基于CBCT影像的经牙槽嵴顶上颌窦提升非植骨种植随访研究

Follow-up study of non-bone graft implantation with transcrestal sinus floor elevation based on CBCT imaging

目的通过CBCT影像观测,经牙槽嵴顶上颌窦提升术中不置入骨替代材料同期种植的5年随访效果。方法选取从2017年1月至2019年4月期间在本院因上颌后牙区缺失行种植手术的患者56例,采用经牙槽嵴顶提升上颌窦粘膜的术式,同期植入种植体,未置入骨替代材料,6个月后行Ⅱ期手术、取模和上部冠修复,术后半年、1年、3年、5年随访观察种植体存留和使用情况,CBCT观测种植体周围和上颌窦内新生骨高度变化情况。结果56例患者完成上颌窦粘膜提升,在未置入骨替代材料情况下同期植入56枚种植体,术后6个月完成Ⅱ期手术和后期修复,术后6个月、1年、3年和5年随访,56枚种植体均良好行使功能,通过CBCT测量显示种植体进入上颌窦周围有显著的骨量生成,且新生骨量保持稳定。结论经牙槽嵴顶上颌窦提升术在没有置入骨替代材料的情况下同期植入种植体也可以取得良好且长期的临床效果。

Objective To observe the 5-year follow-up effect of transcrestal sinus floor elevation and simultaneous implant placement without bone grafting.Methods A total of 56 patients who underwent implant surgery in our hospital due to absence of maxillary posterior dental region from January 2017 to April 2019 were selected.During the operation,osteotome technique combined with water extraction was used to lift the maxillary sinus mucosa through the alveolar crest,and implants were implanted at the same time without bone replacement materials.Two-stage operation,model extraction and upper crown restoration were performed six months later.The retention and use of implants were observed,and the changes of new bone height around implants and in maxillary sinus were observed by CBCT.Results All 56 patients successfully raised maxillary sinus mucosa through alveolar crest and implanted 56 straumann soft tissue implants at the same time.The second stage of surgery and later repair were completed six months after surgery,and the follow-up was six months,one year,three years and five years after surgery.All 56 implants functioned well.CBCT measurements showed that there was significant bone mass formation around the maxillary sinus,and the new bone mass remained stable.Conclusion Transcrestal sinus floor elevation can also achieve good and long-term clinical results without bone replacement materials.