骨凿式上颌窦底提升术同期植入种植体临床疗效的研究

Clinical efficacy of transcrestal sinus floor elevation and simultaneous dental implantation

目的:探讨在垂直骨高度不足的上颌骨后部缺牙区,采用骨凿式上颌窦底提升同期植入种植体手术植骨与无植骨的临床效果。方法:选择需行上颌窦底提升术的患者40名,随机分为植骨组(种植体植入前添加骨移植材料)和无植骨组(种植体植入前不添加骨移植材料)(n=20),术后6、12、24、36个月复查,通过临床和X线检查对种植体存留率、边缘骨吸收及窦底提升后新骨形成状况进行评估。结果:患者上颌窦底提升术后3年,两组种植体存留率均为100%;平均边缘骨吸收植骨组和无植骨组分别为(1.08±0.77)mm、(1.06±0.10)mm(P>0.05),上颌窦内骨获得量分别为(3.01±0.83)mm、(2.76±0.68)mm(P>0.05)。6、12、24个月时,两组间的边缘骨吸收均无统计学差异(P>0.05);上颌窦内骨获得量6、12个月植骨组高于无植骨组(P<0.05),24个月植骨组和无植骨组分别为(3.13±0.81)mm、(2.71±0.70)mm(P>0.05)。相关性分析结果显示,上颌窦底骨获得量与剩余牙槽嵴高度无相关性(-0.414),而与上颌窦高度有显著相关性(0.506)。结论:植骨与否对上颌窦底提升远期临床效果无明显差异。

AIM:To investigate the effects of maxillary sinus elevation with bone graft in the treatment of the rear vertical bone deficiency in maxillary edentulous area.METHODS:40 patients underwent maxillary sinus elevation were included,20 were treated with bone graft and 20 without.The patients were followed up at 6,12,24 and 36 months after operation.Clinical and radiographic examinations were performed to evaluate the rate of implant retention,marginal bone resorption and new bone formation.The effects were compared between the 2 groups.RESULTS:The cumulative implant retention rate of the 2 groups was 100%3 years after operation.The average marginal bone resorption at 36 months after operation was(1.08±0.77)mm in bone graft group and(1.06+0.10)mm in non-bone graft group(P>0.05),there was no significant difference between the 2 groups in each follow-up visit(P>0.05).36 months after operation,the new bone formation in bone graft group and non-bone graft group was(3.01±0.83)mm and(2.76±0.68)mm respectively(P>0.05).CONCLUSION:There is no significant difference of long-term clinical effect of maxillary sinus elevation with bone graft compared with that without bone graft.