不同的鼻竇提升術合併人工植牙治療所造成的骨高度變化之回顧分析

Bone Level Change at Implant-supported Restorations with 2 Different Sinus Lift Procedures in Maxillary Sinus Area

許淨媮(Ching-Yu Hsu) ； 潘裕華(Yu-Hwa Pan) ； 張陽明(Yang-Min Chang) ； 陳必綸(Pi-Lun Chen)

《臺灣口腔顎面外科學會雜誌》 27卷2期 (2016/06) Pp. 82-91

摘要

本篇報告探討於2009至2011年間，在台北長庚醫院口腔外科及義齒補綴科鈴上顎鼻竇區進行兩種不同的鼻竇提升術並植入人工植體後，臨床追蹤至少30個月後的植體的存活率及植體固定式贗復物的成功率，並比較鼻竇開窗術及骨鑿成形術兩組術式對術前及術後骨高度變化的影響。本研究對象共包含40位息者，其中有22位男性及18位女性，平均年齡54.76歲，共植入85支植體，其中骨鑿成形術組共植入63支植體，鼻竇開窗術組共植入22支植體，且皆採取一階段鼻竇提升術合併人工植體植入。術前及術後分別以電腦斷層影像量測手術區域之骨嵴高度：鼻竇開窗術組術前平均剩餘牙嵴高度為4.32 ± 0.84毫米，術後平均增加骨高度為9.24 ± 1 .03毫米：骨鑿成形術術前平均剩餘牙嵴高度為6.88 ± 1.45毫米，術後平均增加骨高度為6.08 ± 1.51毫米。人工植體的長度皆介於10-13毫米，寬度介於4-5毫米，平均癒合時閒為11個月。製作贋復物後，平均追蹤觀察時閒為46.93個月，追蹤結果發現累積之植體成功率為95.3%，累積之植體贋復物成功率為97.65%。研究結果發現臨床上術前平均剩餘牙嵴高度會影響手術醫師選用的鼻竇提升手術方式，並且術式的不同所造成增加的牙嵴骨高度具有顯著的差異性。

關鍵字

鼻竇提升術 ； 植體存活率 ； 植體贋復物成功率

並列摘要

The purpose of this retrospective study was to evaluate the implant survival rate and prosthetic successful rate of implant-supported fixed restoration after two different sinus lift procedures combined with 1-stage implant insertion, and compare peri-implant bone gain between two different sinus lift procedures. This study included 40 patients (22 male and 18 female) who received sinus lift procedure combined with implant therapy at maxillary sinus area at the department of Oral and Maxillofacial Surgery of Chang-Gung Memorial Hospital, Taipei from 2009 to 2011, the average age was 54.76 year-old, total 85 dental implants. The patients separated to 2 groups according to the sinus lift procedures: open sinus group and osteotome group. The open sinus group included 22 dental implants, the mean residual bone height was 4.32 + 0.84 mm and the mean bone gain was 9.24 + 1.03 mm; the osteotome group included 63 dental implants, the mean residual bone height was 6.88 + 1.45 mm and the mean bone gain was 6.08 + 1.51 mm. The implants were ranged from 10 to 13 mm in length and from 4 to 5 mm in diameter. After mean 46.93 months follow-up, the accumulated implant survival rate was 95.3% and prosthetic successful rate was 97.65%. The amount of residual bone height would influence the selection of sinus lift procedures, and different sinus lift procedures would influence the amount of bone gain at maximally sinus area.

並列關鍵字

Sinus lift procedure ； Implant survival rate ； Prosthetic successful rate