超声内提升骨刀在上颌窦内提升术中的临床应用

目的:评价超声内提升骨刀在上颌窦内提升术中的技术优势。方法:16例上颌后牙缺失患者,上颌窦底剩余牙槽骨骨量为4～7 mm,采用超声内提升骨刀行上颌窦底黏膜内提升术,同期植入种植体30枚,术后6个月上部结构修复。随访18个月。结果:术中无1例上颌窦黏膜破裂,术中、术后患者均无头晕、头痛等不适,术后鼻腔无出血,也无骨粉等异物排出;术后种植体稳固,种植体周围牙龈组织健康,无一脱落,咀嚼功能恢复满意。数字曲面断层片显示种植体周围骨未见低密度影,无上颌窦炎症影像;术后18个月种植体末端骨高度(2.1±1.5)mm,窦底提升(3.6±1.8)mm,种植体边缘骨吸收(1.27±0.56)mm。结论:采用超声内提升骨刀代替骨凿技术行上颌窦底黏膜内提升术,具有高效、快速、患者不适感轻、不损伤窦底黏膜的优点,值得在临床上推广。

Inner Lifting in Osteotome Sinus Floor Elevation Technique with Ultrasound Bone Knife

Objective： To evaluate the technical advantages by applying ultrasound bone knife for inner lifting in osteotome sinus floor elevation technique during dental implantation. Methods： 16 cases with maxillary posterior tooth loss were selected, whose height of residual alveolar bone at the bottom site of maxillary sinus were 4.0-7.0 mm. Applying ultrasound bone knife for inner lifting in the operation on the bottom mucosa of maxillary sinus, 30 implants were simultaneously embedded. Restoration of upper structures were constructed after 6 months. Fallow-up period remained 18 months. Results： None of maxillary sinus mucosa was ruptured in those operations. There were no dizziness, headache, nasal bleeding and grafted bone powder discharged. The implants were stable with healthy peri-implant gingival tissue. None of them was loosen or broken off. Panoramic images showed that all the implants were no low-density peri-implant shadow or images of maxillary sinus inflammation. The end of bone height around implant was （2.1±1.5）mm and height of sinus elevation was （3.6±1.8）mm in 18 months after surgery, absorptions of the alveolar bone around the neck of implants was （1.27±0.56）mm in 18 months after surgery. The functions of upper structures were satisfied. Conclusion： Instead of bone chisel, applying ultrasound bone knife for inner lifting in osteotome sinus floor elevation technique during dental implantation serves is a swift and effcient method, not only with little discomfort during and after operation, but also without damage of maxillary sinus mucosa. It has achieved well effect in clinical operation of dental implantation.