应用浓缩生长因子行上颌窦内提升后种植体周围骨变化

摘要

BACKGROUND:Many experiments and clinical studies have reported that venous blood, absorbable colagen sponge and rich fibrin clot, without the use of bone graft material, can al promote new bone formation; therefore, whether only transplanting concentrated growth factor in the maxilary sinus lift could effectively promote bone regeneration? OBJECTIVE: To conduct the maxilary sinus lift with concentrated growth factor as the graft material, and to observe the peri-implant bone level change. METHODS: Totaly 26 patients were involved, including 14 males and 12 females, aged 35-73 years. Maxilary sinus lift was conducted and autologous concentrated growth factor was taken as the graft material. Astra Tech implants were implanted simultaneously. Patients were divided into 6-12 months, 13-18 months and > 18 months groups according to the folow-up time. Patients were divided into≤ 5 mm, 5-7 mm, and≥ 7 mm groups according to the preoperative alveolar bone height. Patients were divided into≤ 2 mm, 2.0-3.0 mm, and≥3 mm groups according to the postoperative maxilary sinus lift height. The survival rate of implants and marginal bone level changes were observed during the folow-up. RESULTS AND CONCLUSION: Totaly 44 implants were implanted, of which 43 implants were considered as successful repair during the 6-18 months of postoperative folow-up. The survival rate of implants was 98%. There were no significant differences in the changes of mesial, distal and middle marginal bone levels between different folow-up time groups. The maxilary sinus lift with transplantation of concentrated growth factor resulted in a good osseointegration within 6-18 months post-operation. In addition, no significant differences were found in the changes of mesial, distal and middle marginal bone levels between different residual alveolar bone height groups, as wel as between different maxilary sinus lift height groups. It showed that the residual alveolar bone height and maxilary sinus lifting height had no significant effect on the peri-implant bone formation. Briefly, these findings demonstrate that the maxilary sinus lift with concentrated growth factor transplantation can result in a high survival rate of implants that are simultaneous implanted, and the alveolar bone around the implant is stable. But the long-term effect needs further observation.%背景：许多实验和临床研究报道不使用植骨材料而单纯采用患者静脉血、可吸收胶原海绵、富纤维蛋白凝块等均可促进新骨形成，那么只移植浓缩生长因子在上颌窦内提升中是否也能有效地促进骨再生？目的：以浓缩生长因子作为移植材料行上颌窦内提升，观察种植体周围骨水平的改变。方法：纳入26例患者，其中男14例，女12例，年龄35-73岁，均以自体浓缩生长因子作为移植材料行上颌窦内提升，同期植入Astra Tech种植体。按随访时间分为6-12个月组、13-18个月组与18个月以上组，按术前剩余牙槽骨高度分为≤5 mm组、5-7 mm组与≥7 mm组，按术后上颌窦提升高度分为≤2 mm组、2.0-3.0 mm组与≥3 mm组，随访观察种植体存留率与边缘骨水平变化。结果与结论：共植入种植体44枚，修复后随访6-18个月，43枚种植体修复成功，种植体存留率为98%。不同随访时间组间近、远中边缘骨水平改变比较差异无显著性意义，显示以浓缩生长因子作为移植材料行上颌窦内提升在随访6-18个月内能形成良好骨结合。不同剩余牙槽骨高度组间的近、远中边缘骨水平改变比较差异无显著性意义，不同窦底提升高度组间的近、远中边缘骨水平改变比较差异无显著性意义，说明剩余牙槽骨高度与上颌窦提升高度对种植体周骨组织形成无明显影响。表明在上颌窦内提升时使用浓缩生长因子移植材料同期植入种植体存留率高，种植体周围牙槽骨稳定，长期效果有待进一步观察。