Buchmann R, Khoury F, Faust C, Lange D E
Department of Periodontology, School of Dental Medicine, University of Münster, Germany.
Clin Oral Implants Res. 1999 Apr;10(2):103-10. doi: 10.1034/j.1600-0501.1999.100204.x.
Augmentation of the maxillary sinus in the atrophied edentulous posterior maxilla is an integral part of implant prosthodontics. This study examined the clinical outcome in 50 periodontally compromised successfully treated subjects with severe maxillary atrophy following oral implantation with Brånemark, IMZ or Frialit-2 endosseous implants between 1991 and 1994. Simultaneous sinus augmentation was achieved using autogenous bone grafts harvested from the anterior mandible. Oral implants in 37 periodontally healthy patients directly placed in the stable local maxillary bone served as controls. The oral rehabilitation included implant supported restorations or removable superstructures over a period between 3 and 5 years. The peri-implant status of implant abutments inserted in the periodontal compromised augmented maxilla resulted in values comparable to the local maxillary bone except for the GCF rates with enhanced levels of 63.9 +/- 49.9 (controls 37.9 +/- 40.7). The average peri-implant Periotest values in the augmented maxillary sinus (test group) were -3.1 PT and +0.2 PT in the controls. The Periotest scores in the sinus area ranked between -7.0 and +5.0 with mean PT values of -1.5 for IMZ, -3.2 for Brånemark and -4.0 for Frialit-2 abutments. The functional integration of oral implants following sinus augmentation with autologous bone grafts and conventionally placed endosseous implants in the local bone was similar. The additional implant stabilization within the mandibular cortical bone grafts resulted in very low Periotest scores. In periodontally compromised subjects treated for chronic adult periodontitis with minimal maxillary bone height less than 5 mm the endosseous implantation with simultaneous sinus augmentation is recommended as an appropriate technique for long-term oral implant rehabilitation.
在上颌后牙区无牙颌骨萎缩患者中进行上颌窦增量是种植修复学的一个重要组成部分。本研究调查了1991年至1994年间，50例牙周状况不佳但成功接受治疗的严重上颌骨萎缩患者，在植入Brånemark、IMZ或Frialit-2种植体后的临床结果。采用取自下颌前部的自体骨移植实现同期上颌窦增量。37例牙周健康患者的种植体直接植入稳定的上颌局部骨作为对照。口腔修复包括种植体支持的修复体或可摘上部结构，为期3至5年。除龈沟液流量水平有所升高（分别为63.9±49.9，对照组为37.9±40.7）外，植入牙周状况不佳的增量上颌骨中的种植体基台周围种植体状况与上颌局部骨相当。上颌窦增量组（试验组）种植体周围平均Periotest值为-3.1 PT，对照组为+0.2 PT。窦区的Periotest评分在-7.0至+5.0之间，IMZ基台的平均PT值为-1.5，Brånemark基台为-3.2，Frialit-2基台为-4.0。自体骨移植上颌窦增量后种植体的功能整合与常规植入局部骨内的种植体相似。下颌皮质骨移植内额外的种植体稳定性导致Periotest评分非常低。对于上颌骨高度小于5 mm的慢性成人牙周炎且牙周状况不佳的患者，建议采用同期上颌窦增量的种植体植入术作为长期口腔种植修复的合适技术。
