Sinus floor elevation using an osteotome technique without grafting materials or membranes

This retrospective study aimed to radiographically assess sinus floor remodeling after using a modified osteotome technique without graft materials or membranes. After pilot drilling, residual bone was fractured and raised with the schneiderian membrane to the final implant length using osteotomes. Self-tapping implants were placed, and restorations were placed 6 months later. Twenty-four patients were available for follow-up after a mean observation period of 17.6 +/- 8.4 months. The implant survival rate at that time was 100%. Bone filling around the implants was measured and compared with baseline digital radiographs. New bone formation was 86.3% +/- 22.1% mesially and 89.7% +/- 13.3% distally. In nine cases, digital volume tomography was used to verify regeneration. Within the limitations of this study, use of the schneiderian membrane led to considerable bone regeneration, and good clinical success was achieved despite the omission of graft materials.     

Radiographic evaluation of dental implants placed using an osteotome technique

BACKGROUND: The osteotome technique has been successfully used for implant placement when a limited vertical height is available at posterior maxilla. However, it is not clear if new bone is formed at the apical portion of the implant placed by this technique without any bone graft. The aim of this study was to radiographically evaluate bone formation around dental implant surfaces exposed to the space created at the sinus floor without the presence of any graft material. METHODS: Forty patients (21 male, 19 female; mean age 46.7 years) who received a total of 75 dental implants together with indirect sinus lifting procedure were included. Initial and 6-month postoperative panoramic films were scanned and analyzed using a commercially available software program. Implants were divided into two groups: initial alveolar bone height <9 mm or > or =9 mm. This helped determine the effect of available bone and exposed implant surface on bone formation in a system where the shortest implant was 8 mm. RESULTS: The mean implant length placed at locations with <9 mm initial bone height (mean 7 +/- 1.3 mm, N = 29 implants) was 11 +/- 1.7 mm; gain in bone height was 3.9 +/- 1.9 mm. At locations where minimum bone height was 9 mm (mean 10.4 +/- 0.7 mm), 44 implants were placed with a 13.5 +/- 1.06 mm mean length. Mean gain in bone height was 2.9 +/- 1.2 mm at these sites. Two implants were lost at stage 2 surgery. The success rate after 25 months of loading was 97.3%. CONCLUSIONS: It is possible to radiographically observe a gain of approximately 3 to 4 mm of bone from the sinus floor to the implant apex. The amount of initial alveolar bone height, presence of sinus membrane perforation, and the amount of exposed implant surface appear to play a role in the presence or absence of radiopacity within the elevated sinus floor, following 6 months of healing.     

Dental implants placement in conjunction with osteotome sinus floor elevation: a 12-year life-table analysis from a prospective study on 588 ITI implants

OBJECTIVES: The purpose of this prospective study was to evaluate the clinical success of placing ITI dental implants in the posterior maxilla using the osteotome technique. MATERIAL AND METHODS: All implants were placed following a one-stage protocol (elevating the sinus floor and placing the implant at the same time). Five hundred and eighty-eight implants were placed in 323 consecutive patients with a residual vertical height of bone under the sinus ranging from 6 to 9 mm. The mean observation follow-up period was 59.7 months (with a range of 12-144 months). This prospective study not only calculated the 12-year cumulative survival and success rates for 588 implants by life-table analysis but also the cumulative success rates for implant subgroups divided per implant length and the percentage of sinus membrane perforation were evaluated. RESULTS: The 12-year cumulative survival and success rates were 94.8% and 90.8%, respectively. The analysis of implant subgroups showed slightly more favourable cumulative success rates for 12 mm long implants (93.4%) compared with 10 and 8 mm long implants (90.5% and 88.9%, respectively). During the study period, only 13 perforations of the Schneiderian membrane were detected with a perforation rate of 2.2% (13 perforations/601 treated sites). Ten perforations out of 13 were caused during the first half of the study period and of these, seven were detected during the first 3 years of this prospective study. CONCLUSION: Based on the results and within the limits of the present study, it can be concluded that ITI implant placement in conjunction with osteotome sinus floor elevation represents a safe modality of treating the posterior maxilla in areas with reduced bone height subjacent to the sinus as survival and success rates were maintained above 90% for a mean observation period of approximately 60 months. Shorter implants (8 mm implants) did not significantly fail more than longer ones (10 and 12 mm implants): the differences were small compared with the number of events; hence, no statistical conclusion could be drawn. But, from the clinical point of view, the predictable use of short implants in conjunction with osteotome sinus floor elevation may reduce the indication for complex invasive procedures like sinus lift and bone grafting procedures.     

上颌窦底冲压提升法种植修复122例缺牙的临床观察

目的探讨上颌窦底冲压提升技术在上颌后牙区种植修复中的应用效果和技术特点。方法1998年7月至2004年7月,共完成122例上颌窦底冲压提升种植修复病例。男性48例,女性74例,平均年龄46·5岁(20~69岁),共植入157枚种植体。随访5年以上21例,3年以上41例,2年以上27例,1年以上33例,平均随访29·7个月。观察方法为临床检查和X线检查。患者均因上颌后牙种植区牙槽嵴顶至上颌窦底之间的剩余骨高度在8~11mm,无法植入足够长度的种植体,因而采用上颌窦底冲压法局部提升上颌窦底骨板及黏骨膜,提升幅度为2~5mm。术中未使用任何骨移植材料,同期植入种植体。若种植体植入时的扭力>0·25N·m,则行一段式种植体直接安装愈合基台,3~4个月后进行种植义齿修复;若种植体植入时的扭力<0·25N·m,则采取埋入式种植技术,3~4个月后再行Ⅱ期种植体暴露手术及修复。结果122例中有12例上颌窦黏骨膜穿破,但在观察期内未发生上颌窦炎等并发症。157枚种植体均获得良好的骨结合并已完成种植修复,至2005年10月为止,无种植体脱落,患者对修复效果满意。结论上颌窦底冲压提升种植修复技术安全、简便、易行;手术创伤小,可在上颌后牙区种植修复病例中选用。     

上颌窦冲顶提升术同期种植体植入的临床研究

目的 研究上颌窦冲顶提升术不植骨同期植入种植体的临床效果及种植特点。方法 43例患者,牙槽嵴顶距窦底骨高度为5～10mm。经上颌窦冲顶提升术不植骨植入56颗ITI种植体。结果 术后X片显示上颌窦底抬高(2.50±1.70)mm。所有患者未发生上颌窦炎的并发症,种植体稳固,X线片显示骨结合良好。所有种植体术后3～4个月均完成种植修复,可正常负重;种植体存留率100%。结论 在选择好适应证及良好的手术操作配合下,上颌窦冲顶提升术不植骨同期植入种植体可以获得很好的种植成功率。     

上颌窦底提升不植骨同期植入种植体的临床疗效观察

目的 观察冲压式上颌窦底提升术(osteotome sinus floor elevation,OSFE)不植骨并同期植入种植体的临床疗效及技术特点.方法 自2000年1月至2008年12月对65例患者经牙槽嵴顶入路,行OSFE并同期行种植体植入术,共植入96枚种植体,手术过程中上颌窦内不植入任何骨充填材料.缺牙区牙槽骨可用骨高度为5～8 mm,平均(6.78 4±1.04)mm.观察方法 为临床和X线片检查.对种植体凸入上颌窦内不同长度、安底改建情况进行卡方检验.结果 除1例单牙种植术后15 d因种植体松动、牙龈红肿取出种植体,其余64例患者随访>5年12例,>3年14例,>2年28例,>1年lO例,平均随访33.4个月.96枚种植体中除1枚于种植15 d后松动取bm外,其余种植体均获得良好的骨结合并完成上部义齿修复,种植体周围软组织无炎症,咀嚼功能良好.种植体凸入上颌窦内1～5 mm,平均2.57 mm,51枚(54%)种植体根方有不同程度的新骨形成,33枚(35%)种植体根方形成了新的上颌窦底,11枚(12%)种植体根周末见明显新骨形成.统计分析显示,种植体凸入上颌窦内的长度与上颌窦底骨改建差异无统计学意义(x2=6.113,P=0.191).结论 应严格把握OSFE适应证;OSFE时不植骨并同期植人种植体的短期临床效果是可预期的;新的窦底形成与上颌窦底提升高度无明显相关性.

Abstract：

Objective To investigate the clinical results of osteotome sinus floor elevation(OSFE)without grafting combined with simultaneous implant placement.Methods A total of 65 patients underwent maxillary sinus floor elevation from alveolus without any bone grafting from January 2000 to December 2008 and 96 implants were placed in the maxillary posterior edentulous region simultaneously.Clinical and radiography examinations were performed.The residual bone height ranged from 5 to 8 mm and the mean bone height was(6.78±1.04)mm.The mean following period was 33.4 months.Statistical analysis was perfbrmed by chi square test.Results Ninety-five of 96 implants were clinically stable and functioned without any pain and other complaints.One implant Was extracted 15 days after operation because of mobility and the other implants obtained osseointegration.The mean implant protrusion lengh Was 2.6 mm,ranging from 1 to 5 mm.Different degree of new bone formation was observed in 51(54%)of implants.New maxillary sinus floor outline Was observed in 33(35%)of implants and there was no obvious new bone in 11(12%)of implants.There Was no significant deference between the implant protrusion length and sinus floor remodeling.Conclusions Under strict indications,the clinical results of OSFE without bone grafting combined with simultaneous implant placement were predictable in short term.The new sinus floor formation was not related to the implant protrusion length.     

植骨和种植体突入长度对经牙槽嵴上颌窦底提升骨改建影响的回顾性研究

目的 利用锥形束CT(CBCT)评价植骨与否和种植体突入长度(IPL)对上颌窦底内提升术后6个月的骨改建的影响.方法 纳入96位患者,总计124颗种植体,将种植体分为:植骨且突入长度小于4 mm组(组1);植骨且突入长度大于4 mm组(组2);未植骨且突入长度小于4 mm组(组3);未植骨且突入长度大于4 mm组(组4...     

Sinus floor elevation via the maxillary premolar extraction socket with immediate implant placement: a case series

Background: When immediate implant placement is considered for teeth with close proximity to the sinus floor, apical extension of the osteotomy is significantly limited, and often a staged approach is used. Implant placement into fresh extraction sockets and sinus floor manipulation using bone‐added osteotome sinus floor elevation with implant placement are techniques most often used independently or sequentially. Very few reports have described the combined use of immediate implant placement in fresh sockets and the bone‐added osteotome sinus floor elevation technique. Methods: We present five cases in which a maxillary premolar was extracted and an implant placed into the extraction site with simultaneous abfracture of the sinus floor using osteotomes. All teeth were extracted atraumatically, and sockets carefully debrided and checked for integrity of the walls. After ideal osteotomy preparation, particulate bone graft was placed in the osteotomy and appropriately sized osteotomes were used for sinus floor elevation. After sufficient elevation, implant placement was completed and particulate bone was packed in the bone–implant gap when indicated. Results: All implants were restored after a minimum healing period of 6 months. At the time of final restoration, bone was seen surrounding the implants from the apical portion to the most coronal thread. All five implants healed without complications and were in function for periods ranging from 6 to 12 months. Conclusions: Immediate implant placement with simultaneous osteotome sinus floor elevation is an advantageous combination of two successfully used techniques. This combined approach can significantly reduce the treatment time for implant therapy in teeth with close sinus proximity and provide the operator with the ability to place implants of desired length.     

Influence of Sinus Floor Configuration on Grafted Bone Remodeling After Osteotome Sinus Floor Elevation

Background: This study investigates influence of the sinus floor configuration on dimensional stability of grafted bone height after the osteotome sinus grafting procedure. Methods: Forty single‐tooth dental implants inserted after placement of bioglass and/or allograft into the sinus area using an osteotome technique in 37 patients were evaluated in this retrospective study. Periapical radiographs were taken using the long‐cone technique before and after implant placement. Specifically, radiographic measurements of grafted bone height at the mesial and distal side of each implant were taken, and the sinus floor configuration was classified into concave, angle, and flat according to the sinus floor profile at the implant site. Furthermore, the intruding angle, defined as the angle between the implant axis and sinus floor, was measured. Results: All implants were clinically stable during a mean follow‐up period of 39.2 months. Mean initial gain of sinus grafted bone height was 7.0 ± 1.9 mm, and later it was reduced to 4.6 ± 1.9 mm at follow‐up (P <0.001). A greater reduction in grafted bone height was revealed in the flat sinus group compared with the concave group (P <0.001). Results from the linear regression showed larger intruding angles were statistically significantly associated with a greater reduction in grafted bone height (r² = 0.55, P <0.001). Conclusion: All bioglass and/or allograft placed in the maxillary sinus after the osteotome technique underwent remodeling and shrinkage; however, the outcome of the procedure was more predictable in sinuses with a concave floor and small implant‐intruding angles.     

胶原骨冲击法上颌窦内提升术的临床研究

背景:经典的上颌窦内提升术(OSAF、BAOSAF)具有较好的治疗效果。但是伴有上颌窦穿孔(10%)、无法预测的植骨量等并发症。多种植骨材料和改良手术方法业已应用ISL。目的:评价应用胶原骨做为上颌窦内提升术提升介质和植骨材料的手术方法,对上颌后牙区剩余骨高度不足患者进行种植手术同期植入胶原骨,探讨其技术要点及临床效果。材料与方法:2007年9月至2009年2月,共完成12例胶原骨Bio-col冲击法上颌窦内提升手术病例。男性5例,女性7例,平均年龄43.4岁(27—58岁),共植入种植体12枚。随访3年以上7例,2年以上5例。平均随访2.6年。评价方法为临床检查、X线检查和共振频率检查(Osstell)。患者上颌后牙区窦底剩余骨高度在5.8—8.0mm(平均6.6mm),提升高度为4.5—10.3mm(平均7.3mm)。术中采用胶原骨Bio-col作为冲击介质辅助提升,并利用胶原骨特性将其置于种植体根部正上方,同期植入种植体并暴露,5个月后完成种植修复。结果:12例中没有上颌窦黏骨膜穿破,术后种植体均获得良好的骨结合并完成种植修复。5个月修复时,共振频率值72—84(平均78)。1年期X线评测,提升高度为2.8—7.6mm(平均5.8mm)观察期内,无种植体脱落,患者对修复效果满意。结论:改良的胶原骨冲击法上颌窦内提升术,有效的降低上颌窦穿孔的风险,并且获得良好的成骨高度。克服既往上颌窦提升后窦底植骨或不植骨,骨高度降低的难题。     

Implant placement in fresh extraction sockets and simultaneous osteotome sinus floor elevation: a case series

The purpose of this study was to evaluate the clinical success of implants placed in fresh extraction sockets with simultaneous maxillary sinus floor elevation using the osteotome technique. Twelve patients were included. All the patients required the extraction of a maxillary premolar--close to the maxillary sinus--and were scheduled for immediate implant placement. One experimental implant was placed per patient, with an 18-month follow-up period. The graft materials used in both sinus augmentation and peri-implant bone defects were a mixture of collagen gel and corticocancellous porcine bone particles. All implants were allowed to heal for 6 months prior to prosthetic rehabilitation. One of the 12 experimental implants failed because of an abscess during early healing. No implants failed after definitive prosthetic rehabilitation. No significant bone loss was detected at the final follow-up visit. The mean bone height before sinus elevation and implant placement was 7.8 mm. Eighteen months after surgery, the mean bone height was 12 mm. When adequately performed, the surgical procedure described in the present study--immediate implant placement and simultaneous sinus floor elevation--appears to be unproblematic and predictable in terms of clinical success.     

The bone-added osteotome sinus floor elevation technique: multicenter retrospective report of consecutively treated patients

A retrospective clinical evaluation of patients consecutively treated from multiple centers was performed. The treatment of these patients utilized the bone-added osteotome sinus floor elevation (BAOSFE) procedure with immediate implant fixation. The BAOSFE method employs a specific set of osteotome instruments to tent the sinus membrane with bone graft material placed through the osteotomy site. A total of 174 implants was placed in 101 patients. Implants were of both screw and cylinder shapes with machined, titanium plasma-sprayed, and hydroxyapatite surfaces from various manufacturers. The 9 participating clinicians used autografts, allografts, and xenografts alone or in various combinations, and the type of graft was selected by the individual clinicians. The choice of graft material did not appear to influence survival rates. Loading periods varied from 6 to 66 months. The survival rate was 96% or higher when pretreatment bone height was 5 mm or more and dropped to 85.7% when pretreatment bone height was 4 mm or less. The most important factor influencing implant survival with the BAOSFE was the preexisting bone height between the sinus floor and crest. This short-term retrospective investigation suggests that the BAOSFE can be a successful procedure with a wide variety of implant types and grafting procedures.     

Summers骨凿提升上颌窦的临床应用

目的评价Summers骨凿在上颌窦闭合式内提升、植骨及同期牙种植术中的效果。方法对上颌后牙区牙槽骨严重吸收的66例患者,采用Summers骨凿预备种植床,植入人工骨并同期植入种植体,术后6个月完成种植修复。结果66例患者上颌窦提升高度2~5 mm,术后皆无上颌窦炎发生。牙科CT扫描显示窦内形成一圆形光滑的突起,提升部位表面光滑完整,无黏膜穿破表现。6个月后X线片显示植入的骨材料无明显吸收,种植体骨结合完成。种植修复完成12~24个月后复查,无种植体松动、脱落,牙龈组织健康,种植体上部结构功能恢复满意。X线片显示：种植体与骨结合紧密,种植体周围骨垂直吸收小于1 mm。结论Summers骨凿可安全地提升上颌窦底,并可避免异位取骨,值得临床推广。     

上颌窦内提升术植骨与不植骨对种植体骨结合的影响

目的探讨上颌窦内提升术植骨与不植骨对种植体骨整合的影响及两者之间的差异。方法将120枚需要进行内提升手术的种植体随机平均分为两组,第一组60枚为实验组,在上颌窦内提升后植入骨材料同期植入种植体;第二组60枚为对照组,上颌窦内提升后不植骨同期植入种植体。对两组种植体进行临床追踪（平均18个月）,观察种植体骨整合、临床检查指标、种植体存留率及影像学变化。结果仅有1例种植体覆盖螺丝暴露,种植体颈部出现骨吸收。所有两组种植体均能完成修复,种植体存留率达到100%,无1例脱落。种植体均能正常行使咀嚼功能,骨整合良好。影像学检查种植体周围均有新骨生长,骨整合良好。结论上颌窦内提升术后不植骨可以取得与植骨同样的效果,可以明显减少患者的种植牙费用,是一种值得推广应用的手术方法。     

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??Objective    To evaluate the clinical results of sinus floor elevation technique with simultaneous dental implantation in the posterior maxilla. Methods    A total of 79 patients underwent osteotome sinus floor elevation from 2009 to 2012. Bio-Oss and PRF were used as augmentation material??with simultaneous placement of implants. Results    The implant lengths ranged from 10 to 13 mm. The average height increase of the implant site was 3.8 ??2 to 5.7??. Sinus membrane perforation occurred in 3 cases and the dental implantation was abandoned. Totally 87 implants were placed. At second stage of surgery?? 3 failed implants were removed. Two implants were removed 18 months after prosthetic rehabilitation. One implant was lost due to progressive bone loss. The overall survival rate was 93.1%??81/87??. No clinical complications of the maxillary sinus area were observed during a follow-up period of 12 to 36 months. Conclusion    Osteotome sinus floor elevation with bone graft was a predictable and safe technique. It simplifies the surgical process and can be taken predictably for implant placement with surgical technique.     

Osteotome sinus floor elevation without grafting material: a 1-year prospective pilot study with ITI implants

OBJECTIVE: The aim of the present pilot study was to evaluate: (1) the predictability of an osteotome sinus floor elevation procedure with ITI-SLA implants without placing a bone grafting material, and (2) the possibility to gain bone height without filling the created space with a bone grafting material. MATERIAL AND METHODS: Seventeen patients received 25 implants protruding in the sinus. Most implants (21/25) were 10 mm long, eight were inserted in type 2 bone, 12 in type 3 and five in type 4 bone. At implant placement, the mean residual bone height (RBH) under the maxillary sinus was 5.4+/-2.3 mm; it was 5.7+/-2.6 mm on the mesial side and 5.1+/-1.9 mm on the distal side. Nineteen implants had less than 6 mm of bone on at least one side and six implants had less than 6 mm on both sides. A healing period of 3-4 months was allowed before abutment tightening at 35 Ncm. The percentage of stable implants at abutment tightening and at the 1-year control was calculated. The endo-sinus bone gain and the crestal bone loss (CBL) at the mesial and distal sides were measured. RESULTS: Abutments were tightened after 3.1+/-0.4 months. All implants but one (96%) resisted the applied 35 Ncm torque. At the 1-year control, all implants were clinically stable and supported the definitive prosthesis. All showed endo-sinus bone gain; the mean gain was 2.5+/-1.2 mm. The mean CBL was 1.2+/-0.7 mm. Endo-sinus bone gain and RBH showed a strong negative correlation (r=-0.78 on the mesial side and -0.80 on the distal side). A good correlation (r=0.73) was found between implant penetration in the sinus and endo-sinus bone gain. CONCLUSION: Elevation of the sinus membrane alone without addition of bone grafting material can lead to bone formation beyond the original limits of the sinus floor. Despite a limited RBH at implant placement, a healing period of 3 months was sufficient to resist a torque of 35 N cm and to lead to a predictable implant function at the 1-year control.     

The use of a piezoelectric ultrasonic osteotome for internal sinus elevation: a retrospective analysis of clinical results

Purpose: To explore the possibility and evaluate the clinical outcome of accomplishing maxillary internal sinus floor augmentation through the use of a piezoelectric osteotome in conjunction with dental implant placement and to discuss this technique. Materials and Methods: Patients attending the outpatient clinic of the Department of Dental Implantology, Hospital of Stomatology, Tongji University, between July 2007 and September 2009, who had insufficient bone volume to harbor endosseous implants at least 8 mm long in the lateral/posterior maxilla because of sinus pneumatization were enrolled in the study. Sinus augmentations were accomplished with a piezoelectric osteotome, followed by implant placement, either immediately or delayed (6 months after augmentation, if the residual ridge height was less than 4 mm). Results: Thirty patients with 36 maxillary molar sites with insufficient alveolar bone height as a result of pneumatization of the sinus were included in this study. The residual vertical bone height ranged from 2 to 8 mm. Twenty-eight implants were placed into 24 patients immediately after sinus augmentation. Another eight implants were placed into 6 patients 6 months after sinus augmentation. Only one sinus membrane perforated (failure rate: 2.78%). Only one implant was lost during the observation period. No other implant mobility or rapid bone loss was seen during a follow-up period of 5 to 27 months. Conclusions: Application of a piezoelectric osteotome for internal sinus elevation simplified manipulation of the membrane and greatly reduced the chance of perforation. The pressure gradient between sinus and implant cavity was helpful in accomplishing this technique.     

Survival of implants placed with the osteotome technique: An update

A literature review is made to analyze the survival of implants placed with the osteotome technique. A PubMed search was made based on the key words "osteotome AND dental implants", corresponding to publications between 1998-2008. The inclusion criteria were: a) a minimum of 10 patients; b) a minimum follow-up of 6 months; c) implants placed using the osteotome technique with or without indirect sinus lift; and d) specification of the implant number and survival rate. Sixty-four articles were identified, of which 20 met the inclusion criteria. A total of 2006 implants were placed in 1312 patients using the osteotome technique. The duration of follow-up after prosthetic loading ranged from 6-144 months. Indirect sinus lift was carried out in all but one of the studies. The residual crest height ranged from 2.8-12 mm, with a mean gain in bone after sinus lift of 2.5-5.1 mm. The time from implant placement to prosthetic loading varied from 1.5-9 months. The percentage implant survival rate was 85.1-100%. The survival rate of implants placed with the osteotome technique is high and does not differ with respect to implant placement with the conventional technique.     

上颌窦底提升同期种植体植入术79例临床分析

目的    观察采用经牙槽嵴入路提升上颌窦底同期植入种植体的临床效果。方法    对2009—2012年南京军区机关医院数字口腔中心接诊的79例上颌后牙缺失患者,行经牙槽嵴顶入路上颌窦底提升,选择性植入人工骨或富血小板纤维蛋白（PRF）,同时植入种植体。结果    79例患者平均提升上颌窦底高度3.8 mm（2.0～5.7 mm）。3例患者因上颌窦黏膜术中发生穿孔,遂关闭创口,未完成种植体植入。其余76例共植入87颗种植体,长度 10～13 mm。Ⅱ期手术时,3颗种植体松动拔除。义齿修复后追踪12～36个月,2颗种植牙松动拔除,1颗有进行性骨吸收,种植体存留率为93.1%（81/87）。所有病例均无上颌窦并发症。结论    经牙槽嵴顶入路上颌窦底提升术较开窗式上颌窦提升创伤小,操作简单,对窦底有适量剩余骨的上颌窦区种植是可行的;但由于窦底黏膜存在穿孔风险,技术要求较高,而且必须有专用的器械。     

上颌窦内提升术同期种植体植入术在修复上颌后牙缺失伴颌骨骨量不足病例中的应用

目的探讨上颌窦内提升术同期牙种植术修复剩余牙槽骨高度(RBH)的上颌后牙缺失颌骨骨量不足的临床疗效。方法选择上颌骨骨量不足行种植修复患者45例(85颗种植体)均行上颌窦内提升术同期牙种植术,其中RBH<5 mm患者加用骨挤压并植入骨粉。分别于术后1、3、6、12个月复查X线检查种植体保留情况,并观察骨改建骨小梁形成及骨吸收情况。结果患者均无上颌窦炎症,种植体周围边缘骨稳定,均获良好骨结合。A组、B组种植体的留存率分别为100.0%和95.6%,差异无统计学意义(χ2=0.51,P>0.05);上颌窦底不同提升高度之间的窦底改建程度比较,差异无统计学意义(χ2=4.49,P>0.05)。结论上颌窦内提升术同期牙种植术可有效修复上颌后牙缺失,颌骨骨量不足,对RBH<5 mm的患者有较好的留存率。