目的：探讨锥形束CT (Cone Beam Computer Tomography，CBCT)在骨质疏松老年人微创种植牙上颌窦底内提升手术中临床应用效果。方法：回顾解放军总医院2013年2月-11月间26例老年上颌窦底内提升术后同期微创种植牙骨质疏松患者，应用CBCT影像诊断系统对上、下颌骨进行标准轴面、冠状面、矢状面多平面重建，同时进行曲面体视图，获得准确数据用于老年骨质疏松牙列缺损患者术前设计、术中引导、术后回访。结果： CBCT辅助上颌窦底内提升后同期植入37枚种植体，术后未发生上颌窦炎、窦底粘膜穿孔等并发症；有2例患者种植术后1 d出现术区面部软组织肿痛，鼻腔间断性出血，考虑有局部上颌窦粘膜破裂，局部使用抗生素术后5d后症状逐渐消失；术后6个月二期修复前CBCT检查种植体骨结合良好，二期修复负载后6个月随访观察种植体骨边缘吸收稳定，无种植体失败。结论： CBCT可以辅助医生顺利完成老年骨质疏松患者上颌窦内提升手术，为老年口腔微创种植术前制定设计方法，术后检查随访提供辅助分析条件。%Objective:To explore the accuracy of posterior maxillary bone height obtained by CBCT and to assess the clinical results of a modified osteotome technique to lift sinus floor in elderly patients with osteoporosis without grafting materials.Methods:26 cases of elderly patients with osteoporosis with maxillary posterior teeth loss were enrolled and analyzed by using the CBCT (ProMax3D) system for imaging diagnosis of the jaw bone. Axial, coronal, and sagittal images were reconstructed, and a panoramic image was further acquired from each scan by using Planmeca Dimaxis Pro software to get the precise data for analysis before and after surgery. Each patient was radiographically assessed by analysis of the bone height, and underwent simultaneous sinus lift without grafting materials and implant installation. 37 implants were inserted in total The clinical results after final restoration were evaluated.Results:The sinus membranes were successfully elevated without any iatrogenic perforation in 37 sites, which received final restorations at 6 months after surgery. 2 cases were found sinus mucosal hyperplasia. The success rate was 100%.Conclusion:CBCT can provide valuable data for determining the bone quality in maxillary posterior area of elderly patients with osteoporosis in treatment planning, as well as for the perioperative period of dental implant surgery and follow-up.
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