牙槽骨严重吸收患者不同种植修复方式的修复效果比较

Study on the repair effects of different repair methods for severe alveolar bone atrophy treated with osteotome sinus floor elevation

目的:对比分析对牙槽骨严重吸收患者采用不同种植修复方式对修复效果的影响。方法:采用回顾性研究纳入因上颌后牙区牙列缺损、牙槽骨高度(RBH)≤5 mm需行骨凿式冲压法上颌窦底提升术及同期植骨、植入种植体且已完成冠修复的患者53例,共植入种植体69枚,冠修复方式分别为粘结固位39枚,螺丝固位30枚。收集各患者术后即刻及戴牙后1、2、3年的影像学资料,测量其种植体近、远中边缘骨高度及种植体根尖骨高度,记录各复查时间点种植体周围的牙周临床指标及患者满意度评分,比较其不同修复方式之间的效果。结果:螺丝固位组与粘结固位组在负载后1、2、3年时两组的近远中边缘、根尖骨吸收程度均无统计学差异(P>0.05);牙周探诊深度相比,除舌侧远中位点为粘结固位组大于螺丝固位组(P<0.05)外,其余各点均无统计学差异(P>0.05);两组患者的满意度评分均在5以上(P>0.05)。结论:对于RBH≤5 mm的患者,采用冲压法上颌窦底提升术是可行的;若冠修复方式选择合适,无论是粘结固位还是螺丝固位均能取得良好的修复效果。

AIM:To study the effects of different repair methods for severe alveolar bone atrophy(RBH≤5 mm)treated with osteotome sinus floor elevation.METHODS:53 patients underwent osteotome sinus floor elevation with bone graft and dental implant for the posterior maxilla area by the same physician.69 dental implants were screw-retained(30)and cement-retained(39)respectively for crown repair.The patients were followed up 1,2 and 3 years after treatment.Image data,perioimplants index and satisfaction scores of the patients were evaluated and compared between the 2 groups.RESULTS:The marginal bone loss and apical bone loss were not statistically different between 2 groups.In the 6 points of periodontal depth,5 check points were P>0.05 between 2 groups,except for the distant lingual point(P<0.05).The patients'satisfaction was above 5 scores(between 2 groups,P>0.05).CONCLUSION:For patients with severe alveolar bone atrophy,it is feasible to use the osteotome sinus floor elevation and use screw-retained or cement-retained crown repair for the individual patient.