经牙槽嵴顶上颌窦底提升术中黏骨膜穿孔后同期植入种植体的短期临床效果观察

Short-term Clinical Effect of Simultaneous Implant Implantation after Mucoperiosteal Perforation During Transalveolar Crest Maxillary Sinus Lift

目的:分析对比经牙槽嵴顶上颌窦底提升术中窦底黏骨膜穿孔与否对种植体早期成功率的短期影响。方法:选取2022年1月-12月就诊于西安交通大学口腔医院综合科并使用CAS-KIT工具行经牙槽嵴顶上颌窦底提升术后同期植入种植体的32例患者共计38个种植位点,对比分析窦底黏膜穿孔组与未穿孔组患者的术后主观感受、术后即刻、术后4个月及修复后影像学表现。结果:32例患者通过使用CAS-KIT工具提升上颌窦黏膜并成功同期植入38枚种植体,术中发现8例患者黏骨膜穿孔,术后所有患者均未出现明显肿痛或感染等不适反应,术后4个月行影像学检查发现上颌窦提升后形成新骨改建,修复后6个月两组种植体均存留无松动,影像学检查结果显示种植体周围骨结合良好,两组种植体周围边缘骨吸收差异无统计学意义(P>0.05)。结论:经牙槽嵴顶上颌窦底提升术中窦底黏骨膜有无发生穿孔,种植体早期成功率均较高。

Objective To analyze and compare the short-term effects of sinus mucoperiosteal perforation during transalveolar crest maxillary sinus floor lifting on the early success rate of implants.Methods 38 implant sites were selected for 32 patients who were admitted to the General Department of Stomatology Hospital of Xi'an Jiaotong University from January to December 2022 and implanted with the implants during the same period after lifting through the alveolar crest and maxillary sinus floor using CAS-KIT.The postoperative subjective feeling,immediate postoperative,postoperative 6 months postoperative and postoperative imaging findings were compared between the sinus mucosa perforation group and the non-perforated group.Results In 32 patients,maxillary sinus mucosa was enhanced using CAS-KIT and 38 implants were successfully implanted in the same period.Mucoperiodium perforation was found in 8 patients during the operation,and no discomfort such as obvious swelling,pain or infection occurred in all patients after the operation.Imaging examination 4 months after the operation revealed that new bone remodeling was formed after maxillary sinus enhancement,and the implants in both groups remained intact 6 months after repair.Imaging results showed that the bone adhesion around the implant was well,and there was no significant difference in bone resorption around the implant between the two groups(P>0.05).Conclusion The success rate of the implant was higher in the early stage,regardless of whether there was perforation of the mucoperiosteal of the sinus floor during transalveolar crest elevation.