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同期牙种植体植入与内镜引导下内提升术:负重后2年的疗效

Simultaneous dental implant placement and endoscope-guided internal sinus floor elevation: 2-year post-loading outcomes.

作者信息

Schleier Peter, Bierfreund Gerrit, Schultze-Mosgau Stefan, Moldenhauer Franziska, Küpper Harald, Freilich Martin

机构信息

Clinic for Special Medicine/Department of Orofacial Surgery, University Hospital Stavanger, Stavanger, Norway.

出版信息

Clin Oral Implants Res. 2008 Nov;19(11):1163-70. doi: 10.1111/j.1600-0501.2008.01561.x.

Abstract

AIMS

To determine whether endoscope-guided sinus elevation procedures can be consistently used to create sufficient bone support for stable implant placement and long-term implant success.

MATERIAL AND METHODS

Sixty-two implants were surgically placed into 30 patients (14 men and 16 women) following internal sinus elevation without the use of graft material. Panoramic radiographs were made pre-, post-operative and after 24 months in order to evaluate the peri-implant bone and maxillary sinuses. Resonance frequency analysis (RFA) was used to evaluate implant stability immediately upon placement and just before prosthesis delivery.

RESULTS

The average pre-operative height of the maxillary alveolar bone was 8.4+/-2.2 mm at the premolar and 7.3+/-3.1 mm at the molar regions. The average bone gain was 3.5+/-1.8 and 4.5+/-1.9 mm in the premolar and molar sites, respectively. Clinical parameters and the RFA (4 and 12 weeks post-operative) outcomes show sufficient stability (ISQ=60) of the inserted implants. Three implants failed during the healing period of 12 weeks. The overall implant success rate was 94%. After loading, no further implant failure was observed. The overall success rate after beginning of implant loading was 100%.

CONCLUSIONS

Sinus floor elevation is a well-established procedure for augmentation of the atrophic maxillary posterior region. The minimally invasive internal sinus floor elevation procedure visually guided by an endoscope helped to prevent, diagnose and manage complications such as sinus membrane perforation. The clinical outcomes of this study show that endoscope-controlled internal sinus floor elevation combined with implant placement results in low intra operative trauma, good implant stability upon placement, low incidence of post-operative symptoms and high success rates after 24 months of loading.

摘要

目的

确定内镜引导下的鼻窦提升术是否能持续用于为稳定种植体植入和长期种植成功创造足够的骨支持。

材料与方法

在不使用植骨材料的情况下,对30例患者(14例男性和16例女性)进行内鼻窦提升术后,通过手术植入62颗种植体。在术前、术后及24个月后拍摄全景X线片,以评估种植体周围骨组织和上颌窦情况。采用共振频率分析(RFA)在种植体植入后即刻及义齿戴入前评估种植体稳定性。

结果

上颌前磨牙区牙槽骨术前平均高度为8.4±2.2mm,磨牙区为7.3±3.1mm。前磨牙区和磨牙区平均骨增量分别为3.5±1.8mm和4.5±1.9mm。临床参数和RFA(术后4周和12周)结果显示植入种植体具有足够的稳定性(ISQ = 60)。在12周的愈合期内有3颗种植体失败。总体种植成功率为94%。加载后,未观察到进一步的种植体失败。种植体加载开始后的总体成功率为100%。

结论

鼻窦底提升术是一种成熟的用于上颌后牙区骨增量的手术。在内镜视觉引导下的微创内鼻窦底提升术有助于预防、诊断和处理诸如鼻窦黏膜穿孔等并发症。本研究的临床结果表明,内镜控制下的内鼻窦底提升术结合种植体植入导致术中创伤小;植入时种植体稳定性良好;术后症状发生率低;加载24个月后成功率高。

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