中国口腔种植学杂志 ›› 2024, Vol. 29 ›› Issue (5): 407-412.DOI: 10.12337/zgkqzzxzz.2024.10.003

• “骨增量”重点栏目 • 上一篇    下一篇

上颌窦外侧壁来源骨块在牙槽嵴水平帐篷植骨技术中的应用

周丹红, 胡玲, 周国栋, 邱悦声, 姜治伟, 杨国利   

  1. 浙江大学医学院附属口腔医院 浙江大学口腔医学院 浙江省口腔疾病临床医学研究中心 浙江省口腔生物医学研究重点实验室 浙江大学癌症研究院 口腔生物材料与器械浙江省工程研究中心,杭州 310000
  • 收稿日期:2024-04-02 出版日期:2024-10-30 发布日期:2024-10-30
  • 通讯作者: 杨国利,Email:guo_li1214@zju.edu.cn,电话:0571-87217430
  • 作者简介:周丹红,硕士研究生,研究方向:数字化口腔种植精度研究;杨国利,教授、主任医师、博士研究生导师,研究方向:数字化口腔种植精度、新型种植系统研发、种植体表面改性在种植体-骨界面和种植体-牙龈界面中的作用及相关机制、基因治疗在种植体周软硬组织愈合中的作用

Application of bone blocks harvested from the lateral wall of the maxillary sinus in horizontal alveolar ridge augmentation using the tenting technique

Zhou Danhong, Hu Ling, Zhou Guodong, Qiu Yuesheng, Jiang Zhiwei, Yang Guoli   

  1. Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou 310000, China
  • Received:2024-04-02 Online:2024-10-30 Published:2024-10-30
  • Contact: Yang Guoli, Email: guo_li1214@zju.edu.cn, Tel: 0086-571-87217430

摘要: 目的 探讨上颌窦外侧壁来源骨块在帐篷植骨技术中对牙槽嵴水平骨增量的临床效果。方法 回顾2018年11月至2023年3月于浙江大学医学院附属口腔医院应用上颌窦外侧壁骨块行上颌后牙区水平帐篷植骨术的牙列缺损患者,通过术前、术后即刻及术后6个月拍摄锥形束CT对比植骨区牙槽嵴骨宽度,同时对患者进行随访。结果 与术前相比,术后即刻距牙槽嵴顶0 mm和3 mm处骨宽度显著增加,差异具有统计学显著性(P<0.05);术后6个月,牙槽嵴顶处的水平骨宽度较术前增量为(3.60±2.29)mm(P>0.05),距牙槽嵴顶3 mm处水平骨宽度较术前增量为(2.85±1.54)mm,差异具有统计学显著性(P<0.05)。与术后即刻相比,术后6个月距牙槽嵴顶不同距离处骨增量效果基本保持稳定,未显示出明显的骨吸收(P>0.05)。结论 上颌窦外侧壁来源的骨块在牙槽嵴水平帐篷植骨技术中有良好的骨增量效果和临床预后,对于上颌后牙区牙槽嵴骨宽度不足,尤其是合并骨高度严重不足需行侧壁开窗上颌窦底提升的病例提供了新的手术方法。

关键词: 上颌窦外侧壁, 帐篷植骨技术, 水平骨增量, 上颌后牙

Abstract: Objective To explore the clinical effect of bone blocks harvested from the lateral wall of the maxillary sinus on horizontal alveolar ridge augmentation using the tenting technique. Methods This study reviewed patients with dental defects who underwent horizontal tenting technique in the maxillary posterior region using bone blocks harvested from the lateral wall of the maxillary sinus at the Stomatology Hospital of Zhejiang University School of Medicine from November 2018 to March 2023. The width of the alveolar ridge in the grafted area was compared using cone beam computer tomography (CBCT) images taken preoperatively, immediately postoperatively, and 6 months postoperatively. Patients were also followed up clinically. Results There was a statistically significant increase in bone width at 0mm and 3mm from the top of the alveolar ridge in the immediate postoperative period compared to the preoperative period (P<0.05). 6 months postoperatively, the increase in horizontal bone width at the top of the alveolar ridge was (3.60±2.29) mm compared to preoperative measurements (P>0.05). The increase in horizontal bone width at 3 mm from the top of the alveolar ridge was (2.85±1.54) mm compared to preoperative measurements, and the difference was statistically significant (P<0.05). And compared to the immediate postoperative period, the bone augmentation at different distances from the top of the alveolar ridge remained basically stable 6 months postoperatively, with no significant bone resorption observed (P>0.05). Conclusion Bone blocks harvested from the lateral wall of the maxillary sinus show effective bone augmentation and favorable clinical outcomes when used in the horizontal alveolar ridge augmentation using the tenting technique. It provides a new surgical method for cases with insufficient alveolar ridge width in the maxillary posterior region, especially when combined with severe bone height deficiency requiring lateral window technique for sinus floor elevation.

Key words: Lateral wall of maxillary sinus, Tenting technique, Horizontal bone augmentation, Maxillary posterior teeth