微创技术在上颌窦内提升植骨中应用效果的影像学评价

doi:10.13701/j.cnki.kqyxyj.2020.07.018

摘要/Abstract

摘要： 目的: 通过随访应用微创技术行上颌窦底内提升植骨并同期种植的病例,用锥形束CT(CBCT)及根尖片对植骨效果进行评价。方法: 选取56例患者(68个上颌后牙区缺牙位点),可用骨高度4~9 mm,运用微创技术行上颌窦底内提升植骨并同期植入种植体,术后即刻、3个月和1年复查时拍摄CBCT和根尖片,测量上颌窦底提升的骨高度和种植体周围边缘骨水平的变化,并对提升植骨后的形态进行分类。结果: 术前骨高度为(6.34±1.15) mm,术后骨高度为(11.57±1.28) mm,术前与术后即刻具有显著性差异。术后即刻的提升高度为(5.23±1.33) mm,术后1年的提升高度为(4.66±1.36) mm,两者具有显著性差异,P＜0.05。对提升后窦底成骨形态分为四种, A型47例(69.1%),B型11例(16.2%),C型4例(5.9%),D型6例(8.8%),穿孔率为4.4%。术后1年种植体边缘骨吸收为(0.65±0.20) mm。结论: 应用本研究中的微创方法进行上颌窦底内提升植骨,操作简便、安全有效,术后窦膜穿孔等并发症发生率低,推荐在临床推广使用。

关键词: 上颌窦内提升, 种植, 微创

Abstract: Objective: To evaluate radiologic outcomes and morphology of a novel device that allows simultaneous hydraulic sinus membrane elevation, bone grafting, and implant placement. Methods: 56 patients with 68 lost teeth in the posterior maxilla with 4 to 9 mm of residual crestal height were operated by minimally invasive Sinus Crestal Approach (SCA) technology. They were analyzed by cone beam computed tomography (CBCT) pre and immediately post operation, three months post-operation, and one year post-operation. The parameters were measured: pre-operative bone height (H0), immediately post-operative bone height (H1), three-month post-operative height (H2), 1 year post-operative height (H3), lift Height H'=H1-H0, three months of osteogenic height H1'=H2-H0, 1 year post-operative osteogenesis height H2'= H3-H0, and post-operative bone tip height H3'. Sinus floor morphology was assessed one year post-operation. Marginal bone lost was measured. Results: The mean heights pre (H0) and immediately post-operation (H1) were (6.34 ±1.15) mm and (11.57±1.28) mm (P<0.01). The post-operative lift height (H') was (5.23±1.33) mm, and the 1 year post-operative lift height (H2') was (4.66±1.36) mm (P<0.05). According to the post-operative CBCT sagittal images, the morphology was divided into four types, 47 cases of type A (69.1%), 11 cases of type B (16.2%), 4 cases of type C (5.9%), and 6 cases of type D (8.8%). A total of 3 cases had perforation, with perforation rate at 4.4%. MBL was (0.65±0.20) mm. Conclusion: The SCA technique was simple and easy to master, which achieved excellent results and low incidence of complications. Long-term clinical studies are needed to confirm these preliminary results.

Key words: crestal sinus lift procedure, implant, minimally invasive

王智, 邹立东. 微创技术在上颌窦内提升植骨中应用效果的影像学评价[J]. 口腔医学研究, 2020, 36(7): 688-692.

WANG Zhi, ZOU Lidong. Minimally Invasive Sinus Augmentation Procedure Using a Sinus Crestal Approach: A Prospective Case Series Study on Radiologic Outcomes[J]. Journal of Oral Science Research, 2020, 36(7): 688-692.

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