原位植入并上颌窦内提同期种植治疗上颌后牙区牙缺失的临床研究

Clinical study of in situ implantation and donetti maxillary implant in the treatment of maxillary posterior teeth loss

目的探讨上颌后牙区牙缺失采用原位植入并上颌窦内提同期种植治疗的疗效。方法选取2012年5月至2013年5月期间我院接收的42例上颌后牙缺失患者,均采取原位植入并上颌窦内提同期种植治疗,术后1、3、6、12个月复诊,观察上颌窦底高度、种植体情况及种植体周围骨量及上颌窦有无炎症变化,术后采用视觉类比量表对痛苦指数进行测评痛苦指数,术后让患者拍摄曲面断层X线片,在X线片上测算上颌窦底提升距离及骨吸收高度。结果 42例患者均未发生上颌窦底黏膜穿孔,无患者发生伤口感染、鼻部渗血和上颌窦炎症,术区创口愈合良好;术后4~6个月,行上部结构修复,均成功负载;对42例患者随访6~12个月,患者无不良自觉症状,种植体无脱落或松动,义齿修复效果满意,牙龈组织健康,成功率达100.0%;随访发现,术后6个月患者的骨吸收值为(0.56±0.18),明显高于3个月时的(0.40±0.21),差异有统计学意义(P<0.05),而术后12个月时患者骨吸收值为(0.59±0.19),与术后6个月时的(0.56±0.18)比较,差异无统计学意义(P>0.05)。结论原位植入并上颌窦内提同期种植治疗上颌后牙区牙缺失,尤其是牙槽骨高度在5 mm以下时,具有操作安全、创伤小、痛苦少等优点,可取得较好的效果,具有推广价值。

Objective To explore the curative effect of in situ implantation and donetti maxillary implant in the treatment of maxillary posterior teeth loss. Methods A total of 42 patients of maxillary posterior teeth loss in our hospital from May 2012 to May 2013 were selected. They were all treated with in situ implantation and donetti maxillary implant, and had subsequent visits 1, 3, 6, 12 months after operation. The inflammatory changes in maxillary sinus floor height, implant, peri-implant bone, and maxillary sinus were observed. Postoperative visual analogue scale was used to evaluate the pain index, and sinus lift distance and bone height were calculated according to postoperative X ray images. Results Forty-two patients had no detectable maxillary sinus mucosa perforation, and no patient had wound infection, nasal bleeding and inflammation of maxillary sinus, with the wound healed well in operation area. Four to six months af-ter operation, the patients received repair of upper structure, and all achieved successful load. During the follow-up of 6-12 months, no symptoms of poor awareness, loss or loosening of implants was found, and the effect of denture restora-tion was satisfactory and gingival tissue was healthy, with a success rate of 100.0%. The bone absorption value at postop-erative 6 months was （0.56 ± 0.18）, which was significantly higher than （0.40 ± 0.21） at postoperative 3 months, P〈0.05. At 12 months after operation, the bone absorption value was （0.59±0.19）, which showed no statistically significant differ-ence with （0.56±0.18） at 6 months after operation （P〉0.05）. Conclusion In situ implantation and donetti maxillary im-plant in the treatment of maxillary posterior maxilla teeth loss has the advantages of safe operation, less trauma, less pain, especially when the alveolar bone height is below 5 mm.