State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
Clin Implant Dent Relat Res. 2017 Dec;19(6):1034-1043. doi: 10.1111/cid.12529. Epub 2017 Aug 29.
Immediate implant insertion and transcrestal sinus augmentation both can provide a lot of advantages for patients and clinicians.
This prospective study aims to verify the use of a modified technique for immediate implant insertion simultaneously with sinus augmentation in different types of sockets.
Thirty-seven patients were recruited for the clinical study and were divided into 3 groups according to the relationship of their maxillary molar roots and sinus floor: group 1 with none of the teeth roots contacts sinus floor; group 2 as at least 1 teeth root contacting sinus floor, but no root is observed penetrating into sinus cavity; group 3 with at least 1 teeth root penetrating into sinus cavity. Implants were inserted after transcrestal sinus floor augmentation and immediately after tooth extraction. The change of mucosa thickness, diagnosis of rhinosinusitis, marginal bone loss (MBL), pocket depth (PD), and sulcus bleeding index were examined through radiographic measurement or clinical monitoring.
During the study period, no implants failed. The relationship of the root of maxillary molars and sinus floor may have an effect on the bone height of the interradicular crest. Sinus mucosa was observed thicker after surgery. After healing period, sinus mucosa returned as thin as presurgery. At the time of 1-year follow-up, MBL was measured on X-ray (group 1: mesial: 0.63 ± 0.20 mm, distal: 0.70 ± 0.14 mm; group 2: mesial: 0.67 ± 0.21, distal: 0.65 ± 0.22 mm; group 3: mesial: 0.70 ± 0.15 mm, distal: 0.73 ± 0.19 mm). No statistical difference was found in MBL and PD as well as bleeding index among 3 groups.
In consideration of the advantages of sinus floor augmentation and immediate implant placement, our clinical result confirms that it is promising to combine the 2 techniques for replacing maxillary molars especially when using residual roots as implant orientation and taking full advantage of the interradicular crest bone.
即刻植入和经牙槽嵴窦底提升术都能为患者和临床医生带来诸多益处。
本前瞻性研究旨在验证一种改良技术在不同类型牙槽窝中即刻植入同时进行窦底提升的应用。
共招募 37 名患者进行临床研究，并根据上颌磨牙根部与窦底的关系分为 3 组：组 1 无牙根部接触窦底；组 2 至少有 1 个牙根部接触窦底，但无牙根观察到穿透窦腔；组 3 至少有 1 个牙根穿透窦腔。经牙槽嵴窦底提升后即刻拔除牙齿后植入种植体。通过放射学测量或临床监测检查黏膜厚度变化、鼻窦炎诊断、边缘骨丧失（MBL）、袋深（PD）和龈沟出血指数。
研究期间无种植体失败。上颌磨牙根部与窦底的关系可能对根间嵴的骨高度有影响。术后观察到窦黏膜增厚。愈合期后，窦黏膜恢复到术前的薄度。在 1 年随访时，X 线测量 MBL（组 1：近中：0.63±0.20mm，远中：0.70±0.14mm；组 2：近中：0.67±0.21，远中：0.65±0.22mm；组 3：近中：0.70±0.15mm，远中：0.73±0.19mm）。3 组间 MBL、PD 和出血指数无统计学差异。
考虑到窦底提升和即刻植入的优势，我们的临床结果证实，结合这两种技术替代上颌磨牙是有前景的，特别是当利用残根作为种植体定位并充分利用根间嵴骨时。
