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北京大学学报（医学版） ›› 2019, Vol. 51 ›› Issue (5): 925-930. doi: 10.19723/j.issn.1671-167X.2019.05.022

• 论著 • 上一篇    下一篇

上颌窦底内提升术同期种植窦内成骨的临床效果

王倩1,李丹2,唐志辉2,△()   

  1. 1. 北京大学口腔医学院·口腔医院,牙周科　国家口腔疾病临床研究中心　口腔数字化医疗技术和材料国家工程试验室 口腔数字医学北京市重点实验室,北京　100081
    2. 北京大学口腔医学院·口腔医院,第二门诊部　国家口腔疾病临床研究中心　口腔数字化医疗技术和材料国家工程试验室 口腔数字医学北京市重点实验室,北京　100081
  • 收稿日期:2017-10-09 出版日期:2019-10-18 发布日期:2019-10-23
  • 通讯作者: 唐志辉 E-mail:tang_zhihui@live.cn
  • 基金资助:
    首都临床特色应用研究与成果推广项目(Z161100000516229)

Sinus floor elevation and simultaneous dental implantation: A long term retrospective study of sinus bone gain

Qian WANG1,Dan LI2,Zhi-hui TANG2,△()   

  1. 1. Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
    2. Department of Second Clinical Division, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
  • Received:2017-10-09 Online:2019-10-18 Published:2019-10-23
  • Contact: Zhi-hui TANG E-mail:tang_zhihui@live.cn
  • Supported by:
    Supported by the Capital Foundation for Clinical Characteristics and Application Research(Z161100000516229)

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摘要：

目的:回顾性评价上颌窦底内提升术在植骨与不植骨的情况下同期植入种植体后上颌窦内成骨的效果。方法:共纳入上颌后牙区缺牙的患者26例,根据术式不同分为上颌窦底内提升+植骨组(A组)和上颌窦底内提升+不植骨组(B组), 同期进行种植,术后30~50个月常规复查随访,观察上颌窦内成骨情况。结果:共植入了27枚种植体(其中A组13枚,B组14枚), 随访时间为40.23(36.20,48.07)个月。A组上颌窦底剩余骨高度(residual bone height, RBH)为(6.64±1.21) mm,B组RBH为(6.96±1.36) mm,二者差异没有统计学意义(P = 0.459)。A组随访时上颌窦内成骨高度(sinus bone gain, SBG)为(2.20±1.71) mm,B组随访时SBG为1.77(0.94, 2.05) mm,二者差异没有统计学意义(P = 0.583)。根据随访时种植体尖端附近成骨情况将种植体尖端成骨分为3类,分别为优、良和中。随访时A组有9枚种植体尖端成骨质量为优和良,B组有8枚种植体尖端成骨质量为优和良,二者差异没有统计学意义((Fisher精确检验,P = 0.695)。A组种植体尖端位于新上颌窦底下方(0.09±1.32) mm,B组种植体尖端位于新上颌窦底下方(0.03±0.91) mm,二者差异没有统计学意义(P = 0.898)。随访时两组总体的SBG为1.85(1.10, 2.20) mm,将两组随访时的SBG分别与多个因素进行相关分析,发现其仅与种植体尖端突出于上颌窦底的高度显著相关(r=0.383, P = 0.049)。结论:上颌窦底内提升术在植骨与不植骨的情况下都能取得较好的效果,SBG主要与种植体尖端提升的高度显著相关。

关键词: 上颌窦底提升术, 种植体, 窦内成骨高度

Abstract:

Objective: To evaluate the sinus bone gains after sinus floor elevation procedures with or without grafts when implants were placed simultaneously. Methods: The research included 26 edentulous patients in the maxillary posterior region, who were divided into 2 different groups according to the sinus lift procedures employed: group of osteotome sinus floor elevation with bone grafts (group A) and group of osteotome sinus floor elevation without bone grafts (group B). The implants were placed simultaneously, and were followed for a period of 30-50 months after sinus floor elevation as routine and then were observed for sinus bone change. Results: There were 27 implants (13 implants for group A and 14 implants for group B)and the following time was 40.23(36.20, 48.07) months. The residual bone height (RBH) was (6.64±1.21) mm for group A and ( 6.96±1.36) mm for group B; the difference between the two groups was not statistically significant (P = 0.459).The sinus bone gain (SBG) when followed was (2.20±1.71) mm for group A, and 1.77(0.94, 2.05) mm for group B; the difference between the two groups was not statistically significant (P = 0.583). The quality of apical bone around implant apex was divided into 3 categories which were excellent, fine and fair.The quality of apical bone around implant apex was excellent and fine for 9 implants in group A and 8 implants in group B, and the difference between the two groups was not statistically significant((Fisher exact test,P = 0.695).The implant apex when followed was (0.09±1.32) mm below the new sinus floor for group A and(0.03±0.91) mm for group B, and the difference between the two groups was not statistically significant(P = 0.898). The SBG for the total was 1.85(1.10, 2.20) mm. The SBG was statistically significantly only related to the protrusion height of the implant apex (r=0.383, P = 0.049). Conclusion: Sinus floor elevation procedures with or without grafts can all gain good results. The SBG is related to the protrusion height of the implant apex significantly.

Key words: Sinus floor elevation, Dental implants, Sinus bone gain

中图分类号: 

  • R782.1

图1

校准示意图"

图2

上颌窦剩余骨高度和上颌窦底倾斜程度的测量"

图3

上颌窦宽度和窦内成骨的测量"

图4

种植体尖端成骨分类"

表1

27枚种植体的一般情况"

Items Implant site Implant length/mm
Premolar Molar 6 8 10
Group A 3 10 7 6
Group B 4 10 1 7 6
Total 7 20 8 13 6

表2

上颌窦底提升前的测量指标"

Items Thickness of sinus membrane/mm RBH/mm Angle of sinus floor/(°) SW/mm
Group A 1.34±1.22 6.64±1.21 38.23±11.24 14.65±4.18
Group B 2.40(0.77,6.40) 6.96±1.36 30.68±11.54 15.96±2.16
P 0.038 0.518 0.098 0.311

表3

上颌窦底提升后的测量指标"

Items Follow-up time/months PH/mm SBG/mm ABH/mm
Group A 40.23(36.20,48.12) 2.00(1.60,2.65) 2.20±1.71 -0.09±1.32
Group B 40.43±6.92 1.75±1.16 1.77(0.94,2.05) -0.03±0.91
P 0.616 0.155 0.583 0.898

图5

A组种植体尖端附近成骨情况"

图6

B组种植体尖端附近成骨情况"

表4

各因素与SBG的相关分析"

Factors P r
PH 0.049 0.383
RBH 0.157 -0.280
Angle of sinus floor 0.225 0.242
Thickness of sinus membrane 0.375 0.178
SW 0.326 0.196
Implant diameter 0.314 0.201
Age 0.164 0.276
Implant length 0.393 0.171
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ISSN 1671-167X
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