上颌后牙区种植修复后6～9年临床疗效观察

发布时间：2018-04-25 13:44

本文选题：种植修复术 + 上颌窦提升术　；参考：《东南大学学报(医学版)》2017年05期

【摘要】：目的:评价上颌窦提升术应用于上颌后牙区垂直骨量不足的种植义齿功能负载6~9年的临床疗效。方法:收集2007~2010年上颌后牙区牙齿缺失行种植义齿修复患者69例,共植入种植体95枚,根据术前剩余牙槽骨高度(RBH)不同分为上颌窦提升术植骨组(A组)27例38枚,上颌窦提升术未植骨组(B组)17例24枚,常规种植组(C组)25例33枚,平均随访85.4个月,评估种植体存留率、种植体周围软组织状态、患者满意度、边缘骨吸收(MBL)、植入骨粉变化、上颌窦底位置变化等指标。结果:95枚种植体中有2枚在术后6个月脱落,存留率97.9%;三组患者对种植修复满意度评分为:(30.5±4.7)分、(29.27±5.34)分、(29.54±5.14)分,不同术式间满意度无差异;术后6~9年随访,种植体周围软组织状态良好,三组间无统计学差异;术后6个月,A、B、C三组种植体近远中边缘骨平均吸收为:(0.26±0.43)mm、(0.35±0.37)mm、(0.50±0.61)mm,结果有统计学差异;术后6~9年随访时,A、B、C三组种植体近远中边缘骨平均吸收为:(1.45±1.20)mm、(1.47±1.64)mm、(1.57±1.51)mm,结果有统计学意义,不同术式间边缘骨吸收无差异;术后A组上颌窦底位置上升,术后6个月为(1.42±2.23)mm,术后6~9年为(1.95±1.87)mm,且有统计学差异,其他两组差异无统计学意义。A组植入骨粉在术后6个月平均剩余64.23%,6~9年剩余6.56%。结论:对垂直骨量不足的上颌后牙区种植修复术后6-9年的远期临床疗效良好,上颌窦底位置上升率较高,所植骨粉大部分被吸收。
[Abstract]:Objective: to evaluate the clinical effect of maxillary sinus lifting for implant prosthesis with insufficient vertical bone mass in maxillary posterior region. Methods: from 2007 to 2010, 69 patients with maxillary posterior tooth loss were treated with implant prosthesis, 95 implants were implanted. According to the height of residual alveolar bone before operation, they were divided into two groups: group A (n = 27) and group A (n = 27). In the maxillary sinus lifting group, there were 17 cases of 24 cases in group B and 33 cases in group C (n = 25). The average follow-up was 85.4 months. The survival rate of implant, the condition of soft tissue around implant, patient satisfaction, bone resorption of marginal bone and bone powder implantation were evaluated. Maxillary sinus floor changes and other indicators. Results of the 95 implants, 2 fell off at 6 months after operation, and the survival rate was 97.9.The score of satisfaction for implant restoration in the three groups was 29.27 卤5.34 and 29.27 卤5.34, respectively, and there was no difference in satisfaction between the three groups. The soft tissue around the implant was in good condition, but there was no statistical difference among the three groups, and the average bone resorption in the three groups was 0.35 卤0.37 卤0.50 卤0.61mm. the average bone resorption of the implants was 0.26 卤0.43 卤0.37 卤0.61 mm at 6 months postoperatively. After 6 ~ 9 years follow-up, the average bone resorption at the distal and distal margin of the implants in the three groups was 1.45 卤1.20 mm and 1.47 卤1.64 卤1.57 卤1.51mm. the results were statistically significant, and there was no difference in the marginal bone resorption between the three groups, and the position of the maxillary sinus floor in group A increased after operation. It was 1.42 卤2.23 mm in 6 months after operation and 1.95 卤1.87 mm in 6 ~ 9 years after operation. There was no significant difference between the other two groups. There was no significant difference between the other two groups. The average remaining 64.23 卤6.56 of bone powder implanted in group A was 64.23 卤6.56 in 6 months after operation. Conclusion: the long-term clinical effect of implant repair in maxillary posterior dental region with insufficient vertical bone mass is good 6-9 years, the rate of elevation of maxillary sinus floor position is higher, and most of the bone graft powder is absorbed.
【作者单位】：南京大学医学院附属口腔医院·南京市口腔医院种植科;
【基金】：国家自然科学基金(81371680,81571800) 江苏省自然科学基金(BK20141083) 江苏省南京市医学科技发展重点项目(ZKX14049)
【分类号】：R783.6

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