改良上颌窦底提升术的临床应用

目的:评价改良上颌窦底提升术在处理上颌后牙区垂直骨量不足中的应用及临床效果。方法:65名上颌后牙缺失患者,共103个植入位点。上颌窦底下方的剩余牙槽骨高度为2～9mm。其中,30例剩余骨高度为5～9mm的患者,采用超声骨刀行上颌窦底内提升术;35例剩余骨高度为2～5mm的患者,行侧壁小开窗上颌窦底提升术。同期或延期植入种植体,随访9-30个月。结果:术后6个月,行上颌窦底内提升术的患者,平均提升高度为4.43mm(2.22～5.47mm);行上颌窦底外提升术的患者,平均提升高度为5.95mm(4.16～12.85mm)。103个种植位点中仅2例在术中发现黏膜穿孔,1例在戴牙后3个月出现种植体松动,其余种植体均形成良好骨结合,存留率为99%。结论:上颌窦底提升术能够有效促进上颌窦内成骨,增加上颌后牙区骨高度,超声骨刀及外提升术中小开窗术式的应用,可显著降低术中并发症的发生率、缩短手术时间、减轻患者术后反应。

Augmentation of Atrophic Posterior Maxilla by Sinus Floor Elevation

Objective:To evaluate the clinical outcomes of the modified sinus floor elevation technique for bone regeneration in pneumatized sinus.Methods:65 patients(103 implant sites) with edentulous posterior maxilla were included in this study.The residual bone height(RBH) was from 2mm to 9mm.Transcrestal sinus floor elevation was carried out in 30 patients whose RBH was between 5mm and 9mm.The others were operated using lateral technique with a small window.Implants were placed simultaneously or delayed.Results:Six months later,the mean grafted heights of internal and external sinus floor were 4.43mm and 5.95mm respectively.In 103 implant sites,2 implants were found with their membrane perforations and 1 implant was lost after loading.The cumulated survival rate was 99%.Conclusion:Sinus floor elevation is a predictable technique for sinus augmentation.Application of piezosurgery system and modified lateral window technique will be benefit for patients to reduce the intraoperative complications and uncomfortable feeling.