上颌窦内提升植骨及同期牙种植术临床应用.docVIP

上颌窦内提升植骨及同期牙种植术的临床应用 　　[摘要]目的：评价使用上颌窦内提升器械进行上颌窦内提升植骨同期牙种植术的临床效果。方法：16例（22枚）上颌后牙高度不足患者，采用上颌窦内提升术同期植入德国Ankylos种植体，其中窦底提升高度超过3mm（共13枚种植体）植入自体骨或人工骨，并同期行牙种植体植入术，术后6～10个月行种植义齿修复。结果：术后曲面断层片显示上颌窦内提升植骨组（共13枚种植体）窦黏膜提升幅度在3.3～11.2mm（平均提升6.46mm），种植体末端进入窦内长度1.6～7mm（平均3.89mm），1例术后鼻腔有出血，1周后症状消失。1例种植术后4个月失败脱落，脱落后5个月重新补种成功。结论：上颌窦内提升植骨同期牙种植术能有效解决上颌后牙区牙槽骨高度骨量严重不足的牙种植问题。 　　[关键词]上颌窦内提升；牙种植；骨移植 　　[中图分类号]R782.12 [文献标识码]A [文章编号]1008-6455（2014）22-1923-03 　　Clinical applications of sinus augmentation with simultaneous implant placement 　　SHEN Ning，TANG Zeng-bin，WEI Hui-ping，CHEN Wei 　　（Department of Oral and Maxillofacial Surgery，Guangxi Zhuang Autonomous Region，Peoples Hospital，Nanning 530021，Guxnagxi，China） 　　Abstract： Objective To evaluate the therapeutic effect of immediately inserted dental implants in sinus lift. Methods Sixteen patients received 22 sinus elevations with simultaneous implant placement utilizing the osteotome technique.13 implants were placed with the use of bone grafting material，9 implants were installed without any additional grafting material.For each patient， presurgical and postsurgical （6 months after the surgery） radiography were performed to assess bone formation at the implant sites. Results Successful maxillary sinus membrane elevation with bone grafting materials was performed in all 11 patients （13 implants），the mean elevated sinus membrane height was 6.46 mm（range 3.3 to 11.2mm）.An average bone gain of 3.89mm was observed.The main complications were perforation of the Schneiderian membrane and postoperative nasal bleeding， One implant failed to integrate within 4 months. Conclution Sinus elevation with simultaneous implant placement using grafting material is a predictable treatment method for implant rehabilitation. 　　Key words：maxillary sinus floor lifting； dental implantation；bone graft 　　上颌后牙牙槽骨高度不足往往由于上颌后牙缺失引起牙槽骨萎缩、上颌窦气腔化等原因造成，常规种植时种植体易穿破上颌窦黏膜引发上颌窦炎，导致种植失败。上颌窦底提升技术是解决上颌窦窦底垂直骨量不足的一种极有临床价值的方法[1]。我科从2009年开始对上颌后牙区牙槽骨高度不足的患者，采用经牙槽嵴顶入路上颌窦内提升植骨同期植入德