以胶原蛋白海绵为载体的纤维蛋白混合物在上颌窦提升术中的应用

Clinical Evaluation of Autologous Fibrin Mixed with Collagen Sponges Applied in a Transcrestal Maxillary Sinus Lift Procedure

目的:评价以胶原蛋白海绵为载体的纤维蛋白混合物在严重牙槽骨吸收患者上颌窦提升术中的临床效果。方法:收集上颌后部牙槽骨严重吸收患者18例共21个牙位,上颌窦底剩余牙槽骨的垂直高度1.0~4.0 mm。采集患者的外周血经离心获得血浆纤维蛋白,将纤维蛋白液体吸附到牛源性的胶原蛋白海绵中组成混合物。再将混合物经牙槽嵴顶方形开窗进路植入到上颌窦底,同期植入百康短种植体。术后6个月做影像学检查,分析上颌窦腔内新骨的形成情况。结果:18例患者共21颗种植体均获得良好骨结合,种植体骨结合成功率100%。平均剩余牙槽骨高度由2.7 mm增加到6.9 mm,获得4.2 mm的新骨增加量。病例均顺利完成上部冠桥修复,随访期内未发生种植体脱落。结论:以胶原蛋白海绵为载体的纤维蛋白混合物作为植入材料,应用到严重牙槽骨吸收患者上颌窦提升术中可获得良好的临床效果。

Objective:To evaluate the clinical outcome of the autologous fibrin mixed with the collagen sponges applied in the maxillary sinus lift procedure in the patients with severe alveolar bone resorption.Method:A total of 18 patients with severe alveolar bone resortion were included in this study,the residual bone height below the maxillary sinus ranged from 1.0 mm to 4.0 mm,21 implants were inserted in the patients.Autologous fibrin was obtained from the peripheral blood of the patients followed by the centrifugation,and then mixed with the bovine collagen sponges.The mixtures were placed into the maxillary sinus floor via a transcrestal maxillary sinus lift procedure with the simultaneous insertion of Bicon short implants.The radiogaraphic examination was performed at 6 months after the surgery to analyze the new bone formation in the maxillary sinus.Result:There were a total of 21 implants in 18 patients,all of which obtained good osseointegration.The success rate of the short implants was 100%.The average residual alveolar bone height increased from 2.7 mm to 6.9 mm,a mean 4.2 mm new bone height was abtained.All the patients finished the prosthetic restorations,no imlant failed during the follow-up period.Conclusion:The use of autologous fibrin mixed with collagen sponges applied in a transcrestal maxillary sinus lift procedure in the patients with severe alveolar bone resorption can abtained good clinical results.