本文選題：經(jīng)牙槽嵴頂上頜竇底提升術(shù) + 膠原蛋白海綿��； 參考：《山東大學(xué)》2017年碩士論文

【摘要】：目的:通過收集18位患者病史資料、治療相關(guān)詳細資料及影像學(xué)資料,統(tǒng)計經(jīng)牙槽嵴頂上頜竇底提升術(shù)中僅植入膠原蛋白海綿并同期種植技術(shù)的存留率及臨床效果,為簡化手術(shù)過程、減輕患者痛苦及經(jīng)濟負擔提供一種良好的參考。方法:從2012年12月份至2016年12月份于山東大學(xué)口腔醫(yī)院種植科就診的病例中,選擇經(jīng)牙槽嵴頂上頜竇底提升術(shù)中僅植入膠原海綿并同期種植的病例,共計18例,包含21個牙位。根據(jù)2002年Cochran提出的種植體成功標準:①種植體骨結(jié)合穩(wěn)固;②無疼痛及任何主觀感覺;③無頻繁發(fā)作的種植體周圍炎;④種植體周圍無連續(xù)性透射影像;統(tǒng)計其存留率,統(tǒng)計所有術(shù)中和術(shù)后的并發(fā)癥,同時追蹤觀察負載后半年的存留率和臨床使用情況。并通過對術(shù)后及術(shù)后6月CBCT的觀測,分別記錄術(shù)后及術(shù)后6月時近遠中及植體根部提升高度,及術(shù)后6月時植體周圍骨結(jié)合情況,評價膠原蛋白海綿的成骨效果。使用SPSS軟件對測量數(shù)據(jù)進行統(tǒng)計學(xué)分析,P0.05時具有統(tǒng)計學(xué)差異。結(jié)果:(1)存留率:在觀察的18例患者,21個牙位中,所有患者術(shù)后均未出現(xiàn)上頜竇黏膜破裂穿孔、感染等臨床并發(fā)癥。18例患者,21個種植體在術(shù)后6個月均取得良好的骨結(jié)合,存留率為100%,最終修復(fù)效果好,病人滿意。負載后半年復(fù)診時,18例患者,21個牙位的存留率為100%,21個種植修復(fù)體均能行使良好的咀嚼功能,未出現(xiàn)種植體松動、感染,上頜竇穿孔、感染等跡象。(2)數(shù)據(jù)測量結(jié)果:21個牙位的近遠中側(cè)牙槽骨剩余高度約為(6.44±2.09)mm,平均值為6.27mm;近中牙槽骨高度為(6.96±2.27)mm,遠中牙槽骨高度為(6.09±1.86)mm。骨結(jié)合后,種植體近遠中側(cè)的新骨生成量約為0.94-7.72mm,平均(2.5±1.59)mm;近中竇底新骨高度為(2.57±1.74)mm,遠中為(2.58± 1.39)mm。近遠中側(cè)新骨生成量無統(tǒng)計學(xué)差異。(3)CBCT觀察:在納入條件的18例患者,21個牙位中,21個種植體突入上頜竇部分,植體根部均可發(fā)現(xiàn)形成了新的上頜竇底影像,種植體周圍均可見密度均勻連續(xù)的高密度影像。結(jié)論:在上頜后牙區(qū)剩余牙槽骨高度不足時,采用經(jīng)牙槽嵴頂上頜竇底提升術(shù),在上頜竇內(nèi)植入膠原蛋白海綿代替骨替代材料,臨床上可取得良好的效果,成功率高,且能有效避免上頜竇底黏膜穿孔、上頜竇感染等臨床并發(fā)癥,降低了手術(shù)風險,減輕了患者的經(jīng)濟負擔,易于患者接受,可在臨床上推廣應(yīng)用。
[Abstract]:Objective: to investigate the survival rate and clinical effect of collagen sponge implantation and simultaneous implantation during transalveolar ridge maxillary sinus floor lifting by collecting 18 patients' medical history and imaging data. It provides a good reference for simplifying the operation process and alleviating the pain and economic burden of patients. Methods: from December 2012 to December 2016, only collagen sponge was implanted into the maxillary floor of maxillary sinus in Shandong University Stomatology Hospital from December 2012 to December 2016. A total of 18 cases, including 21 teeth, were selected. According to the successful implant standard proposed by Cochran in 2002, the osseous fixation without pain and any subjective sensation, there was no continuous transmission image around the implant, and the survival rate of the implant was counted. All postoperative and intraoperative complications were recorded, and the retention rate and clinical use of the patients were followed up half a year after loading. The osteogenic effect of collagen sponge was evaluated by observing the CBCT after operation and 6 months after operation, recording the elevation of the proximal distal and the root of the implant and the osseous binding around the implant at 6 months after the operation. There was statistical difference when using SPSS software for statistical analysis of measurement data. Results the survival rate: among 18 patients, 21 teeth were observed, all of them had no clinical complications, such as rupture and perforation of maxillary sinus mucosa, infection and other clinical complications. The 21 implants had good osseous union at 6 months after operation. The survival rate is 100%, the final repair effect is good and the patient is satisfied. The survival rate of 21 teeth was 100, 21 implants could perform good masticatory function without implant loosening, infection, maxillary sinus perforation. Results: the residual height of proximal distal alveolar bone in 21 teeth was about 6.44 鹵2.09 mm, the average was 6.27 mm, the height of proximal alveolar bone was 6.96 鹵2.27 mm, and the height of distal alveolar bone was 6.09 鹵1.86 mm. After bone-binding, the new bone formation of the implants was about 0.94-7.72mm, with an average of 2.5 鹵1.59mm, and the height of the new bone near the middle sinus floor was 2.57 鹵1.74mm and 2.58 鹵1.39mmm. There was no statistical difference in the amount of new bone formation in the proximal distal side. The CBCT observation showed that 21 implants protruded into the maxillary sinus and the root of the implants formed a new image of the maxillary sinus floor in the 18 patients who were included in the condition. High density images with uniform and continuous density can be seen around the implants. Conclusion: when the height of the remaining alveolar bone in the maxillary posterior region is insufficient, the transalveolar ridge top maxillary sinus floor lifting technique and the implantation of collagen sponges into the maxillary sinus to replace the bone substitute material can achieve good clinical results and high success rate. And can effectively avoid the maxillary sinus floor mucosa perforation, maxillary sinus infection and other clinical complications, reduce the risk of surgery, reduce the economic burden of patients, easy to accept, can be used in clinical application.
【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R782.1

【參考文獻】

相關(guān)期刊論文 前5條

1 康娟;;CGF膜在上頜竇內(nèi)提升術(shù)中的應(yīng)用效果[J];中國社區(qū)醫(yī)師;2016年15期

2 遲妍妍;樂堯金;劉旭昭;李琪;雷靜;湯順清;;膠原蛋白海綿的生物特性及體內(nèi)降解吸收[J];中國組織工程研究;2014年34期

3 覃鳳均;陳旭;李遲;;膠原蛋白海綿治療Ⅱ度燒傷創(chuàng)面的臨床療效研究[J];中國全科醫(yī)學(xué);2010年18期

4 王碧,葉勇,程勁,張廷有,但衛(wèi)華,王坤余;膠原蛋白制備生物醫(yī)學(xué)材料的特征及改性方法[J];化學(xué)世界;2003年11期

5 朱梅湘,穆暢道,林煒1,史宗潔;膠原作為生物醫(yī)學(xué)材料的優(yōu)勢與應(yīng)用[J];化學(xué)世界;2003年03期

相關(guān)碩士學(xué)位論文 前1條

1 段志廣;類人膠原蛋白止血海綿的性能研究[D];西北大學(xué);2008年

，

本文編號：1921940