上颌窦宽度及角度预测经牙槽嵴顶上颌窦底提升术骨移植稳定性的价值

目的: 探讨通过锥形束CT（CBCT）测量上颌窦宽度及角度,评估牙槽嵴顶上颌窦底提升术骨移植稳定性的价值。方法: 选取行经牙槽嵴顶上颌窦底提升术并同期种植的78例患者为研究对象。所有患者术前、术后6个月均行CBCT检查,测量上颌窦宽度、角度及根端骨吸收量。分析影响牙槽嵴顶上颌窦底提升术骨移植稳定性的因素,评估上颌窦宽度、上颌窦角度预测牙槽嵴顶上颌窦底提升术骨移植稳定性的价值。采用SPSS 18.0软件包对数据进行统计学分析。结果: 术后6个月种植体根端骨平均吸收量为（1.81±0.26）mm,其中,49例≤1.81 mm,29例>1.81mm。Logistic多因素回归分析显示,上颌窦宽度、上颌窦角度是影响牙槽嵴顶上颌窦底提升术骨移植稳定性的独立因素（OR：3.873、4.518,95%CI：1.594~9.412、1.859~10.979,P<0.05）。ROC曲线分析显示,上颌窦宽度、上颌窦角度及两者联合预测牙槽嵴顶上颌窦底提升术骨移植稳定性的AUC分别为0.764、0.742和0.908。结论: 上颌窦宽度和角度是影响牙槽嵴顶上颌窦底提升术骨移植稳定性的指标,两者联合预测术后骨移植稳定性效能良好。

The value of maxillary sinus width and angle in predicting the stability of maxillary sinus floor lifting via alveolar crest

PURPOSE: To explore the value of cone beam CT (CBCT) measuring the width and angle of the maxillary sinus to predict the stability of bone graft during alveolar crest top and maxillary sinus floor elevation. METHODS: Seventy- eight patients undergoing transalveolar crest maxillary sinus floor elevation and implantation at the same time were collected as research subjects. The width, angle of the maxillary sinus and the amount of bone resorption at the root end were examined by cone beam(CBCT) before and 6 months after operation. The factors affecting the stability of bone grafts during alveolar ridge top and maxillary sinus floor elevation were analyzed, and the value of maxillary sinus width and maxillary sinus angle in predicting the stability of bone graft stability during alveolar ridge top and maxillary sinus floor elevation was analyzed. SPSS 18.0 software package was used for data analysis. RESULTS: Bone resorption at the root end of the implant was (1.81±0.26) mm 6 months after operation. Among them, forty-nine patients had root end bone resorption ≤1.81 mm, and 29 patients had root end bone resorption >1.81 mm. Logistic multivariate regression analysis showed that the width and the angle of the maxillary sinus were independent factors affecting the stability of bone graft during alveolar crest top and maxillary sinus elevation (OR: 3.873, 4.518, 95%CI: 1.594~9.412, 1.859~10.979, P<0.05). ROC curve analysis showed that the AUC of maxillary sinus width, maxillary sinus angle and combination of the two to predict the stability of the bone graft during alveolar crest top and maxillary sinus elevation was 0.764, 0.742, 0.908, respectively. CONCLUSIONS: The width and angle of the maxillary sinus are indicators that affect the stability of bone graft during elevation of the alveolar crest and maxillary sinus floor. Combination of the two indicators is effective in predicting the stability of bone graft.