基于CBCT和扩孔阻力梯度变化的上颌窦底骨质分类

Classification of maxillary sinus floor bone based on CBCT and drilling resistance gradient and key points of osteotome sinus floor elevation

目的应用CBCT观察分析并结合术中扩孔阻力,对上颌窦底骨质进行分类,分析不同类别的临床特征,总结不同分类采用经牙槽嵴顶提升的操作要点。方法对2013年7月~2018年3月我院种植中心的603例行经牙槽嵴顶上颌窦提升患者的CBCT进行观察,结合CBCT和扩孔阻力的梯度变化对上颌窦底骨质进行分类。结果基于CBCT和扩孔阻力的梯度变化将上颌窦底骨质分为三类,Ⅰ类均质型(52%),Ⅱ类三层型(45%),Ⅲ类不规则型(3%),其中Ⅰ类包括2个亚类,即1亚类低密度型(38%),2亚类高密度型(14%);Ⅱ类包括2个亚类,即1亚类骨皮质薄型(19%),2亚类骨皮质厚型(26%)。结论本文应用CBCT和扩孔阻力梯度变化对患者上颌窦底骨质进行分类,方法简单易行,可为经牙槽嵴顶上颌窦提升术手术方法的选择提供参考。

Objective To propose a new classification of maxillary sinus floor bone based on CBCT and drilling resistance gradient.Methods CBCT data were obtained from 603 patients who underwent osteotome sinus floor elevation.The maxillary sinus floor bone was classified based on CBCT and gradient changes of drilling resistance.Results The maxillary posterior region was divided into three types,homogeneous typeⅠ(52%),three-layered typeⅡ(45%)and irregular typeⅢ(3%).TypeⅠincluded 2 subtypes,low-density(38%)and high-density(14%),and typeⅡincluded 2 subtypes,thin cortical bone(19%)and thick cortical bone(26%).Conclusion The maxillary sinus floor bone was divided into 3 types based on CBCT and drilling resistance gradient,which can be used as a reference for the selection of surgical methods for transcrestal sinus floor elevation.