Lu Wei, Lin Mengna, Zhao Shifang, Wang Huiming, He Fuming
Department of Periodontology, Stomatology Hospital Affiliated to Zhejiang University School of Medicine, Hangzhou 310006, China.
Department of Implantology, Stomatology Hospital Affiliated to Zhejiang University School of Medicine, Hangzhou 310006, China.
Zhejiang Da Xue Xue Bao Yi Xue Ban. 2017 May 25;46(6):630-636. doi: 10.3785/j.issn.1008-9292.2017.12.09.
To evaluate the clinical efficacy of modified lateral window for maxillary sinus floor augmentation (MSFA). Fifty-five patients who visited the Stomatology Hospital Affiliated to Zhejiang University School of Medicine between June 2012 and October 2014 were enrolled in the study. Patients underwent MSFA with Bio-Oss grafts based on modified access window. During the operation the vertical height of the bony window was reduced from 6-8 mm of conventional oval window to 4-5 mm of slot-shaped window. The sinus membrane was detached completely via the lateral access and large particle Bio-Oss graft was placed in the sub-mucosal space. The implant survival, graft height, graft volume and resorption rates were measured. Intra-op and post-op complications were recorded. There were 86 implants inserted. The 2-4 year cumulative survival rates were 97.67% by implant-based analysis and 96.36% by patient-based analysis. The residual bone height was (4.7±2.6) mm and bone width was (8.4±2.7) mm. The bone height of implantation site immediately after operation was (16.1±2.5) mm and it was (16.2±2.2) mm at restoration. The bone heights at 1 and 2 years after operation were (14.9±2.5) mm and (13.6±2.6) mm, respectively. The graft height was (10.6±2.8) mm and the graft volume was (1569±745) mm immediately after operation. The resorption rate of graft height 6 months after operation was 3.79% and that of graft volume was 7.87%. The 1-year accumulative resorption rate of graft height was 6.63% and that of graft volume was 10.89%. The 2-year accumulative resorption rate of graft height was 7.58% and that of graft volume was 15.26%. Small membrane perforation during MSFA was observed in 5 cases and all were successfully repaired by a collagen Bio-Gide membrane. The modified lateral technique obtains high implant survival rate, excellent graft stability and low complication rate at 2-4 year clinical follow-up, indicating that it is a safe, predictable and minimally invasive surgical method for severe atrophic maxillary posterior dentition.
评估改良外侧开窗上颌窦底提升术（MSFA）的临床疗效。选取2012年6月至2014年10月期间就诊于浙江大学医学院附属口腔医院的55例患者纳入本研究。患者接受基于改良入路窗口的MSFA联合Bio-Oss骨粉植入术。手术过程中，骨窗垂直高度从传统椭圆形窗口的6 - 8毫米减至槽形窗口的4 - 5毫米。通过外侧入路完全剥离窦膜，并在黏膜下间隙植入大颗粒Bio-Oss骨粉。测量种植体存留率、植骨高度、植骨体积及吸收速率，记录术中及术后并发症。共植入86枚种植体。基于种植体分析的2 - 4年累积存留率为97.67%，基于患者分析的为96.36%。剩余骨高度为（4.7±2.6）毫米，骨宽度为（8.4±2.7）毫米。术后即刻种植位点的骨高度为（16.1±2.5）毫米，修复时为（16.2±2.2）毫米。术后1年和2年的骨高度分别为（14.9±2.5）毫米和（13.6±2.6）毫米。术后即刻植骨高度为（10.6±2.8）毫米，植骨体积为（1569±745）立方毫米。术后6个月植骨高度的吸收速率为3.79%，植骨体积的吸收速率为7.87%。1年植骨高度的累积吸收速率为6.63%，植骨体积的累积吸收速率为10.89%。2年植骨高度的累积吸收速率为7.58%，植骨体积的累积吸收速率为15.26%。5例患者在MSFA术中出现小的窦膜穿孔，均通过胶原Bio-Gide膜成功修复。改良外侧技术在2 - 4年临床随访中获得了较高的种植体存留率、良好的植骨稳定性及较低的并发症发生率，表明其是一种治疗严重萎缩性上颌后牙列的安全、可预测且微创的手术方法。
