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经皮上颌窦底提升并用凝胶型注射型异种骨代用品:临床、放射学和组织学分析。

Transcrestal maxillary sinus floor elevation with injectable xenogeneic bone substitute in gel form: A clinical, radiological and histological analysis.

机构信息

Department of Head and Neck and Sensory Organs, Division of Oral Surgery and Implantology, Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Rome, Italy.

Department of Head and Neck and Sensory Organs, Division of Oral Surgery and Implantology, Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Rome, Italy,

出版信息

Am J Dent. 2024;37(SIA):25A-28A.

Abstract

PURPOSE

This retrospective study measured the increase in bone tissue using the transcrestal maxillary sinus floor elevation with injectable xenogeneic bone substitute in gel form with simultaneous implant placement. This procedure allows elevation of the sinus floor atraumatically, reducing the risk of perforation of the Schneiderian membrane.

METHODS

52 subjects needing unilateral sinus floor elevation, with a residual crestal height from 2 mm to 5 mm, and a request for at least one implant-prosthetic rehabilitation in the posterior maxillary area were enrolled. Transcrestal maxillary sinus floor elevation was performed with injectable xenogeneic bone substitute in gel form. The sinus elevation was measured after the surgery and 6 months later with a CBCT. Average values were calculated for each measure.

RESULTS

46 implants were simultaneously placed; six implants were placed after 4 months because of the lack of primary stability. All the placed implants, with a follow-up varying from 3 to 5 years after loading, osseointegrated successfully resulting in a survival rate of 100%. Average pre-operative bone height was 4.2 mm while after the surgery the average value reached was 10.1 mm with an average value of new bone gain of 6.43 mm. Histological analysis revealed the presence of 33.2% of vital bone.

CLINICAL SIGNIFICANCE

Transcrestal sinus floor elevation with injectable xenogenic bone substitute in gel form is a minimally invasive technique that can reduce the incidence of Schneider membrane perforations, making a widely used method, such as sinus floor elevation, safer and less operator dependent.

摘要

目的

本回顾性研究通过注射型凝胶状异种骨替代物经牙槽嵴顶入路行上颌窦底提升术并同期植入种植体,测量骨组织的增加量。该方法可无创性提升窦底,降低穿通硬脑膜的风险。

方法

52 例患者上颌窦需要单侧提升,牙槽嵴顶剩余高度为 2-5mm,且要求在后牙区至少进行一项种植体-义齿修复。采用注射型凝胶状异种骨替代物经牙槽嵴顶入路行上颌窦底提升术。术后及 6 个月时采用锥形束 CT(CBCT)测量窦底提升高度。对每项测量值进行平均计算。

结果

同期植入 46 枚种植体;6 枚种植体因初期稳定性不足,于术后 4 个月时植入。所有植入的种植体在负荷后随访 3-5 年,均成功骨整合,存活率为 100%。术前平均骨高度为 4.2mm,术后平均值为 10.1mm,平均新骨增加量为 6.43mm。组织学分析显示有 33.2%的活骨。

临床意义

注射型凝胶状异种骨替代物经牙槽嵴顶入路行上颌窦底提升术是一种微创技术,可降低硬脑膜穿孔的发生率,使广泛应用的提升术更安全,且对术者的依赖性更小。

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