recent clinical results were satisfactory, but the long-term effects still need further observation.