经牙槽突上颌窦底提升术成骨效果影响因素的研究进展

The research progress of factors influencing the osteogenic effect ofmaxillary sinus floor elevation

近年来,随着口腔种植学理论及技术的发展,在上颌后牙区萎缩牙槽嵴植入种植体修复缺牙成为越来越多医患的选择。由于牙周病造成的牙槽骨骨量丢失,以及牙齿缺失后牙槽嵴顶和上颌窦底的破骨细胞活跃、上颌窦气化造成的上颌后牙区牙槽骨双向吸收,常使得在上颌后牙区植入种植体所需的垂直骨量不足,如何在上颌后牙区萎缩牙槽嵴实现骨增量,为种植体植入创造条件,是上颌后牙区种植术面临的主要问题之一。上颌窦底提升技术为上颌后牙区种植体植入及修复创造了条件并得到了广泛的认可,经牙槽突上颌窦底提升术由于创伤小等优点,更易于被患者所接受,在临床工作中最为常见。然而种植术后的成骨效果存在较大的不可预测性,其影响因素并未完全明了,骨替代材料的使用及使用方法、上颌窦黏膜炎症及穿孔、上颌窦底的宽度、吸烟及糖尿病等全身情况都可能对术后成骨效果造成影响,本文对经牙槽突上颌窦底提升术成骨效果的影响因素做一总结,以利于临床工作中对种植效果的预测、评估。

In recent years,with the development of the theory and technology in oral implantology,implanting in the atrophic alveolar ridge of the posterior maxillary area has become more and more choices for doctors and patients.Due to the loss of alveolar bone caused by periodontal disease,the bidirectional absorption of alveolar bone caused by the active osteoclasts and maxillary sinus gasification,the vertical bone is insufficient for implanting in the maxillary posterior area.How to achieve bone augmentation in the atrophic alveolar ridge and create conditions for implants placement is the main problemof implanting surgery in the posterior maxillary area.The maxillary sinus floor elevation has created the conditions for the implanting and the restoration of the maxillary posterior area,and it has been widely recognized.Because of the advantages of less trauma,the transalveolar technique is easier to be accepted by patients,so it has become the most common method to solve this kind of difficulties in clinical work.However,the osteogenic effect of the surgery has great unpredictability.The influencing factors are not fully understood,the use of bone substitute materials,the sinus schneiderian membrane inflammation and perforation,the width of the maxillary sinus floor,smoking and diabetes,etc.may affect the postoperative osteogenic effect.In this paper,we report the related factors that may influence the osteogenic effect,so as to predict and evaluate the operation effect in clinical work.