老年病人即刻种植同期上颌窦内提升术的临床效果评价

doi:10.3969/j.issn.1003-9198.2025.05.008

摘要/Abstract

摘要： 目的探讨老年病人上颌后牙拟拔除,预计剩余骨高度(residual bone height,RBH)不足(RBH＜5 mm)时应用即刻种植同期单纯经牙槽嵴顶入路上颌窦底提升术(osteotome sinus floor elevation,OSFE)伴不植骨的临床效果。方法回顾性选择2019年6月至2021年6月于南通市口腔医院种植科行上颌后牙区即刻种植修复同期OSFE的老年病人40例,共计40枚种植体,根据是否植骨分为不植骨组(20枚)与植骨组(20枚)。比较2组种植体留存率、术后即刻及6个月的种植体稳定系数(implant stability quotient, ISQ),计算并比较2组术后6、12、24个月、2年的骨增量变化、种植体颈部骨量变化。结果 40枚种植体,成功39枚(97.5%),其中不植骨组成功20枚(100.0%),植骨组成功19枚(95.0%),2组种植体留存率差异无统计学意义(P>0.05)。2组术后即刻、6个月的ISQ值比较,差异均无统计学意义(P＞0.05)。上颌窦底骨增量方面,2组均有有效的提升,术后6、12、24个月,植骨组的骨增量均大于不植骨组,差异有统计学意义(P＜0.05);种植体颈部骨量方面,2组术后6、12、24个月种植体颈部骨量差异均无统计学意义(P＞0.05)。结论对于老年病人,即刻种植同期OSFE不植骨粉具有良好的临床效果,可满足老年病人的诉求。

关键词: 上颌窦内提升术, 即刻种植, 植骨, 短种植体

Abstract: Objective To explore the clinical effect of immediate implantation combined with osteotome sinus floor elevation (OSFE) without bone grafting at the posterior maxilla in the elderly patients with insufficient residual bone height (RBH < 5 mm) after tooth extraction. Methods A retrospective study was conducted on 40 elderly patients who underwent immediate implantation combined with OSFE at the posterior maxilla at Department of Implantology, Nantong Stomatological Hospital from June 2019 to June 2021, with a total of 40 implants. The patients were divided into no-bone-grafting group (20 implants) and bone-grafting group (20 implants). The implant survival rate, implant stability quotient (ISQ) immediately after surgery and 6 months after surgery, and the changes in RBH and bone volume at the implant neck 6, 12, and 24 months after surgery were compared between the two groups. Results Among the 40 implants, 39 were successful (97.5%), including 20 in the no-bone-grafting group (100.0%) and 19 in the bone-grafting group (95.0%), with no significant difference between the two groups (P>0.05). There was no significant difference in the ISQ value immediately after surgery and 6 months after surgery between the two groups (P>0.05). Both groups achieved effective sinus floor elevation. The bone height increase in the bone-grafting group was significantly greater than that in the no-bone-grafting group 6, 12, and 24 months after surgery (P<0.05). There was no significant difference in the bone volume at the implant neck 6, 12, and 24 months after surgery between the two groups (P>0.05). Conclusions For the elderly patients, immediate implantation combined with OSFE without bone graft has good clinical effect and meets the needs of elderly patients.

Key words: osteotome sinus floor elevation, immediate implantation, bone graft, short implant

中图分类号:

R 783.4

陈冬雷, 郝丹, 王萍, 葛维燕, 郭海波. 老年病人即刻种植同期上颌窦内提升术的临床效果评价[J]. 实用老年医学, 2025, 39(5): 472-476.

CHEN Donglei, HAO Dan, WANG Ping, GE Weiyan, GUO Haibo. Clinical effect of immediate implantation and osteotome sinus floor elevation in elderly patients[J]. Practical Geriatrics, 2025, 39(5): 472-476.

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