本文選題：上頜竇內(nèi)提升 + 剩余牙槽骨高度��； 參考：《安徽醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的：探討骨擠壓器行上頜竇底內(nèi)提升(osteotome sinus floor elevation, OSFE)不植骨同期種植術(shù)在上頜后牙區(qū)種植的應(yīng)用及臨床效果。 方法：2011～2012年就診于我院種植中心25例上頜后牙缺失的患者,缺牙區(qū)剩余牙槽骨高度(residual bone high, RBH)為4-8mm,其中,男性14例,女性11例,用骨擠壓器行OSFE不植骨同期牙種植術(shù),共植入34顆種植體,其中RBH為4-5mm的種植11顆(A組),RBH為5-8mm的種植23顆(B組),術(shù)后6月行種植體上部冠修復(fù)。通過1-2年的臨床觀察,根據(jù)Albrekkson-Zarb標(biāo)準(zhǔn)分析種植體成功率,評(píng)估種植體周圍軟組織健康狀況(松動(dòng)度指數(shù)、牙周探診深度、改良菌斑以及改良齦溝出血)。所有患者于術(shù)前、術(shù)后即可、術(shù)后6月、12月拍攝全景片,評(píng)價(jià)種植體與周圍骨組織結(jié)合狀況、竇底提升后新骨形成狀況以及種植體頸部邊緣骨吸收狀況。 結(jié)果：觀察期內(nèi)34顆種植體脫落一顆,存留率為97.1%。除失敗的一顆種植體外,其余種植體未松動(dòng),患者依從性比較好,種植體周圍軟組織健康,無明顯炎癥,改良齦溝出血指數(shù)為0或1,改良菌斑指數(shù)為0、1或2,牙周探診深度平均為2.88±0.25mm,患者對(duì)修復(fù)效果均滿意。術(shù)后6個(gè)月X線片檢查種植區(qū)竇底形成新骨高度分別為A組：2.86-0.28mm,B組：2.41±0.54mm,種植體骨結(jié)合良好,術(shù)后12個(gè)月X線復(fù)查種植體頸部周圍垂直方向骨吸收2mm。 結(jié)論：在掌握好適應(yīng)證以及規(guī)范的手術(shù)操作條件下,骨擠壓器行上頜竇底提升種植術(shù)方法可靠,效果肯定,能有效應(yīng)用于竇底R(shí)BH不足的上頜后牙缺失者,并能獲得較高的成功率。術(shù)中均未植入骨移植材料,術(shù)后竇底均有不同程度的新骨形成。但是,還需增加樣本量及延長(zhǎng)觀察時(shí)間對(duì)種植修復(fù)的長(zhǎng)期臨床效果和成功率進(jìn)一步研究。
[Abstract]:Objective: to investigate the application and clinical effect of osteotome sinus floor elevation, OSFE) implantation without bone grafting in maxillary posterior teeth. Methods from 2011 to 2012, 25 patients with maxillary posterior tooth loss were treated in the implant center of our hospital. The residual alveolar bone height (bone high, RBH) was 4-8 mm, including 14 males and 11 females. Implants without OSFE bone graft were performed with bone extruder. A total of 34 implants were implanted, of which 11 were 4-5mm implants. In group A, 23 implants were implanted with 5-8mm. The upper crown of the implants was repaired 6 months after operation. According to the clinical observation of 1-2 years, the success rate of implant was analyzed according to Albrekkson-Zarb standard, and the health status of soft tissue around the implant (mobility index, depth of periodontal probing, improved plaque and improved gingival sulcus bleeding) were evaluated. The panoramic images were taken before and after operation, 6 months and 12 months after operation to evaluate the binding of implants to the surrounding bone tissue, the formation of new bone after sinus floor lifting and the bone resorption in the neck of implant. Results: during the observation period, 34 implants fell off one, and the survival rate was 97.1. Except for one failed implant, the implant was not loosened, the patient's compliance was good, the soft tissue around the implant was healthy, and there was no obvious inflammation. The modified gingival sulcus bleeding index was 0 or 1, the modified plaque index was 0 or 2, and the average depth of periodontal probing was 2.88 鹵0.25 mm. At 6 months after operation, the height of new bone formation in the sinus floor of implant area was 2. 86-0. 28mm in group A and 2. 41 鹵0. 54mm in group B, respectively. The osseous osseointegration of implant was good, and the bone resorption in vertical direction around the implant neck was reexamined 12 months after operation. Conclusion: under the condition of proper indication and standard operation, the method of maxillary sinus floor lifting and implantation with bone extruder is reliable and effective. It can be used effectively in patients with missing maxillary posterior teeth with insufficient RBH in the sinus floor. And can obtain higher success rate. No bone graft was implanted during the operation and new bone formation was found in the sinus floor after operation. However, the long-term clinical effect and success rate of implant restoration should be further studied by increasing sample size and prolonging observation time.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R783.6

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