超声骨刀在上颌窦外提升术中的应用

Application of piezoelectric osteotomy in maxillary sinus extraction

目的:探讨超声骨刀用于上颌窦外提升术中的临床疗效,为临床应用提供参考。方法:选择单侧或双侧上颌后牙缺失且预行种植修复的患者24例,其中男14例,女10例,年龄34~66岁,平均(51.6±2.1)岁。所有患者均行临床检查并拍摄X线片,牙槽嵴顶至上颌窦底高度为2.1~4.9mm。随机分为实验组与对照组,每组12例。实验组使用超声骨刀去骨开窗,而对照组采用传统球钻。比较两组的上颌窦黏膜穿孔发生率以及术后疼痛反应等并发症发生率。结果:实验组上颌窦黏膜穿孔率为0,对照组上颌窦黏膜穿孔率为16.67%(2/12),差异有统计学意义(P<0.05)。实验组术后6h和24hVAS得分分别为(3.000±0.499)和(2.342±0.408),而对照组分别为(4.967±0.566)和(3.908±0.587),两组比较差异有统计学意义(P<0.05);两组术后72h的VAS得分比较,差异无统计学意义。结论:超声骨刀用于上颌窦外提升术能够有效降低上颌窦开窗式外提升术中黏膜穿孔率,并且能够明显减轻局部疼痛肿胀等并发症,值得在临床治疗中进行推广。

Objective: To investigate the clinical curative effect of piezoelectric osteotomy for maxillary sinus extraction,and to provide reference for clinical application. Methods: Twenty-four patients (14 males and 10 females) with unilateral or bilateral loss of maxillary posterior teeth and preimplantation restoration were selected,aged 34-66 years,mean age(51.6±2.1) years.All patients were divided into experimental group and control group randomly,12 cases in each group.That the height is about 2.1-4.9 mm from the alveolar crest to the maxillary sinus floor.The experimental group was treated with piezoelectric osteotomy and sinus membrane elevation ,while the control group was treated with traditional ball drill.The differences of the incidence of perforation of maxillary sinus extraction and pain response between the two groups were observed. Results: The perforation rate of maxillary sinus mucosa in the experimental group was 0,and that in the control group was 16.67%(2/12).VAS in the experimental group was (3.000±0.499) and (2.342±0.408) at 6 h and 24 h after surgery,while that in the control group was (4.967±0.566) and (3.908±0.587),respectively,the difference was statistically significant ( P <0.05).There was no statistically significant difference in VAS at 72 h after surgery between the two groups. Conclusion: The piezoelectric osteotomy and sinus membrane elevation can effectively avoid the opportunity of mucosal perforation,and significantly reduce the local pain and swelling and other complications,which is worthy of clinical promotion.