李蓬;朴牧子;胡洪成;王勇;赵一姣;申晓婧;

• 1:北京大学口腔医学院·口腔医院第二门诊部国家口腔疾病临床医学研究中心口腔数字化医疗技术和材料国家工程实验室口腔数字医学北京市重点实验室
• 2:北京大学口腔医学院·口腔医院口腔医学数字化研究中心

摘要(Abstract)：

目的:应用锥形束计算机断层(cone beam computed tomography,CBCT)及三维测量研究经嵴顶上颌窦底提升术不植骨同期植入种植体后窦内骨高度和骨体积的变化,分析影响窦内骨增量的相关因素。方法:选择2014年1月至2019年12月在北京大学口腔医院第二门诊部就诊的38例牙列缺损患者影像学资料进行回顾性分析,38例患者经牙槽嵴顶上颌窦底提升后不植骨同期植入44枚种植体。比较分析术前和术后9～68个月拍摄的CBCT,测量种植体颊侧、腭侧、近中和远中位点的窦内新增骨高度,通过Mimics软件建模配准,布尔(Boolean)运算计算出上颌窦内新增的骨体积,并且分析影响窦内新增骨高度和新增骨体积的相关因素,根尖片追踪监测边缘骨吸收情况。结果:术前上颌窦底平均剩余牙槽骨高度(residual bone height,RBH)为(3.41±1.23) mm,种植体突入长度(protruded length,PL)为(3.41±1.28) mm,种植体周围各位点窦内新增骨高度远中为(2.44±1.23) mm、近中为(2.88±1.20) mm、颊侧为(2.83±1.22) mm和腭侧为(2.96±1.16) mm,术后窦内平均新增骨高度为(2.78±1.13)mm,窦内新增骨体积为(122.15±73.27) mm3。多因素分析显示调整性别、年龄、吸烟等因素后,窦内平均新增骨高度与PL和成骨时间呈正相关,与术前RBH呈负相关,而窦内新增骨体积与PL和成骨时间呈正相关。观察期内种植体成功率100%,平均边缘骨吸收为0(0～1.41) mm。结论:经嵴顶上颌窦底提升术不植骨同期植入种植体可增加种植体周围窦内骨高度,不植骨亦可以获得窦内一定体积的新骨形成,RBH、PL及成骨时间均是影响窦内成骨量的重要因素。

关键词(KeyWords)： 窦底增高术;牙种植;X线计算机体层摄影术

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 李蓬;朴牧子;胡洪成;王勇;赵一姣;申晓婧;

Email:

DOI: 10.19723/j.issn.1671-167X.2021.01.015

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