当牙齿缺失时,种植体被认为是牙齿替换的高质量解决方案。上颌骨后牙长期缺失往往会导致上颌窦气化和牙槽嵴吸收,上颌后牙区磨牙缺失的患者往往牙槽骨量和质量不足,导致种植体支持的修复剩余牙槽骨高度(RBH)不足,使得种植牙的植入具有...当牙齿缺失时,种植体被认为是牙齿替换的高质量解决方案。上颌骨后牙长期缺失往往会导致上颌窦气化和牙槽嵴吸收,上颌后牙区磨牙缺失的患者往往牙槽骨量和质量不足,导致种植体支持的修复剩余牙槽骨高度(RBH)不足,使得种植牙的植入具有挑战性。获得骨增量最常见的手术方式有:上颌窦底提升术、引导骨再生术、植骨术、牙槽嵴扩大术、牙槽牵张成骨术等。上颌骨后部的种植体骨支持往往较差。这种情况可以采用上颌窦底提升术进行治疗。上颌窦底提升术联合骨增量材料的临床技术在骨量不足的病例中已大量应用和研究。因此,上颌窦底提升术后新骨形成的机制及影响因素的研究对于临床术式的选择及种植的远期成功具有重要意义。When teeth are missing, implants are considered be a high-quality solution for tooth replacement. Long-term loss of posterior maxillary teeth often leads to maxillary sinus pneumatization and alveolar ridge resorption. Patients with missing molar teeth in the posterior maxillary region often have insufficient alveolar bone volume and quality, resulting in insufficient restorative remaining alveolar bone height (RBH) for implant support, making dental implant placement challenging. The most common surgical procedures to obtain bone augmentation are maxillary sinus floor lift, guided bone regeneration, bone grafting, alveolar ridge expansion, and alveolar distraction osteogenesis. Bone support for implants in the posterior maxilla is often poor. This condition can be treated with maxillary sinus floor lift. The clinical technique of maxillary sinus floor elevation combined with bone augmentation materials has been used and studied extensively in cases of insufficient bone mass. Therefore, the study of the mechanism of new bone formation after maxillary sinus floor elevation and the factors affecting it are of great importance for the choice of clinical procedure and the long-term success of the implant.展开更多
目的探讨伴有牙源性上颌窦炎(odontogenic maxillary sinusitis,OMS)患牙拔除后因骨量不足行上颌窦底提升术及种植修复的临床效果,为临床提供参考。方法本研究已通过单位伦理委员会审查批准,并获得患者知情同意。上颌后牙区患牙无保留...目的探讨伴有牙源性上颌窦炎(odontogenic maxillary sinusitis,OMS)患牙拔除后因骨量不足行上颌窦底提升术及种植修复的临床效果,为临床提供参考。方法本研究已通过单位伦理委员会审查批准,并获得患者知情同意。上颌后牙区患牙无保留价值且确诊为OMS,拔牙后6~8个月骨高度不足行上颌窦底提升术及同期种植45例作为研究组。同期随机纳入上颌后牙区患牙无保留价值但未诊断为OMS,拔牙后6~8个月因种植区域骨高度不足行上颌窦底提升术及同期种植48例作为对照组。研究组中部分上颌窦底骨质不连续及上颌窦底剩余牙槽骨高度<4 mm的病例行侧壁开窗上颌窦底提升术共13例,其余32例行穿嵴顶上颌窦底提升术。对照组上颌窦底剩余牙槽骨高度<4 mm的病例行侧壁开窗上颌窦底提升术共8例,其余40例行穿嵴顶上颌窦底提升术。种植术后6~8个月行二期修复治疗。种植术后21 d、3个月、8个月及修复后每6个月进行随访,修复后24个月比较2组上颌窦内成骨高度(sinus bone gain,SBG)、种植体尖端成骨高度(apical bone height,ABH)和种植体边缘骨吸收(marginal bone loss,MBL)情况。结果研究组45例种植术前上颌窦黏膜厚度均值(1.556±0.693)mm,大于对照组(1.229±0.425)mm,差异有统计学意义(P<0.001),但上颌窦底提升术均无上颌窦黏膜穿孔。修复后24个月,研究组SBG、ABH和MBL与对照组差异均无统计学意义(P>0.05)。结论伴OMS的患牙拔除后,上颌窦炎症减退、缺牙区骨质高度和密度得到一定程度的恢复,通过上颌窦底提升手术及种植修复,可以达到与非OMS患牙拔除后上颌窦底提升术及种植修复同样的效果。展开更多
文摘当牙齿缺失时,种植体被认为是牙齿替换的高质量解决方案。上颌骨后牙长期缺失往往会导致上颌窦气化和牙槽嵴吸收,上颌后牙区磨牙缺失的患者往往牙槽骨量和质量不足,导致种植体支持的修复剩余牙槽骨高度(RBH)不足,使得种植牙的植入具有挑战性。获得骨增量最常见的手术方式有:上颌窦底提升术、引导骨再生术、植骨术、牙槽嵴扩大术、牙槽牵张成骨术等。上颌骨后部的种植体骨支持往往较差。这种情况可以采用上颌窦底提升术进行治疗。上颌窦底提升术联合骨增量材料的临床技术在骨量不足的病例中已大量应用和研究。因此,上颌窦底提升术后新骨形成的机制及影响因素的研究对于临床术式的选择及种植的远期成功具有重要意义。When teeth are missing, implants are considered be a high-quality solution for tooth replacement. Long-term loss of posterior maxillary teeth often leads to maxillary sinus pneumatization and alveolar ridge resorption. Patients with missing molar teeth in the posterior maxillary region often have insufficient alveolar bone volume and quality, resulting in insufficient restorative remaining alveolar bone height (RBH) for implant support, making dental implant placement challenging. The most common surgical procedures to obtain bone augmentation are maxillary sinus floor lift, guided bone regeneration, bone grafting, alveolar ridge expansion, and alveolar distraction osteogenesis. Bone support for implants in the posterior maxilla is often poor. This condition can be treated with maxillary sinus floor lift. The clinical technique of maxillary sinus floor elevation combined with bone augmentation materials has been used and studied extensively in cases of insufficient bone mass. Therefore, the study of the mechanism of new bone formation after maxillary sinus floor elevation and the factors affecting it are of great importance for the choice of clinical procedure and the long-term success of the implant.
文摘目的探讨伴有牙源性上颌窦炎(odontogenic maxillary sinusitis,OMS)患牙拔除后因骨量不足行上颌窦底提升术及种植修复的临床效果,为临床提供参考。方法本研究已通过单位伦理委员会审查批准,并获得患者知情同意。上颌后牙区患牙无保留价值且确诊为OMS,拔牙后6~8个月骨高度不足行上颌窦底提升术及同期种植45例作为研究组。同期随机纳入上颌后牙区患牙无保留价值但未诊断为OMS,拔牙后6~8个月因种植区域骨高度不足行上颌窦底提升术及同期种植48例作为对照组。研究组中部分上颌窦底骨质不连续及上颌窦底剩余牙槽骨高度<4 mm的病例行侧壁开窗上颌窦底提升术共13例,其余32例行穿嵴顶上颌窦底提升术。对照组上颌窦底剩余牙槽骨高度<4 mm的病例行侧壁开窗上颌窦底提升术共8例,其余40例行穿嵴顶上颌窦底提升术。种植术后6~8个月行二期修复治疗。种植术后21 d、3个月、8个月及修复后每6个月进行随访,修复后24个月比较2组上颌窦内成骨高度(sinus bone gain,SBG)、种植体尖端成骨高度(apical bone height,ABH)和种植体边缘骨吸收(marginal bone loss,MBL)情况。结果研究组45例种植术前上颌窦黏膜厚度均值(1.556±0.693)mm,大于对照组(1.229±0.425)mm,差异有统计学意义(P<0.001),但上颌窦底提升术均无上颌窦黏膜穿孔。修复后24个月,研究组SBG、ABH和MBL与对照组差异均无统计学意义(P>0.05)。结论伴OMS的患牙拔除后,上颌窦炎症减退、缺牙区骨质高度和密度得到一定程度的恢复,通过上颌窦底提升手术及种植修复,可以达到与非OMS患牙拔除后上颌窦底提升术及种植修复同样的效果。
