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目的:观察在余留牙槽嵴不足8mm时使用上颌窦底粘膜提升的技术并同期植入种植体后的5年随访的临床效果。方法:收集2007-2009年在本院进行上颌窦底内提升病例22例,年龄19-70岁,术前、术后及6月后进行CBCT检查,共植入27枚种植体,术后6月完成上部修复。种植体的直径为4.7mm(SD 0.4mm),种植体长度为10mm(SD 1.0mm),余留牙槽嵴高度为6.7mm(SD 1.2mm),每年随访观察种植临床使用情况。结果:术后6月CBCT检查未发现有明显的种植体边缘骨吸收,种植位点新骨生成量为2.5mm(SD 1.5mm),5年随访观察种植体成功率为96.3%。讨论:在RBH为4-6mm时,使用骨凿进行内提升后植入种植牙治疗周期更短,更简单,花费更低。CBCT的应用及对骨凿技术的理解和掌握降低了损伤窦腔粘膜的风险。通过CBCT检查观察到在上颌窦底粘膜提升后使得种植体维持窦腔粘膜下创造空间以诱导新骨生成。新骨生成通常伴随着上颌窦底的重建,窦底提升区域密度增加,窦底外形轮廓变得光滑。结论:本研究认为在RBH仅有4.1-8mm时,使用不植骨的OSFE技术同期种植体植入临床效果稳定可靠。
OBJECTIVE: To observe the clinical effect of maxillary sinus mucosal ascending technique with remaining alveolar crest less than 8mm and 5-year follow-up after implantation of implants in the same period. Methods: Twenty-two cases of maxillary sinus ascending ascension in our hospital from 2007 to 2009 were collected, ranging in age from 19 to 70 years. Preoperative, postoperative, and postoperative CBCT were performed. A total of 27 implants were implanted. Month to complete the upper repair. The diameter of the implant was 4.7 mm (SD 0.4 mm), the length of the implant was 10 mm (SD 1.0 mm), and the remaining height of the alveolar ridge was 6.7 mm (SD 1.2 mm). The clinical use of the implant was followed up every year. Results: No significant edge bone resorption was found in CBCT at 6 months after operation. The new bone formation at implant site was 2.5 mm (SD 1.5 mm). The follow-up of 5-year follow-up was 96.3%. Discussion: When the RBH is 4-6mm, implanting the implant with an internal osteotome increases the shorter, simpler, and lower implant cycle. The use of CBCT and the understanding and mastery of osteotome techniques have reduced the risk of damage to sinus mucosa. CBCT examinations were performed to allow the implant to maintain sinusoidal submucosal space to induce new bone formation after lifting of the maxillary sinus mucosa. New bone formation is usually accompanied by the reconstruction of the floor of the maxillary sinus. The density of the ascending sinus area increases and the shape of the sinus floor becomes smooth. CONCLUSIONS: This study concluded that when RBH was only 4.1-8 mm, the clinical effect of concurrent implant placement with OSFE without bone graft was stable and reliable.