用盘钻经牙槽嵴提升上颌窦底手术的临床效果观察

目的 观察并评估应用盘钻行经牙槽嵴上颌窦底提升同期种植体植入术的临床效果.方法 上颌后牙缺失患者37例,种植区剩余牙槽骨高度为3～8 mm,平均(5.61±1.61) mm,应用盘钻行上颌窦底提升,同期植入种植体51枚,评估手术安全性及舒适度.术后3～6个月行上部结构修复,随访3～24 个月,观察种植体稳定性、骨结合及种植体周围骨量变化情况.结果 本组术中提升上颌窦底高度2～8 mm,平均(4.75±1.55) mm;所有病例均未发生上颌窦黏膜穿孔,患者主观感觉良好,痛苦指数为(2.22±0.98).随访期内,所有病例均未出现上颌窦感染等并发症,骨结合良好,种植体及修复体无松动、脱落,留存率100%.种植体根方骨量于术后6个月趋于稳定,术后1年颈部骨吸收(1.20±0.72) mm.结论 应用盘钻行经牙槽嵴上颌窦底提升同期种植体植入术,近期效果满意.

Abstract：

Objective To evaluate the clinical effect of the disk-up sinus reamer (DSR) applied to transcrestal maxillary sinus floor elevation with simultaneous placement of implants. Methods Thirty-seven patients underwent transcrestal maxillary sinus floor elevation with fifty-one implants placed simultaneously using the DSR. The residual bone height(RBH) was 3 to 8 mm, (5.61±1.61) mm on average. The safety of this technique and the pain index during the operation was evaluated. The final prostheses were restored in 3-6 months postoperatively. The follow-up period was 3 to 24 months. The stability and osseointegration of the implants were clinically evaluated, and the endo-sinus bone gain around the implants were measured. Results The elevation height ranged from 2 to 8 mm, with an average of (4.75±1.55) mm. There was no detectable sinus membrane perforation, no serious suffering or uncomfortable subjective sensation in any patients during operation with a pain index of (2.22±0.98). During the follow-up period, no sinus complication was observed. Favorable osseointegration was obtained. There were no implants or prostheses which were loose or lost. The survival rate was 100%. The radiographic results demonstrated that the endo-sinus bone gain tended to reach stabilization after 6 months and the marginal bone loss was(1.20±0.72) mm after 12 months. Conclusions Transcrestal maxillary sinus floor elevation with simultaneous implant placement by DSR is a safe, invasive and handy technique, with higher elevation height,fewer clinical complications and less pain. It shows satisfactory clinical results in short term and a long-term observation is still needed.

Clinical study of transcrestal maxillary sinus floor elevation with the disk-up sinus reamer

Objective To evaluate the clinical effect of the disk-up sinus reamer (DSR) applied to transcrestal maxillary sinus floor elevation with simultaneous placement of implants. Methods Thirty-seven patients underwent transcrestal maxillary sinus floor elevation with fifty-one implants placed simultaneously using the DSR. The residual bone height(RBH) was 3 to 8 mm, (5.61±1.61) mm on average. The safety of this technique and the pain index during the operation was evaluated. The final prostheses were restored in 3-6 months postoperatively. The follow-up period was 3 to 24 months. The stability and osseointegration of the implants were clinically evaluated, and the endo-sinus bone gain around the implants were measured. Results The elevation height ranged from 2 to 8 mm, with an average of (4.75±1.55) mm. There was no detectable sinus membrane perforation, no serious suffering or uncomfortable subjective sensation in any patients during operation with a pain index of (2.22±0.98). During the follow-up period, no sinus complication was observed. Favorable osseointegration was obtained. There were no implants or prostheses which were loose or lost. The survival rate was 100%. The radiographic results demonstrated that the endo-sinus bone gain tended to reach stabilization after 6 months and the marginal bone loss was(1.20±0.72) mm after 12 months. Conclusions Transcrestal maxillary sinus floor elevation with simultaneous implant placement by DSR is a safe, invasive and handy technique, with higher elevation height,fewer clinical complications and less pain. It shows satisfactory clinical results in short term and a long-term observation is still needed.