穿牙槽嵴顶四周剥离上颌窦底提升术后植骨高度变化研究

A retrospective study of short-term changes in graft height after the transcrestal around detached sinus floor elevation technique

目的评估穿牙槽嵴顶四周剥离上颌窦底提升术后植骨高度变化。方法 13例上颌后牙缺失剩余骨高度不足(<10mm)患者共16个种植位点进行穿牙槽嵴顶四周剥离上颌窦底提升术同期植入无机牛骨基质(BioOss)。术后即刻及二期复诊时拍摄CBCT测量上颌窦底提升高度,两者之间进行配对t检验。结果术前剩余牙槽骨高度从2.46~8.54mm,平均5.46±1.76mm;16个位点共植入15颗种植体,种植体长度从11.0~11.5mm,平均11.07±0.18mm。术后上颌窦底提升高度从7.95~12.97mm,平均10.37±1.61mm;术后修复完成时间从4~10个月,平均6.0±1.76个月;术后复诊拍摄CBCT时间3~6个月,平均4.31个月,复诊时上颌窦底提升高度从5.83~15.24mm,平均10.07±2.31mm;与术后即刻相比,上颌窦底提升高度改变幅度从-2.12~5.32mm,平均降低0.30±1.84mm,占术后即刻上颌窦底提升高度的2.9%,两者之间无显著性差异(P=0.51);与术后即刻相比,复诊时4个位点上颌窦底提升高度增加(占所有位点的25%),增加幅度从0.24~5.32mm,平均2.16±2.19mm,其余12个位点上颌窦底提升高度降低(占所有位点的75%),降低高度从0.08~2.12mm,平均1.13±0.60mm。结论穿牙槽嵴顶四周剥离上颌窦底提升术后短期内大部分位点植骨高度降低,少部分位点植骨高度增加,总起来说植骨高度稳定无显著变化。

Objective To evaluate short-term changes in sinus-graft height after the transcrestal around detached sinus floor elevation technique（TADSFET） in the posterior maxillary region where the residual bone height（RBH）was less than 10 mm. Methods TADSFET was carried in 13 patients（16 implant sites）. Anorganic bovine bone（Bio-Oss） was used as the augmentation material. CBCT was used to measure the elevated height immediately after operation and after a minimum period of 3 months. Paired-samples T test was used to compare the difference. Results The RBH ranged from 2.46 to 8.54 mm（averaged 5.46 ±1.76 mm）. 15 implants were placed in 13 patients（16 implant sites）. The implant length ranged from 11.0 to 11.5 mm（averaged 11.07±0.18 mm）. The mean elevated height of the 16 implant sites was 10.37 ±1.61 mm（ranged from 7.95 to 12.97 mm） immediately after operation. The follow-up period ranged from 3 to 6 months（averaged 4.31 months）. The mean elevated height of the 16 implant sites was 10.07±2.31 mm（ranged from 5.83 to 15.24 mm）in the follow-up period. The percent change in measured graft height was -2.9%, from -2.12 to 5.32 mm（averaged -0.30 ±1.84 mm）, with no statistically significant difference（P =0.51）. Increase of the grafted height was observed in 25% implant sites（4 implant sites）, ranged from 0.24 to 5.32 mm（averaged 2.16 ±2.19 mm） and the rest of 12 implant sites（75%） decreased from 0.08 to 2.12 mm（averaged 1.13±0.60 mm）. Conclusion The transcrestal around detached sinus floor elevation technique（TADSFE） with inorganic bovine bone（Bio-Oss）maintains gain bone height stability in a short-term observation.