开窗植骨与闭合冲压上颌窦底提升同期种植的临床研究

目的:研究比较上后牙缺失牙槽嵴高度不足患者,根据上颌窦底牙槽嵴骨高度不同,选用开窗植骨或闭合冲压提升上颌窦底,同期种植牙的治疗效果。方法:43例(55侧)上后牙缺失患者,其中34例(40侧)窦底牙槽嵴骨高6~10 mm者行闭合冲压上颌窦底提升术,其余9例(15侧)骨高2~5 mm者行开窗植骨上颌窦底提升手术,均同期完成一期种植体植入手术。结果:所有患者术后未出现上颌窦炎症,9例行开窗植骨上颌窦底提升手术的患者,无窦膜穿孔,平均提升窦底高度5.8 mm,26颗种植体平均负载30个月,种植体稳定,骨结合状况良好。34例行闭合冲压上颌窦底提升术的患者,平均提升窦底高度4.3 mm,手术操作中有3颗发生可察觉窦膜破孔,发生率为4.1%(3/73),在73颗种植体中,有2颗种植体失败,71颗种植体平均负载23个月,种植体稳定,未见明显骨吸收,成功率97.3%(71/73)。结论:闭合冲压上颌窦底提升术是一种微创、简单、可靠用于上颌后牙上颌窦底牙槽嵴骨高度不足的种植临床技术,临床上应根据上颌窦底牙槽嵴骨高度不同,选用开窗植骨或闭合冲压提升上颌窦底。

Clinical Study of Maxillary Sinus Lift with Bone Graft and Internal Sinus Floor Elevation and Simultaneous Placement of Implants

Objective: To study the effect of maxillary sinus lift with bone graft or internal sinus floor elevation with simultaneous placement of implants according to different height of alveolar ridges.Methods: 43 patients suffered the loss of up posterior teeth.34 cases whose bone height of maxillary sinus floor was between 6-10mm underwent internal sinus floore elevation,and other 9 cases whose bone height between 2-5mm underwent maxillary sinus lift with bone graft.all cases were simultaneously placed implants.Results: There were no clinical complaints of maxillary sinusitis for all cases.9 cases who underwent maxillary sinus lift with bone graft had not detectable Schneiderian membrane perforation during operation procedure,and the mean increase height was 5.8mm.A total of 26 implants had loaded for 30 months and were stable.And well osseointegration on X-ray film.34 cases who underwent internal sinus floor elevation showed the mean increase of 4.3mm.There were 3 implants which had detectable Schneiderian membrane perforation during operation procedure,and 2 implants lost.The rest implants 71 have loaded for 23 months and were stable and well osseointegration on X-ray film.Conclusion: Two sinus lift approaches show desirable clinical results.Internal sinus floore elevation is a mini-trauma and reliable clinical technique for sinus lift.