Marchetti Claudio, Pieri Francesco, Trasarti Stefano, Corinaldesi Giuseppe, Degidi Marco
Department of Oral and Maxillofacial Surgery, School of Dentistry, University of Bologna, Italy.
Int J Oral Maxillofac Implants. 2007 May-Jun;22(3):399-407.
The objectives of this study were to (1) evaluate the survival of implants placed in maxillary sinuses augmented with a 70:30 mixture of autogenous bone and anorganic bovine hydroxyapatite (Bio-Oss) at 1 and 5 years, (2) observe the difference in survival rate between 1-stage and 2-stage procedures, and (3) compare the survival rate of rough-surfaced implants with that of machined implants.
A total of 30 consecutively patients (48 sinuses) with Cawood and Howell Class V and VI atrophy were evaluated. Lateral osteotomy techniques were used in all cases. Implants were placed either simultaneous with grafting (1-stage procedure) or after a delay (2-stage procedure), depending on the amount of residual bone. A 70:30 mixture of autogenous bone and anorganic bovine hydroxyapatite was used as the graft material. All patients were followed up at 1 year after prosthetic loading, while a limited group of these patients was followed up to 5 years.
In 8 patients where the residual crestal bone under the sinus floor assessed by computed tomography was at least 4.5 mm (mean, 5.3 mm), the 1-stage procedure was used for 11 sinus elevations and 32 implants. In 22 patients where the residual crestal bone was less than 4.5 mm (mean, 2.5 mm), the 2-stage procedure was used for 37 sinus elevations and 108 implants. For the 140 implants placed, the overall survival rate was 95.7% at the healing abutment surgery, and the cumulative survival rate was 94.9% at 1 and 5 years. The type of surgical technique was significantly associated with implant failure (P < .05); implants placed using the 1-stage procedure showed a failure rate of 12.5%, while implants placed with the 2-stage procedure had a failure rate of 2.8%. No significant difference in survival rate was observed with respect to implant surface.
A high survival rate was achieved when sinus elevation was performed with a combination of autogenous bone and anorganic bovine hydroxyapatite, even where a minimal amount of residual crestal bone was present. The survival rate was improved when implants were placed after a healing period.
本研究的目的是：（1）评估在上颌窦中植入用自体骨与无机牛羟基磷灰石（Bio-Oss）按70:30混合比例进行增量后的种植体在1年和5年时的存留情况；（2）观察一期手术和二期手术之间存留率的差异；（3）比较粗糙表面种植体与机械加工表面种植体的存留率。
共评估了30例连续的Cawood和Howell V级和VI级萎缩患者（48个上颌窦）。所有病例均采用外侧截骨技术。根据剩余骨量，种植体要么与植骨同时植入（一期手术），要么延迟植入（二期手术）。使用自体骨与无机牛羟基磷灰石按70:30混合比例作为植骨材料。所有患者在修复体加载后1年进行随访，其中有限的一组患者随访至5年。
在通过计算机断层扫描评估窦底下方剩余牙槽嵴骨至少为4.5 mm（平均5.3 mm）的8例患者中，一期手术用于提升11个上颌窦和植入32颗种植体。在剩余牙槽嵴骨小于4.5 mm（平均2.5 mm）的22例患者中，二期手术用于提升37个上颌窦和植入108颗种植体。对于植入的140颗种植体，在愈合基台手术时总体存留率为95.7%，在1年和5年时的累积存留率为94.9%。手术技术类型与种植体失败显著相关（P <.05）；采用一期手术植入的种植体失败率为12.5%，而采用二期手术植入的种植体失败率为2.8%。种植体表面在存留率方面未观察到显著差异。
当使用自体骨与无机牛羟基磷灰石联合进行上颌窦提升时，即使存在少量剩余牙槽嵴骨，也能获得较高的存留率。在愈合期后植入种植体时，存留率有所提高。
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