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目的:比较上颌窦挤压内提升(OSFE)植骨与不植骨种植修复的临床效果。方法:选择上颌后牙区种植修复的35例患者,其剩余牙槽嵴高度(RBH)为4~8 mm,共植入43颗种植体。A组16例患者为植骨组,20个种植位点,牙槽骨可用骨高度平均(5.87±1.19)mm,植入人工骨粉后植入种植体;B组19例患者为不植骨组,23个种植位点,缺牙区牙槽骨可用骨高度平均(5.67±1.10)mm,上颌窦提升后直接植入种植体。6个月后行二期手术完成修复。采用临床检查、X线检查及视觉模拟评分法(visual analogue scale,VAS)进行效果评价。结果:两组病例的牙槽嵴高度差异比较无统计学意义。在平均约36.7个月的随访期内,A组种植体的存留率为100%(20/20),B组中有1枚种植体因咬合力过大及口腔卫生较差脱落,种植体的存留率为95.6%(22/23),两组病例的存留率比较无统计学差异。两组患者的VAS值比较亦相当。所有种植体骨结合良好,种植体周围软组织无炎症,种植义齿咀嚼功能良好。结论:在严格控制适应症、准确掌握种植技巧的前提下,RBH在4~8 mm之间的病例无需额外植入骨代替材料即可取得理想的修复效果,简化了手术的操作,减少了手术的风险和创伤,节省了手术的时间和费用,易被患者接受。
Objective: To compare the clinical effects of osseous augmentation (OSFE) with or without bone graft in the maxillary sinus. Methods: Thirty-five patients with maxillary posterior teeth were implanted. The remaining alveolar ridge height (RBH) was 4 ~ 8 mm. A total of 43 implants were implanted. In group A, 16 patients were treated with bone graft and 20 implant sites. The average height of the alveolar bone available for bone implantation was 5.87 ± 1.19 mm. Implants were implanted with artificial bone meal. In group B, 19 patients were not bone graft , And 23 planting sites. The average available bone height of alveolar bone in edentulous area was (5.67 ± 1.10) mm, and the maxillary sinus was implanted directly after implantation. After 6 months to complete the repair of two surgery. Clinical evaluation, X-ray examination and visual analogue scale (VAS) were used to evaluate the effect. Results: There was no significant difference in alveolar ridge height between the two groups. During the mean follow-up period of about 36.7 months, the survival rate was 100% (20/20) in group A, one in group B due to excessive bite force and poor oral hygiene, The survival rate was 95.6% (22/23). There was no significant difference in survival between the two groups. The VAS values of the two groups were comparable. All implants with good bone union, soft tissue around the implant without inflammation, implant denture chewing function well. CONCLUSIONS: With rigorous control of indications and accurate mastery of implanting skills, RBH between 4 and 8 mm can achieve the desired results without the need for additional bone substitute materials, simplifying the operation and reducing the need for surgery The risk and trauma, saving the time and cost of surgery, easily accepted by patients.