带止动环序列钻辅助穿牙槽嵴顶四周剥离上颌窦底提升的临床研究

Clinical applications of transcrestal around osteotomes and sequential drills with stops Lyu Tieming, Wang Liadan detached sinus floor elevation technique using

纳入2017年2月至5月于清华大学附属垂杨柳医院口腔科就诊的11例上颌后牙缺失患者（15个种植位点），术前锥形束CT测量剩余骨高度（residual bone height，RBH）〈10 mm，需行上颌窦底提升术。术前RBH为（6.18±1.60）mm [（3.10-8.34）mm]，其中6个位点RBH〈6 mm，9个位点RBH≥6 mm。种植位点对应上颌窦底黏膜厚度（1.21±0.92）mm [（0.50-4.24）mm]。15个种植位点均应用带止动环序列钻逐级备洞磨穿上颌窦底骨皮质后用新型骨凿行穿牙槽嵴顶四周剥离上颌窦底提升术，术中植入无机牛骨基质及种植体15枚。术后即刻拍摄锥形束CT显示所有上颌窦底提升种植位点区域均形成一外形连续界限清晰的＂帐篷状＂隆起，上颌窦内均未见异常液平面。上颌窦底提升高度（7.83±1.57）mm [（5.94-11.01）mm]。随访7-10个月，随访期间所有种植体均存留无松动脱落。

Sinus floor elevation was needed in 11 patients having 15 implant sites with the residual bone height （RBH） was less than 10 mm in the posterior maxillary region from Feb to May 2017. The RBH ranged from 3.10 to 8.34 mm [averaged （6.18±1.60） mm]. RBH〈6 mm was observed in 40% implant sites （6 implant sites） and RBH≥6 mm was observed in 60% implant sites （9 implant sites）. The thickness of the sinus floor membrane correspond to the implant site measured by cone beam CT （CBCT） ranged from 0.50 to 4.24 mm [averaged （1.21±0.92） mm]. Sequential drills with stops were used to perforate the cortical bone of the sinus floor firstly, then the transcrestal around detached sinus floor elevation technique （TADSFET） was carried with osteotomes. Anorganic bovine bone was used as the augmentation material.Fifteen implants were placed in 15 implant sites. CBCT pictures showed that there was a smooth and continuous tent-shaped apophysis on each lifted site and no air fluid level was observed in the sinus immediately after operation. The mean elevated height of the 15 implant sites was （7.83±1.57） mm （ranged from 5.94 to 11.01 mm）. The mean follow-up time was 7.91 months （7-10 months）. The survival rate was 100% during the follow up period.