单纯经牙槽嵴顶入路上颌窦底提升术应用于后牙区严重骨高度不足的临床效果分析

doi:10.13591/j.cnki.kqyx.2022.08.008

摘要/Abstract

摘要： 目的探讨上颌后牙区严重剩余骨高度(residual bone height,RBH)不足,即RBH在4 mm左右时应用单纯经牙槽嵴顶入路上颌窦底提升术,同期植入种植体的临床效果。方法选择2017—2019年期间于南通市口腔医院种植科进行上颌后牙区种植修复的患者46例(51枚种植),分为不植骨组(21枚)、植骨组(15枚)、浓缩生长因子(concentrated growth factor,CGF)组(15枚),对术后即刻、术后6个月、1年、2年的骨增量变化、种植体稳定系数(implant stability quotient, ISQ)、种植体机械及生物并发症等进行观察,并进行了术后即刻和术后2周患者的满意度调查问卷。运用SPSS21.0软件对数据进行统计学分析。结果三组术后、6个月的ISQ值比较,差异无统计学意义(P>0.05);上颌窦骨增量方面,三组和术前相比,骨增量的差异具有统计学意义(P<0.05),植骨组和CGF组增量大于不植骨组,差异有统计学意义(P<0.05);在随访问卷中,患者对于单纯经牙槽嵴顶入路上颌窦底提升术具有更高的满意度,差异具有统计学意义(P<0.05)。结论在上颌后牙区RBH约4 mm左右时,单纯经牙槽嵴顶入路上颌窦底提升术具有良好的临床效果,并且更易得到患者的认可。

关键词: 经牙槽嵴顶入路上颌窦底提升术, 剩余骨高度, 植骨, 短种植体

Abstract: Objective To evaluate the clinical effect of osteotome sinus floor elevation (OSFE) and simultaneous implant placement in limited alveolar bone of posterior maxilla without bone grafting when residual bone height (RBH) was about 4 mm. Methods A total of 46 patients (51 implants) from 2017 to 2019 were selected. Patients were divided into three groups (without bone grafting group (21), bone grafting group (15) and concentrated growth factor (CGF) group(15)). Changes of bone increment, implant stability quotient (ISQ), mechanical and biological complications of implants were tested and observed immediately after surgery, 6 months, 1 year and 2 years after surgery. Patient satisfaction questionnaire was conducted immediately after surgery and 2 weeks later. SPSS 21.0 software was used for statistical analysis of data. Results There was no significant difference in ISQ value among the three groups immediately or 6 months after surgery (P>0.05). In terms of maxillary sinus bone increment, there was statistically significant difference from data before surgery in three groups (P<0.05), and the increment in the bone graft group and CGF group was greater than that in the non-graft group, with statistically significant difference (P<0.05). In the follow-up questionnaire, patients were more satisfied with osteotome sinus floor elevation without bone grafting, and the difference was statistically significant (P<0.05). Conclusion When the RBH is about 4 mm in the maxillary posterior region, osteotome sinus floor elevation without bone grafting has good clinical effects and is more easily accepted by patients.

Key words: osteotome sinus floor elevation, residual bone height, bone graft, short implant

中图分类号:

R782.12

陈冬雷, 郝丹, 葛维燕, 孔琴, 郭海波. 单纯经牙槽嵴顶入路上颌窦底提升术应用于后牙区严重骨高度不足的临床效果分析[J]. 口腔医学, 2022, 42(8): 717-722.

CHEN Donglei, HAO Dan, GE Weiyan, KONG Qin, GUO Haibo. Clinical analysis of osteotome sinus floor elevation without bone grafting in limited alveolar bone of posterior maxilla[J]. Stomatology, 2022, 42(8): 717-722.

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