106例侧壁开窗式上颌窦底提升术的回顾性研究

发布时间：2018-03-13 20:36

本文选题：侧壁开窗　切入点：上颌窦底提升　出处：《浙江大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的：通过收集106位患者病史资料、治疗相关详细资料及影像学资料,研究侧壁开窗式上颌窦底提升术对垂直骨量、窦底黏膜厚度的影响,研究并讨论相关并发症以及建议的治疗方法,为临床治疗提供一定的参考。材料方法：以2012年1月9日至2013年12月31日来浙江大学医学院附属口腔医院种植科就诊的106位上颌后牙缺失患者为研究对象。根据口腔检查、全景片以及CBCT片进行术前评估,制定合理的种植手术方案,通过测量术前术后38例114份同期种植的全景片及22例66份同期种植的CBCT片,统计出垂直骨量、黏膜厚度的改变情况。记录所有术中和术后的并发症,比如过量出血、上颌窦底黏膜穿孔、感染、创口裂开、急性上颌窦炎、移植骨吸收。统计出种植体存留率。结果：(1)术前原始骨高度为4.89±2.30mm,术后即刻骨高度为13.29±2.32mm,相比术前增加了8.38±3.00mm,术后3-6个月骨高度为12.94±2.211mm。术前与术后即刻骨高度有显著性差异,P=0.0000.05。术前与术后3-6个月骨高度有显著性差异,P=0.0000.05。术后即刻与术后3-6个月骨高度无显著性差异,P=0.5320.05。(2)术前黏膜厚度为2.38±2.99mm,术后即刻黏膜厚度为2.42±3.15mm,术后3-6个月黏膜厚度为2.91±4.06mm。三个时间点的黏膜厚度无显著性差异,P=0.7820.05。 (3)术中8例发生窦底黏膜穿孔,术后3例当晚少量鼻出血,术后1-2周3例伤口裂开,术后2周1例急性上颌窦炎伴化脓性感染；术后6个月内,有6例患者的移植骨出现部分吸收,6颗种植体发生松动或自行脱落。平均随访时间为16个月,种植体存留率为96.6%。结论：(1)侧壁开窗式上领窦底提升术并同期种植,术后即刻显示骨高度显著增加,并能在术后3-6个月保持该骨高度,不发生骨吸收。 (2)侧壁开窗式上颌窦底提升术并同期种植,术后即刻及术后3-6个月内都不会引起窦底黏膜厚度的增加。 (3)并发症有黏膜穿孔、感染、创口裂开、移植骨吸收以及种植体松动、脱落,可通过术前周密检查、术中控制手术操作、修补穿孔黏膜、术后适当加大抗生素剂量、缝合裂开创口并配合使用漱口水及系统性抗生素治疗等方法预防及治疗相关并发症。
[Abstract]:Objective: to study the effects of lateral wall fenestration on the vertical bone mass and the thickness of sinus floor mucosa in 106 patients. To study and discuss the related complications and suggested treatment methods, to provide some reference for clinical treatment. Materials: from January 9th 2012 to December 31st 2013, 106 patients with maxillary posterior tooth loss were selected from the Department of Implant, affiliated Stomatology Hospital of Zhejiang University Medical College as subjects. Preoperative evaluation was performed according to oral examination, panoramic film and CBCT film. To make a reasonable implant operation plan, the changes of vertical bone mass and mucosal thickness were measured in 38 cases (114 cases) and 66 cases (66 cases) of CBCT before and after implantation. All the complications during and after operation were recorded. For example, excessive bleeding, perforation of the maxillary sinus floor, infection, laceration of the wound, acute maxillary sinusitis, bone resorption. Results the original bone height was 4.89 卤2.30mm before operation and 13.29 卤2.32mm immediately after operation, which was 8.38 卤3.00mm higher than that before operation, and 12.94 卤2.211mm. there was significant difference between preoperative bone height and immediate bone height. There was significant difference between preoperative and postoperative bone height of 3-6 months. There was no significant difference in bone height between 3 and 6 months after operation. The mucosal thickness was 2.38 卤2.99mm before operation, 2.42 卤3.15mm immediately after operation and 2.91 卤4.06mmm. there was no significant difference in mucosal thickness between 3 and 6 months after operation. There were 8 cases of sinus mucosal perforation during operation, 3 cases of epistaxis that night, 3 cases of wound rupture at 1-2 weeks after operation, 1 case of acute maxillary sinusitis with suppurative infection 2 weeks after operation, 6 months after operation, 1 case of acute maxillary sinusitis with suppurative infection. There were 6 patients with partial resorption and 6 implants loosened or self-abscission. The average follow-up time was 16 months and the implant retention rate was 96.6B. Conclusion 1) the lateral wall fenestration of the upper collar sinus floor was implanted simultaneously, and the bone height was significantly increased immediately after operation, and the bone height could be maintained 3 to 6 months after operation without bone resorption. 2) the lateral wall fenestration of maxillary sinus floor lifting and implantation at the same time did not increase the thickness of sinus floor mucosa immediately after operation and 3 to 6 months after operation. Complications include mucosal perforation, infection, wound rupture, graft resorption, loosening and shedding of implants. To prevent and treat related complications by suturing the dehiscence and using gargle and systemic antibiotics.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R783.6

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