上颌窦底内提升同期不植骨种植术的临床疗效观察

发布时间：2018-06-06 05:34

本文选题：上颌窦内提升 + 剩余牙槽骨高度　；参考：《安徽医科大学》2014年硕士论文

【摘要】：目的：探讨骨挤压器行上颌窦底内提升(osteotome sinus floor elevation, OSFE)不植骨同期种植术在上颌后牙区种植的应用及临床效果。方法：2011～2012年就诊于我院种植中心25例上颌后牙缺失的患者,缺牙区剩余牙槽骨高度(residual bone high, RBH)为4-8mm,其中,男性14例,女性11例,用骨挤压器行OSFE不植骨同期牙种植术,共植入34颗种植体,其中RBH为4-5mm的种植11颗(A组),RBH为5-8mm的种植23颗(B组),术后6月行种植体上部冠修复。通过1-2年的临床观察,根据Albrekkson-Zarb标准分析种植体成功率,评估种植体周围软组织健康状况(松动度指数、牙周探诊深度、改良菌斑以及改良龈沟出血)。所有患者于术前、术后即可、术后6月、12月拍摄全景片,评价种植体与周围骨组织结合状况、窦底提升后新骨形成状况以及种植体颈部边缘骨吸收状况。结果：观察期内34颗种植体脱落一颗,存留率为97.1%。除失败的一颗种植体外,其余种植体未松动,患者依从性比较好,种植体周围软组织健康,无明显炎症,改良龈沟出血指数为0或1,改良菌斑指数为0、1或2,牙周探诊深度平均为2.88±0.25mm,患者对修复效果均满意。术后6个月X线片检查种植区窦底形成新骨高度分别为A组：2.86-0.28mm,B组：2.41±0.54mm,种植体骨结合良好,术后12个月X线复查种植体颈部周围垂直方向骨吸收2mm。结论：在掌握好适应证以及规范的手术操作条件下,骨挤压器行上颌窦底提升种植术方法可靠,效果肯定,能有效应用于窦底RBH不足的上颌后牙缺失者,并能获得较高的成功率。术中均未植入骨移植材料,术后窦底均有不同程度的新骨形成。但是,还需增加样本量及延长观察时间对种植修复的长期临床效果和成功率进一步研究。
[Abstract]:Objective: to investigate the application and clinical effect of osteotome sinus floor elevation, OSFE) implantation without bone grafting in maxillary posterior teeth. Methods from 2011 to 2012, 25 patients with maxillary posterior tooth loss were treated in the implant center of our hospital. The residual alveolar bone height (bone high, RBH) was 4-8 mm, including 14 males and 11 females. Implants without OSFE bone graft were performed with bone extruder. A total of 34 implants were implanted, of which 11 were 4-5mm implants. In group A, 23 implants were implanted with 5-8mm. The upper crown of the implants was repaired 6 months after operation. According to the clinical observation of 1-2 years, the success rate of implant was analyzed according to Albrekkson-Zarb standard, and the health status of soft tissue around the implant (mobility index, depth of periodontal probing, improved plaque and improved gingival sulcus bleeding) were evaluated. The panoramic images were taken before and after operation, 6 months and 12 months after operation to evaluate the binding of implants to the surrounding bone tissue, the formation of new bone after sinus floor lifting and the bone resorption in the neck of implant. Results: during the observation period, 34 implants fell off one, and the survival rate was 97.1. Except for one failed implant, the implant was not loosened, the patient's compliance was good, the soft tissue around the implant was healthy, and there was no obvious inflammation. The modified gingival sulcus bleeding index was 0 or 1, the modified plaque index was 0 or 2, and the average depth of periodontal probing was 2.88 卤0.25 mm. At 6 months after operation, the height of new bone formation in the sinus floor of implant area was 2. 86-0. 28mm in group A and 2. 41 卤0. 54mm in group B, respectively. The osseous osseointegration of implant was good, and the bone resorption in vertical direction around the implant neck was reexamined 12 months after operation. Conclusion: under the condition of proper indication and standard operation, the method of maxillary sinus floor lifting and implantation with bone extruder is reliable and effective. It can be used effectively in patients with missing maxillary posterior teeth with insufficient RBH in the sinus floor. And can obtain higher success rate. No bone graft was implanted during the operation and new bone formation was found in the sinus floor after operation. However, the long-term clinical effect and success rate of implant restoration should be further studied by increasing sample size and prolonging observation time.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R783.6

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