磨除与骨凿上颌窦底内提升术在垂直骨量不足后牙牙列缺损中的疗效比较

doi:10.19439/j.sjos.2026.02.010

摘要/Abstract

摘要： 目的:比较磨除与骨凿上颌窦底内提升术在垂直骨量不足后牙牙列缺损中的效果。方法:选择2020年1月—2021年12月收治的92例垂直骨量不足后牙牙列缺损患者,采用随机数字表法分为对照组（n=46）与试验组（n=46）。对照组采用磨除上颌窦底内提升术,试验组采用骨凿上颌窦底内提升术。对比两组手术相关情况、骨组织吸收情况、剩余牙槽骨高度（residual bone height,RBH）、种植体成功率、种植体周围软组织情况、患者满意度及术后并发症。结果:两组种植体长度及直径相比无显著差异（P>0.05）,试验组手术时间显著长于对照组（P<0.05）,术中出血量显著高于对照组（P<0.05）。术后1年,两组探诊深度（probing depth,PD）、龈乳头指数、改良出血指数（modified sulcular bleeding index,mSBI）、改良菌斑指数（modified plaque index,mPLI）相比无显著差异（P>0.05）,试验组患者满意度显著高于对照组（P<0.05）,两组总并发症发生率相比无显著差异（P>0.05）。术后3年,两组种植体根尖、远中和近中边缘骨吸收量显著升高（P<0.05）,且试验组更高（P<0.05）,两组RBH显著升高（P<0.05）,且试验组更高（P<0.05）;两组种植体成功率相比无显著差异（P>0.05）。结论:磨除与骨凿上颌窦底内提升术在垂直骨量不足后牙牙列缺损中的疗效良好,对种植体周围软组织影响较小。骨凿上颌窦底内提升术可促进骨组织吸收,增加RBH,提升患者满意度,但会增加术中创伤。

关键词: 磨除, 骨凿, 上颌窦底内提升术, 垂直骨量不足, 后牙区牙列缺损, 并发症

Abstract: PURPOSE: To compare the effect of grinding and bone chiseling maxillary sinus internal lifting in dentition defects of posterior teeth with insufficient vertical bone mass. METHODS: A total of 92 patients with dentition defects in the posterior teeth area due to insufficient vertical bone mass admitted from January 2020 to December 2021 were selected and divided into the control group (n=46) and the experimental group (n=46) by random number table method. The control group was treated with maxillary sinus floor internal lifting via grinding, while the experimental group was treated with maxillary sinus floor internal lifting via bone chiseling. The operative conditions, bone resorption, residual bone height (RBH), implant success rate, peri-implant soft tissue, patient's satisfaction and postoperative complications were compared between the two groups. Results: There was no significant difference in implant length and diameter between the two groups (P>0.05). The operation time in the experimental group was significantly longer than in the control group (P<0.05), and the amount of intraoperative blood loss was significantly higher than in the control group(P<0.05). One year after surgery, there were no significant differences in probing depth (PD), gingival papillary index, modified sulcular bleeding index (mSBI) and modified plaque index (mPLI) between the two groups (P>0.05), the satisfaction rate of patients in the experimental group was significantly higher than that in the control group (P<0.05), and there was no significant difference in the total incidence of complications between the two groups(P>0.05). Three years after surgery, the bone resorption amounts at the root, distal and near midedge of the implants in both groups increased significantly(P<0.05), and more prominent in the experimental group (P<0.05). RBH in both groups increased significantly(P<0.05), and more prominent in the experimental group (P<0.05). There was no significant difference in the success rate of the implants between the two groups(P>0.05). CONCLUSIONS: Internal lifting of the maxillary sinus by grinding and bone chiseling has good effect in dentition defects of posterior teeth with insufficient vertical bone mass and has a relatively small impact on the soft tissues around the implants. Internal maxillary sinus lifting with bone chisel can promote bone tissue absorption, increase RBH, and improve patients' satisfaction, with increased intraoperative trauma.

Key words: Grinding, Bone chisel, Internal maxillary sinus lifting, Insufficient vertical bone mass, Posterior dentition defect, Complication

中图分类号:

R782.1

张月, 黄宁, 李然. 磨除与骨凿上颌窦底内提升术在垂直骨量不足后牙牙列缺损中的疗效比较[J]. 上海口腔医学, 2026, 35(2): 171-175.

Zhang Yue, Huang Ning, Li Ran. Comparison of the effect of grinding and bone chiseling maxillary sinus internal lifting in dentition defects of posterior teeth with insufficient vertical bone mass[J]. Shanghai Journal of Stomatology, 2026, 35(2): 171-175.

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