Nedir Rabah, Nurdin Nathalie, Khoury Paul, Perneger Thomas, Hage Marc El, Bernard Jean-Pierre, Bischof Mark
Ardentis Clinique Dentaire Vevey, Swiss Dental Clinics Group, Vevey, Switzerland; Department of Stomatology and Oral Surgery, School of Dental Medicine, University of Geneva, Geneva, Switzerland.
Clin Oral Implants Res. 2013 Nov;24(11):1257-64. doi: 10.1111/j.1600-0501.2012.02569.x. Epub 2012 Aug 27.
(1) To measure and compare endo-sinus bone levels around implants randomly placed with an osteotome sinus floor elevation (OSFE) procedure in grafted (control) and non-grafted (test) sinuses, (2) to evaluate the OSFE efficacy with short, tapered, and chemically modified hydrophilic surfaced implants in extremely atrophic maxillae, (3) to show that fused corticals may constitute a complication risk.
The TE(®) SLActive 8 mm-long implants (Straumann AG) were placed using an OSFE procedure in 4 mm or less of bone height. Healing time before prosthetic rehabilitation was 10 weeks. One year after implant placement, bone levels were measured on standardized periapical radiographs.
Thirty-seven (17 tests, 20 controls) implants were placed in 12 patients with a mean maxillary residual bone height (RBH) of 2.4 ± 0.9 mm. Before loading, two control implants failed (RBH 1.4 and 1.2 mm); two others rotated at loading (one test, RBH 0.9 mm; one control, RBH 1.5 mm) but were uneventfully loaded after three additional months of healing. These adverse events and complications occurred when implants were placed in merged corticals. Endo-sinus bone gain was 3.9 ± 1.0 and 5.0 ± 1.3 mm for the test and control groups (P = 0.003). The 1-year success rate was 100% and 90%, respectively (P = 0.49).
Although more bone is gained when grafting material is used, this may not be required to promote endo-sinus bone gain. The OSFE procedure with or without grafting material could be efficient when the RBH is ≤ 4 mm. However, when both corticals merged, the risk of complication could increase.
（1）测量并比较在移植（对照）和未移植（试验）的上颌窦中，通过骨凿上颌窦底提升术（OSFE）随机植入种植体周围的窦内骨水平；（2）评估短型、锥形且具有化学改性亲水性表面的种植体在极度萎缩的上颌骨中进行OSFE的疗效；（3）表明融合皮质骨可能构成并发症风险。
采用OSFE手术，将TE(®) SLActive 8毫米长的种植体（士卓曼公司）植入骨高度为4毫米或更低的区域。修复前的愈合时间为10周。种植体植入一年后，在标准化根尖片上测量骨水平。
12例患者共植入37枚种植体（17枚试验组，20枚对照组），上颌平均剩余骨高度（RBH）为2.4±0.9毫米。在加载前，2枚对照种植体失败（RBH分别为1.4毫米和1.2毫米）；另外2枚在加载时发生旋转（1枚试验组，RBH 0.9毫米；1枚对照组，RBH 1.5毫米），但在额外愈合3个月后顺利加载。这些不良事件和并发症发生在种植体植入融合皮质骨时。试验组和对照组的窦内骨增量分别为3.9±1.0毫米和5.0±1.3毫米（P = 0.003）。1年成功率分别为100%和90%（P = 0.49）。
虽然使用移植材料时获得的骨量更多，但促进窦内骨增量可能并不需要使用移植材料。当RBH≤4毫米时，无论有无移植材料，OSFE手术都可能有效。然而，当两层皮质骨融合时，并发症风险可能会增加。
