植骨和种植体突入长度对经牙槽嵴上颌窦底提升骨改建影响的回顾性研究

Retrospective study on the merits of bone grafts and the influence of implant protrusion length after osteotome si‐nus elevation surgery

目的利用锥形束CT(CBCT)评价植骨与否和种植体突入长度(IPL)对上颌窦底内提升术后6个月的骨改建的影响。方法纳入96位患者,总计124颗种植体,将种植体分为:植骨且突入长度小于4 mm组(组1);植骨且突入长度大于4 mm组(组2);未植骨且突入长度小于4 mm组(组3);未植骨且突入长度大于4 mm组(组4)。种植体植入后6个月,测量种植体顶端骨高度变化量(ABG)、皮质骨高度变化量(CBG)、骨密度变化量(BDG)和边缘骨吸收(MBL)指标,并进行统计分析。结果植骨的组1和组2的CBG高于不植骨组;未植骨的组3和组4的ABG和BDG高于植骨组;未植骨的组3的ABG和BDG均高于组4;植骨的组2的CBG高于组1;4组的MBL差异无统计学意义。结论不植骨条件下,与IPL<4 mm相比,IPL>4 mm者的BDG较小,IPL与CBG无相关性。植骨可通过增加皮质骨高度,使BDG不受IPL影响来加速成骨进程。

Objective This study aims to evaluate the endo-sinus bone remodeling of dental implants placed via osteotome sinus floor elevation(OSFE) after 6 months and using different implant protrusion lengths and bone grafts through cone beam computed tomography(CBCT).Methods Ninety-six patients with 124 implants were included and assigned into four groups.Group 1:implant protrusion length<4 mm with bone graft;group 2:implant protrusion length>4 mm with bone graft;group 3:implant protrusion length<4 mm without bone graft;group 4:implant protrusion length>4 mm without bone graft.Apical bone gain(ABG),cortical bone gain(CBG),bone density gain(BDG),and marginal bone loss(MBL) were observed and analyzed at baseline and 6 months after implant surgery.Results The CBG in grafted groups 1 and 2 was higher than that in non-grafted groups.The ABG and BDG were higher in non-grafted groups3 and 4 than in grafted groups,and the levels in group 3 were higher than those in group 4.The CBG in grafted group 2 was higher than that in group 1.No significant difference was observed in MBL analysis.Conclusion The BDG of IPL<4 mm implants was higher than IPL>4 mm implant when bone grafts were not applied.No relevance was observed between IPL and CBG.Bone grafts can accelerate endosinus bone remodeling by increasing CBG and dissipating the influence of IPL on BDG.