基于骨性充填材料的上颌窦底提升术替代治疗手段及研究现状

Alternative treatments of sinus augmentation with bone grafts:research status and clinical application

上颌窦底提升术是口腔种植领域中一种常用的骨增量手段。传统上颌窦底提升术应用的骨性替代材料存在供区损伤、免疫排斥、操作耗时及费用较高等问题。以自体血液制品及可注射生物材料为代表的新型充填材料具有成本较低、操作简便等优势,成为目前的研究热点并逐步应用于临床。近年有研究报道了在不植入任何骨性替代材料的前提下,仅提升上颌窦膜,同期行种植体植入术可获得手术成功。此外,为避免提升过程中侵入上颌窦腔带来的潜在风险,粗短植体及种植体斜行植入的方式也逐步得以应用。本文尝试从上颌窦底提升术的理论基础、影响因素、植入材料及替代治疗策略的选择等方面进行综述,以为后续研究及术者的临床抉择提供参考。

The traditional sinus lifting uses bone grafts to fulfill extended space in order to promote bone formation. However,it has disadvantages such as donor site deformity,immunologic rejection,high cost-effect etc. Therefore,with the improvements of tissue engineering and biomaterials,some bone substitute materials,eg. blood products and injectable hydrogel,were used in bone augmentation procedures. Besides,sinus lifting without any grafts was reported to be successful. Furthermore,in order to avoid the complications and complexity of sinus augmentation,some alternative strategies had been introduced to enable implantation without sinus lifting.There are still debates about the necessity and optimal choices of grafting materials and alternative treatment of sinus lifting procedures,so the aim of the study is to make a mini-review about the alternative therapy of sinus augmentation including the osteogenesis mechanism,influencing factors,grafting material selection and alternative surgery.