上颌窦外侧壁来源骨块在牙槽嵴水平帐篷植骨技术中的应用

Application of bone blocks harvested from the lateral wall of the maxillary sinus in horizontal alveolar ridge augmentation using the tenting technique

目的探讨上颌窦外侧壁来源骨块在帐篷植骨技术中对牙槽嵴水平骨增量的临床效果。方法回顾2018年11月至2023年3月于浙江大学医学院附属口腔医院应用上颌窦外侧壁骨块行上颌后牙区水平帐篷植骨术的牙列缺损患者,通过术前、术后即刻及术后6个月拍摄锥形束CT对比植骨区牙槽嵴骨宽度,同时对患者进行随访。结果与术前相比,术后即刻距牙槽嵴顶0 mm和3 mm处骨宽度显著增加,差异具有统计学显著性(P<0.05);术后6个月,牙槽嵴顶处的水平骨宽度较术前增量为(3.60±2.29)mm(P>0.05),距牙槽嵴顶3 mm处水平骨宽度较术前增量为(2.85±1.54)mm,差异具有统计学显著性(P<0.05)。与术后即刻相比,术后6个月距牙槽嵴顶不同距离处骨增量效果基本保持稳定,未显示出明显的骨吸收(P>0.05)。结论上颌窦外侧壁来源的骨块在牙槽嵴水平帐篷植骨技术中有良好的骨增量效果和临床预后,对于上颌后牙区牙槽嵴骨宽度不足,尤其是合并骨高度严重不足需行侧壁开窗上颌窦底提升的病例提供了新的手术方法。

Objective To explore the clinical effect of bone blocks harvested from the lateral wall of the maxillary sinus on horizontal alveolar ridge augmentation using the tenting technique.Methods This study reviewed patients with dental defects who underwent horizontal tenting technique in the maxillary posterior region using bone blocks harvested from the lateral wall of the maxillary sinus at the Stomatology Hospital of Zhejiang University School of Medicine from November 2018 to March 2023.The width of the alveolar ridge in the grafted area was compared using cone beam computer tomography(CBCT)images taken preoperatively,immediately postoperatively,and 6 months postoperatively.Patients were also followed up clinically.Results There was a statistically significant increase in bone width at 0mm and 3mm from the top of the alveolar ridge in the immediate postoperative period compared to the preoperative period(P<0.05).6 months postoperatively,the increase in horizontal bone width at the top of the alveolar ridge was(3.60±2.29)mm compared to preoperative measurements(P>0.05).The increase in horizontal bone width at 3 mm from the top of the alveolar ridge was(2.85±1.54)mm compared to preoperative measurements,and the difference was statistically significant(P<0.05).And compared to the immediate postoperative period,the bone augmentation at different distances from the top of the alveolar ridge remained basically stable 6 months postoperatively,with no significant bone resorption observed(P>0.05).Conclusion Bone blocks harvested from the lateral wall of the maxillary sinus show effective bone augmentation and favorable clinical outcomes when used in the horizontal alveolar ridge augmentation using the tenting technique.It provides a new surgical method for cases with insufficient alveolar ridge width in the maxillary posterior region,especially when combined with severe bone height deficiency requiring lateral window technique for sinus floor elevation.