OSFE植骨与不植骨种植修复的临床效果对比研究

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。

Comparison of the Clinical Implant Prosthesis Effect of OSFE Cases with and without Bone Grafting

Objective:To compare the clinical implant prosthesis effect of OSFE cases with and without bone grafting.Methods:35 maxillary posterior implant cases with RBH4~8 mmand 43 total implants were implanted. GroupA with bone grafting had 20 planting sites, in which the available alveolar bone height was on average (5.87± 1.19) mm, artificial bone grafting followed by the implantation. 23 points were in Group B without bone grafting, which the available alveolar bone height was on average (5.67± 1.10) mm, implanted straight after maxillary sinus augmentation. 6 months later, the second-phase operation completed the repair, and then clinical examination, x-ray examination and visual analog scale method (Visual analogue scale,VAS) were used for evaluation.Results:The alveolar ridge height difference of two groups had no statistical significance. At an average of 36.7 months'' follow-up period, the implant retention of groupA was 100% (20/20), 1 implant in groupB fell off due to too much bite force and poor oral health, the retention was 95.6%, the retention had no statistical difference between two groups. The VAS results of two groups were similar. Osseointegration of all implants was well. There was no inflammation of soft tissue around the implant and the implant-supported denture masticatory function well.Conclusion:By controlling indications strictly, grasping the premise of cultivation techniques accurately, RBH between 4~8 mm cases without additional implants and bone substitute materials could achieve the desired outcomes, simplify surgical operations, reduce the risk of surgery and trauma, save time and expense of surgery, and was easily to be accepted.