Kaneko Takahiro, Masuda Issei, Horie Norio, Shimoyama Tetsuo
Department of Oral and Maxillofacial Surgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
J Oral Maxillofac Surg. 2012 Mar;70(3):e217-24. doi: 10.1016/j.joms.2011.10.025.
Sinus lifting without graft materials allows new bone formation in the sinus, but the amount of bone formation varies. This study aimed to investigate whether nongrafted sinus lifting using a titanium bone fixation device can promote bone formation in the sinus.
Patients with atrophic posterior maxillae jeopardizing implant stability were included. After nongrafted sinus lifting in combination with implant placement, repositioning of the bone window and additional space-maintaining management were performed by use of the bone fixation device. The primary variables recorded retrospectively included implant survival and preoperative and postoperative alveolar crest height with and without Schneiderian membrane perforation. Independent variables included patient demographics, position and dimension of the implants, complications, and follow-up period. The t test was used for comparing differences in bone levels. The implant survival rate was estimated by uses of Kaplan-Meier statistics.
The study included 11 patients (4 men and 7 women) and a total of 21 implants. Radiographically, new bone formation around the implant was generally observed in accordance with the implant apex. Postoperative alveolar crest height (mean, 10.9 ± 2.2 mm) was significantly higher compared with residual alveolar crest height (mean, 4.7 ± 1.4 mm), and no significant difference in bone formation was seen according to membrane perforation. The cumulative survival rate was 95.2%.
This nongrafted sinus-lifting procedure using a bone fixation device could attain predictable bone formation. Additional space-maintaining management using a bone fixation device in a nongrafted sinus lift offers a useful technique for promoting bone formation in the sinus.
不使用植骨材料进行上颌窦提升可使上颌窦内形成新骨，但骨形成量存在差异。本研究旨在调查使用钛骨固定装置进行非植骨上颌窦提升是否能促进上颌窦内的骨形成。
纳入上颌后牙区萎缩且危及种植体稳定性的患者。在非植骨上颌窦提升联合种植体植入后，使用骨固定装置对骨窗进行复位及额外的空间维持管理。回顾性记录的主要变量包括种植体存留情况以及术前和术后有无施奈德膜穿孔时的牙槽嵴高度。自变量包括患者人口统计学资料、种植体的位置和尺寸、并发症以及随访时间。采用t检验比较骨水平的差异。使用Kaplan-Meier统计方法估算种植体存留率。
本研究纳入11例患者（4例男性和7例女性），共21枚种植体。影像学检查显示，种植体周围通常可观察到与种植体根尖相应的新骨形成。术后牙槽嵴高度（平均为10.9±2.2mm）显著高于残余牙槽嵴高度（平均为4.7±1.4mm），且根据膜穿孔情况，骨形成无显著差异。累积存留率为95.2%。
这种使用骨固定装置的非植骨上颌窦提升术可实现可预测的骨形成。在非植骨上颌窦提升术中使用骨固定装置进行额外的空间维持管理为促进上颌窦内骨形成提供了一种有用的技术。
