旋磨法上颌窦内提升术临床应用及术后5年观察

The clinical application and effects analysis of osteotome sinus floor elevation using sinustech reamer for 5 years

目的:探讨应用旋磨法上颌窦内提升术治疗剩余牙槽骨高度不足的上颌后牙缺失的可行性及临床疗效。方法:选取19例上颌后牙缺失患者,应用旋磨法行上颌窦内提升术,提升高度<2 mm,同期植入种植体29颗,种植体尖端进入上颌窦内长度<2 mm。术后即刻行螺旋CT扫描,术后3~4个月进行上部结构修复,修复后每年进行临床观察;术后1年、5年后进行CT检查,分析临床疗效。结果:所有19例患者的29个位点均成功实施上颌窦底黏膜提升,无穿孔,无继发上颌窦炎症;初期稳定性好,术后3~4个月种植体骨结合良好;术后1年、5年CT显示种植体周围边缘未见明显骨吸收,义齿能正常行使咬合功能且无松动,上颌窦底皮质骨增生改建包绕种植体尖端。结论:旋磨法上颌窦内提升术方法可靠,成功率高,可有效治疗剩余牙槽骨高度不足的上颌后牙缺失。

Objective： To investigate the effect of osteotome sinus floor elevation using sinustech reamer in the cases with residual bone high deficiency in maxillary posterior areas. Methods： Nineteen cases（ 29 teeth） were received sinus lift with the application of sinustech reamer. The height of sinus membrane lift was less than 2 mm in every placement. Twentynine implants were placed without bone grafts and the height of the apical part implant that entered the sinus was less than 2 mm. An immediate CT scan was followed to perform a thorough examination on every placement. The implants were restored after 3 - 4 months. All the patients were followed up for 5 years to evaluate the effect with clinical examination and CT scan.Results： No damage or laceration of the sinus membrane was observed in 29 placements. None of the cases occurred inflammation of maxillary sinus. The alveolar bones were well osteointegrated with 29 implants after 3 - 4 months. There was no obvious bone absorption around the implants after 5-year follow-up. The tips of the implants were surrounded by new reconstruced cortical bone of maxillary sinus floor. All the implants were well functional. Conclusion： The technique of osteotome sinus floor elevation using sinustech reamer with satisfactory therapeutic effect and high success rate,and could be used in the maxillary posterior area implant placement with residual bone high deficiency.