冲压法上颌窦底提升同期种植体植入94例五年临床回顾

摘要

目的 总结冲压法上颌窦底提升同期牙种植体植入后5年的临床疗效,为提高手术远期疗提供数据.方法 收集2005年1月至2009年12月行冲压法上颌窦底提升同期种植、同一术者的连续临床病例.收集术前计划行冲压法上颌窦底提升患者共94例,男性55例,女性39例,平均年龄(46.9±11.8)岁.完成冲压法上颌窦底提升者共90例(96侧上颌窦),同期植人种植体126枚.患者术前拍摄曲面体层X线片,术后、功能负载后以及每年复诊时拍摄根尖X线片及曲面体层X线片,评价种植体存留率、边缘骨吸收情况,并观察上颌窦底新骨改建情况.结果 术中有4例上颌窦底黏膜穿孔,黏膜穿孔率为3.08％ (4/130);愈合期内4枚种植体脱落,种植体早期成功率为96.80％(121/125).功能负载后患者随访率为72.09％(62/86),种植体随访率75.00％(90/120),随访时间(34.4±20.4)个月,随访中所有种植体功能行使良好,种植体功能负载后累积存留率为100.00％.愈合期内种植体周围边缘骨吸收(0.75 ±0.51) mm,随访期内边缘骨吸收(0.48±0.41) mm.种植体植入位置剩余骨高度(7.27±1.30) mm;术后种植体突入上颌窦内高度为(2.77 ±1.15) mm;上颌窦底提升高度为(4.52士1.39)mm;经过(7.4±2.6)个月的愈合期,上颌窦底新骨形成高度为(3.81±1.60) mm.在经历(34.4±20.4)个月的随访期后,上颌窦底新骨高度较功能负载时降低了0.37(0.10,0.88) mm.结论 冲压法上颌窦底提升同期牙种植体植入术安全可靠,术后影像学证实获得了良好的上颌窦底提升及成骨效果,上颌窦底新骨高度在远期随访中略有降低.%Objective To evaluate the clinical and radiographic outcomes of placing dental implants in the posterior maxilla using the transalveolar technique.Methods Between January 2005 and December 2009,a total of 94 cases,55 males and 39 females,aged (46.9 ± 11.8) years,were consecutively enrolled in this study with maxillary sinus floor augmentation using the transalveolar technique.Radiographic evaluations were conducted on panoramic and periapical radiographs at each recall.The follow-up clinical examination included cumulative survival rate(CSR) of implants,peri-implant marginal bone loss(MBL) and the height of sinus floor augmentation and the endo-sinus bone gain(ESBG).Results Sinus membrane perforation was found in 4 cases.Finally 126 implants (90 cases) were placed.The perforation rate of this surgical procedure was 3.08％ (4/130).Four implants lost during the healing time,the early success of implants was 96.80％ (121/125).During a mean follow-up time of (34.4 ± 20.4) months,all the implants were successfully in function,with the cumulative survival rate after function loading of 100.00％.The mean MBL was (0.75 ± 0.51) mm during the healing time,and (0.48 ±0.41) mm during the follow-up period.The mean residual bone height(RBH) was (7.27 ± 1.30) mm at the position of implants placement,the length of implant protruding into the sinus was (2.77-± 1.15) mm,and the height of sinus floor augmentation was (4.52 ± 1.39) mm.At the loading time,the mean endo-sinus bone gain was (3.81 ± 1.60) mm.After the follow-up time of 34 months,the newly formed bone on the maxillary sinus floor underwent further remodeling with a median bone reduction value of 0.37 (0.10,0.88) mm.Conclusions Maxillary sinus floor augmentation using the transalveolar technique is a predictable treatment modality.The augmentation of the maxillary sinus floor using the transalveolar technique could lead to bone formation under the sinus.The newly formed bone showed slight absorbtion in the long term follow-up.