骨挤压钻法穿牙槽嵴上颌窦底提升的临床效果观察

doi:10.12337/zgkqzzxzz.2024.02.011

中国口腔种植学杂志 ›› 2024, Vol. 29 ›› Issue (1): 62-69.DOI: 10.12337/zgkqzzxzz.2024.02.011

骨挤压钻法穿牙槽嵴上颌窦底提升的临床效果观察

王可心, 季平, 李帝泽, 陈媛, 赵洪永, 陆沁怡, 白雅馨, 陈陶

重庆医科大学附属口腔医院口腔疾病与生物医学重庆市重点实验室重庆市高校市级口腔生物医学工程重点实验室,重庆 401147

收稿日期:2023-10-13 出版日期:2024-02-29 发布日期:2024-03-07
通讯作者: 陈陶,Email：chentao1985@hospital.cqmu.edu.cn,电话：023-88765639
作者简介:王可心硕士研究生,研究方向：口腔种植学临床研究;陈陶教授、副主任医师、博士生导师,研究方向：口腔种植学临床及基础研究
基金资助:
重庆市科卫联合医学科研项目（2023GDRC001）; 重庆医科大学附属口腔医院新技术新项目（QYYL2022X001）; 重庆英才计划“包干制项目”（cstc2021ycjh-bgzxm0336）

Clinical effects of osseodensification technique for transalveolar sinus floor elevation

Wang Kexin, Ji Ping, Li Dize, Chen Yuan, Zhao Hongyong, Lu Qinyi, Bai Yaxin, Chen Tao

Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing 401147, China

Received:2023-10-13 Online:2024-02-29 Published:2024-03-07
Contact: Chen Tao, Email:chentao1985@hospital.cqmu.edu.cn, Tel: 0086-23-88765639
Supported by:
Joint Project of Chongqing Health Commission and Science and Technology Bureau (2023GDRC001); New Technology and New Project of Stomatological Hospital of Chongqing Medical University (QYYL2022X001); The "Lump-sum System" Project of Chongqing Talent Plan，China (cstc2021ycjh-bgzxm0336)

摘要/Abstract

摘要： 目的观察并评估应用骨挤压钻法穿牙槽嵴上颌窦底提升的临床效果。方法收集 2022年5月至2023年5月就诊于重庆医科大学附属口腔医院种植科,应用骨挤压钻法行穿牙槽嵴上颌窦底提升并同期植入种植体的病例39例,女性21例,男性18例,年龄21~73岁,平均（51.67±11.68）岁。术后6个月行永久修复。术前（T0）、术后即刻（T1）及术后6个月（T2）拍摄锥形束CT（cone beam computed tomography, CBCT）,对种植位点的窦底剩余骨高度（residual bone height,RBH）、骨密度（bone density,BD）及窦底垂直骨高度（vertical bone height,VBH）等进行测量并比较。功能负荷前测量种植体稳定性（implant stability,IST）、计算上颌窦底黏骨膜穿孔率以及种植体留存率并进行统计学分析。结果 39例患者共植入种植体53颗。T0牙槽骨高度为3.38~9.40 mm,平均（6.16±1.00） mm,T1和T2的牙槽骨高度分别为（11.25±1.10） mm和（10.36±0.99） mm。不同时间点观测的牙槽骨高度差异有统计学意义（P<0.001）。T0、T1、T2的骨密度中位数分别为196.65 Hu、441.70 Hu和435.04 Hu。T0与T1间骨密度的差异有统计学意义（P<0.0001）。采用该方法,上颌窦底黏骨膜穿孔率为1.89%（1/53）。2颗种植体于术后6个月脱落,总体种植体留存率为96.23%（51/53）,其余种植体在功能负荷前均获得良好的IST值（77.61±4.78）,且在随访期间内未出现种植体周炎的迹象。结论骨挤压钻法穿牙槽嵴上颌窦底提升可获得良好的上颌窦提升效果,术后上颌窦黏骨膜穿孔率较低。该方法用于穿牙槽嵴上颌窦底提升的短期临床效果良好,但长期临床效果仍需进一步随访观察。

关键词: 上颌窦底提升, 骨挤压, 种植体稳定性, 上颌窦膜穿孔

Abstract: Objective To investigate the clinical effects of the osseodensification technique applied to transalveolar maxillary sinus floor elevation with simultaneous implant placement. Methods A total of 39 patients underwent transalveolar sinus floor elevation using osseodensification and implant placement in the Department of Implantology, Stomatological Hospital of Chongqing Medical University from May 2022 to May 2023. 21 cases were female, and 18 cases were male, with ages ranging from 21 to 73 years old and an average of (51.67±11.68) years old. Definitive prosthesis was delivered 6 months after implant surgery. Cone-beam computed tomography (CBCT) was conducted preoperatively (T0), postoperatively (T1), and at 6-month follow-up (T2), measuring residual bone height (RBH), vertical bone height (VBH), and bone density (BD) at the implant site. Implant stability test (IST), sinus membrane perforation rate, and implant survival rate (SR) were recorded and analyzed 6 months after implant surgery. Results A total of 39 patients underwent maxillary sinus floor elevation surgery with 53 implants placed simultaneously. Alveolar bone heights ranged from 3.38 to 9.40 mm at T0, with a mean of (6.16±1.00) mm, (11.25±1.10) mm at T1, and (10.36±0.99) mm at T2. Significant differences in alveolar bone height were observed among different observation points (P <0.001). The BDT0, BDT1 and BDT2 were 196.65 Hu, 441.70 Hu, and 435.04Hu respectively. Significant differences in bone density between T0 and T1 (P<0.0001) were found. The sinus membrane perforation rate was 1.89%. 2 implants were lost in 6 months after surgery, yielding a cumulative implant survival rate of 96.23%. The remaining implants exhibited favorable IST values 77.61±4.78 at 6 months post-surgery, and no peri-implant inflammation was observed during the follow-up period. Conclusion The osseodensification technique may achieve optimal clinical effects for transalveolar sinus floor elevation. The technique exhibits acceptable short-term outcomes, while further studies on long-term clinical effects are required.

Key words: Sinus floor elevation, Osseodensification, Implant stability, Perforation of the maxillary sinus membrane

王可心,季平,李帝泽,等. 骨挤压钻法穿牙槽嵴上颌窦底提升的临床效果观察[J]. 中国口腔种植学杂志, 2024, 29(1): 62-69. DOI: 10.12337/zgkqzzxzz.2024.02.011

Wang Kexin, Ji Ping, Li Dize, Chen Yuan, Zhao Hongyong, Lu Qinyi, Bai Yaxin, Chen Tao. Clinical effects of osseodensification technique for transalveolar sinus floor elevation[J].Chinese Journal of Oral Implantology, 2024, 29(1): 62-69.DOI: 10.12337/zgkqzzxzz.2024.02.011.

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骨挤压钻法穿牙槽嵴上颌窦底提升的临床效果观察

Clinical effects of osseodensification technique for transalveolar sinus floor elevation

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