光纤内镜辅助穿牙槽嵴上颌窦底提升同期种植的临床评价

doi:10.12337/zgkqzzxzz.2024.02.008

中国口腔种植学杂志 ›› 2024, Vol. 29 ›› Issue (1): 42-48.DOI: 10.12337/zgkqzzxzz.2024.02.008

光纤内镜辅助穿牙槽嵴上颌窦底提升同期种植的临床评价

苏汉福¹, 陈希立¹, 郭雪琪¹, 葛青¹, 赵世勇¹, 葛林虎¹, 宿玉成², 王丽萍¹

¹广州医科大学口腔医学院·附属口腔医院种植科广东省口腔组织修复与重建工程技术研究中心广州市口腔再生医学基础与应用研究重点实验室,广州 510182;
²中国医学科学院北京协和医院口腔种植中心,北京 100032

收稿日期:2023-05-11 出版日期:2024-02-29 发布日期:2024-03-07
通讯作者: 王丽萍,Email: wanglplj@126.com,电话：020-81261560
作者简介:苏汉福博士、博士后、主治医师,研究方向：牙槽骨再生、口腔种植修复;王丽萍主任医师、教授、博士后合作导师、研究生导师,研究方向：种植软硬组织再生材料与机理,数字化精准种植与口腔颅颌面修复重建
基金资助:
广东省教育厅项目（2018KTSCX186）; 广州市科技计划项目（202002030301）

Clinical evaluation of fiber-optic endoscope-assisted transalveolar sinus floor elevation with simultaneous implant placement

Su Hanfu¹, Chen Xili¹, Guo Xueqi¹, Ge Qing¹, Zhao Shiyong¹, Ge Linhu¹, Su Yucheng², Wang Liping¹

¹Department of Oral Implantology, School and Hospital of Stomatology Guangdong Engineering Research Center of Oral Restoration and Reconstruction & Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou Medical University, Guangzhou 510182, China;
²Dental Implant Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100032, China

Received:2023-05-11 Online:2024-02-29 Published:2024-03-07
Contact: Wang Liping, Email: wanglplj@126.com, Tel: 0086-20-81261560
Supported by:
Project of Educational Commission of Guangdong Province of China (2018KTSCX186); Science and Technology Project in Guangzhou (202002030301)

摘要/Abstract

摘要： 目的探究光纤内镜辅助穿牙槽嵴上颌窦底提升同期种植的临床效果。方法选取2017年9月至2018年9月于广州医科大学附属口腔医院种植科行冲顶法穿牙槽嵴上颌窦底提升同期种植的35名患者（共51颗种植体）作为研究对象。术中采用光纤内镜直视对比捏鼻鼓气法检查上颌窦黏骨膜完整性,探讨牙槽骨骨质类型、上颌窦底骨皮质厚度、上颌窦底黏骨膜厚度和窦底提升高度与上颌窦黏骨膜穿孔的关系,并探讨上颌窦黏骨膜穿孔对术后6个月时种植体稳定系数（implant stability quotient,ISQ）的影响。结果 51例穿牙槽嵴上颌窦底提升中以捏鼻鼓气法检出上颌窦黏骨膜穿孔2例,内镜辅助下检出穿孔10例,结果具有显著差异（P=0.013）。上颌窦黏骨膜穿孔与牙槽骨骨质类型、上颌窦底黏骨膜厚度（<3 mm）和窦底提升高度皆无明显相关,而与窦底骨皮质厚度显著相关（P=0.001）;上颌窦黏骨膜穿孔直径>2 mm时需更长愈合时间以获得理想的ISQ。结论穿牙槽嵴上颌窦底提升中,光纤内镜可显著提高上颌窦黏骨膜穿孔检出率,利于术者判断窦底黏膜的情况以及选择更为合适的修复时机。

关键词: 内镜, 穿牙槽嵴上颌窦底提升, 同期种植, 上颌窦, 上颌窦黏骨膜

Abstract: Objective To investigate the clinical effect of fiber-optic endoscope-assisted transalveolar technique for sinus floor elevation with simultaneous implant placement. Methods 35 patients who visited the Affiliated Stomatology Hospital of Guangzhou Medical University from September 2017 to December 2018 were selected as research subjects. A total of 51 transalveolar sinus floor elevations with simultaneous implant placements were performed. The integrity of the sinus floor mucoperiosteum was examined intraoperatively using a fiber-optic endoscope with direct visualization compared with the Valsalva test. The relationship between maxillary sinus mucoperiosteal perforation and the following factors: alveolar bone quality (Lekholm and Zarb classification), sinus floor bone cortical bone thickness, sinus floor mucoperiosteal thickness, and sinus floor elevation height was also explored. The effect of perforation of the mucoperiosteum on the implant ISQ at 6 months postoperatively was also investigated. Results Among the 51 cases of transalveolar sinus floor elevation, only 2 cases of mucoperiosteal perforation were detected by the Valsalva test, while 10 cases of perforation were detected by the endoscope, and the results showed a significant difference (P=0.013). There was no significant correlation between sinus mucoperiosteal perforation and alveolar bone quality classification, sinus floor mucoperiosteal thickness (<3 mm), or sinus floor elevation height, while there was a significant correlation with sinus floor cortical bone thickness (P=0.001). Maxillary sinus mucoperiosteal perforations with a diameter of >2 mm required a longer healing time to obtain the ideal implant ISQ. Conclusion The fiber-optic endoscope can significantly improve the detection rate of sinus mucoperiosteal perforation in transalveolar sinus floor elevation, which is helpful for the operator to judge the condition of the sinus floor mucoperiosteum and to choose a more appropriate timing for restoration.

Key words: Endoscope, Transalveolar technique for sinus floor elevation, Simultaneous implant placement, Maxillary sinus, Maxillary sinus mucoperiosteum

苏汉福,陈希立,郭雪琪,等. 光纤内镜辅助穿牙槽嵴上颌窦底提升同期种植的临床评价[J]. 中国口腔种植学杂志, 2024, 29(1): 42-48. DOI: 10.12337/zgkqzzxzz.2024.02.008

Su Hanfu, Chen Xili, Guo Xueqi, Ge Qing, Zhao Shiyong, Ge Linhu, Su Yucheng, Wang Liping. Clinical evaluation of fiber-optic endoscope-assisted transalveolar sinus floor elevation with simultaneous implant placement[J].Chinese Journal of Oral Implantology, 2024, 29(1): 42-48.DOI: 10.12337/zgkqzzxzz.2024.02.008.

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光纤内镜辅助穿牙槽嵴上颌窦底提升同期种植的临床评价

Clinical evaluation of fiber-optic endoscope-assisted transalveolar sinus floor elevation with simultaneous implant placement

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