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使用压电超声骨刀进行内窦提升:临床结果的回顾性分析。

The use of a piezoelectric ultrasonic osteotome for internal sinus elevation: a retrospective analysis of clinical results.

机构信息

Department of Oral and Maxillofacial Implantology, Affiliated Stomatological Hospital, School of Stomatology, Tongji University, Shanghai, China.

出版信息

Int J Oral Maxillofac Implants. 2012 Jul-Aug;27(4):920-6.

Abstract

PURPOSE

To explore the possibility and evaluate the clinical outcome of accomplishing maxillary internal sinus floor augmentation through the use of a piezoelectric osteotome in conjunction with dental implant placement and to discuss this technique.

MATERIALS AND METHODS

Patients attending the outpatient clinic of the Department of Dental Implantology, Hospital of Stomatology, Tongji University, between July 2007 and September 2009, who had insufficient bone volume to harbor endosseous implants at least 8 mm long in the lateral/posterior maxilla because of sinus pneumatization were enrolled in the study. Sinus augmentations were accomplished with a piezoelectric osteotome, followed by implant placement, either immediately or delayed (6 months after augmentation, if the residual ridge height was less than 4 mm).

RESULTS

Thirty patients with 36 maxillary molar sites with insufficient alveolar bone height as a result of pneumatization of the sinus were included in this study. The residual vertical bone height ranged from 2 to 8 mm. Twenty-eight implants were placed into 24 patients immediately after sinus augmentation. Another eight implants were placed into 6 patients 6 months after sinus augmentation. Only one sinus membrane perforated (failure rate: 2.78%). Only one implant was lost during the observation period. No other implant mobility or rapid bone loss was seen during a follow-up period of 5 to 27 months.

CONCLUSIONS

Application of a piezoelectric osteotome for internal sinus elevation simplified manipulation of the membrane and greatly reduced the chance of perforation. The pressure gradient between sinus and implant cavity was helpful in accomplishing this technique.

摘要

目的

探讨应用压电骨刀完成上颌窦内提升术同期植入种植体的可能性,并对其进行临床效果评估。

材料与方法

选择 2007 年 7 月至 2009 年 9 月于同济大学附属口腔医院种植科就诊的上颌窦气化导致牙槽骨高度不足,无法植入至少 8mm 长的骨内种植体的患者。采用压电骨刀行上颌窦提升术,若剩余牙槽嵴高度<4mm,则于提升术后 6 个月行种植体植入术。

结果

本研究共纳入 30 例患者的 36 个上颌磨牙区,因上颌窦气化导致牙槽骨高度不足。窦底至牙槽嵴顶的垂直骨高度为 2~8mm。24 例患者于提升术后即刻植入 28 枚种植体,6 例患者于提升术后 6 个月植入 8 枚种植体。术中仅有 1 例患者发生上颌窦黏膜穿孔(穿孔率:2.78%)。随访 5~27 个月,共有 1 枚种植体脱落,无种植体松动或明显骨吸收。

结论

应用压电骨刀行上颌窦内提升术可简化手术操作,降低穿孔风险,且窦底与种植窝之间的压力梯度有利于提升手术的完成。

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