- 期刊
植牙合併無補骨之骨鑿式上頜竇撐高術：系統性回顧與後設分析
Outcomes of Implants Placed after Osteotome Sinus Floor Elevation without Bone Grafts: a Systematic Review and Meta-analysis
摘要
目的：欲植牙重建殘餘骨脊高度不足的上顎後牙區時，骨鑿式上頷竇撐高術的侵入性較低也較省時。術中若用骨粉填入撐高的空間，會增加成本與手術時間。本研究的目的是評估在面對上頜骨缺損時，進行骨鑿式上頜竇撐高術合併植牙且不搭配補骨時，術後植體存活率以及骨水平變化，了解是否能將此方法列為常規治療選項之一。方法：本研究由電子資料庫Pubmed、Cochrane與Embase搜尋從1986至2024年2月以英文撰寫的文獻。符合納入標準的研究文獻利用後設分析。以平均值計算植體存活率，平均值與標準差及信賴區間來統計竇內骨增生和植體周圍骨喪失。並以漏斗圖來表示研究之間的異質性。結果：總共納入20篇文獻，於追蹤期間植體的平均存活率為95%，術後追蹤竇內骨增生量為：2.72毫米、植體邊緣骨喪失0.92毫米。當初始殘餘骨脊高度不足5毫米時，植體存活率與超過5毫米的組別接近，竇內骨增生量較多，但也有較多植體邊緣骨喪失。結論：處理上頷後牙區齒槽骨萎縮患者，骨鑿式上頜竇撐高術同時植牙且無搭配補骨為一個可行的治療選項。與常規植牙相比，兩者植體存活率接近，且骨鑿式上頜竇撐高術同時植牙且無搭配補骨術後並無較多植體邊緣骨喪失。
並列摘要
Purpose: When reconstructing posterior maxillary teeth with inadequate residual bone height by dental implants, the osteotome sinus floor elevation (OSFE) technique is considered less invasive and time-saving . However, grafting the elevated space may increase costs and surgical time. The purpose of this study is to determine whether OSFE combined with implant placement without grafting can be a treatment option in by assessing the postoperative implant survival rate and bone level changes. Methode: In this study, a comprehensive search of English-language literature from 1986 to February 2024 was conducted in electronic databases including PubMed, Cochrane, and Embase. Meta-analysis was performed on studies meeting inclusion criteria. Implant survival rates were calculated by mean values, and statistical analyses for sinus bone growth and peri-implant bone loss included mean values, standard deviations, and confidence intervals. Funnel plots were used to visualize heterogeneity among the studies. Resulte: Twenty studies that met the inclusion criteria were reviewed . The pooled survival rate of implants was 95% (95% CI: 93-96). The endo-sinus bone gain was 2.72mm (95% CI: 2.30-3.14). The marginal bone loss around implants was 0.92 mm (95% CI: 0.7-1.13). Conclusione: Implants survival rate of OSFE without grafting is similar to the conventional dental implantation. Besides, there is no significant increase in marginal bone loss around the implants following the osteotome sinus floor elevation procedure and implantation without grafting. In conclusion, the osteotome sinus floor elevation procedure without grafting is an effective treatment for patients with atrophic alveolar bone in the posterior maxilla.