CBCT在闭合式上颌窦内提升术的临床应用研究
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[摘要]目的：探讨锥束CT(Cone Beam Computer Tomography,CBCT)评估上颌后牙区牙槽骨高度准确程度，评价其指导闭合式上颌窦内提升术的临床效果。方法：对55例计划行上颌后牙区种植患者拍摄CBCT，根据分析结果将适合行上颌窦内提升术患者纳入研究人群，治疗结束后评估其临床效果。结果：CBCT上颌后牙区牙槽骨骨量不足者检出45例，1例上颌窦根尖囊肿，2例窦底粘膜过度增生，其中4例窦底距离牙槽嵴顶骨高度小于4mm者建议使用上颌窦侧壁开窗上颌窦底提升植骨手术，38 例完成闭合式上颌窦内提升并全部完成修复，成功率为100%。结论：CBCT在上颌后牙区颌骨骨量判断及术前指导有着重要作用。
[关键词]锥束CT；上颌窦底提升；种植
[中图分类号]R783.5 [文献标识码]A [文章编号]1008-6455(2011)06-0921-04
Clinical application of the sinus floor elevation using osteotome technique guided by CBCT
CHANG Xiao-feng,HU Na,HE Long-long,LI Da-xu,LIU Shao-li
(Department of Oral Implant,Stomatology College,Xi'an Jiaotong University,Xi'an 710004,Shaanxi,China)
Abstract:ObjectiveTo Explore the accuracy of posterior maxillary bone height by CBCT and assess the clinical results after a modified osteotome technique to lift sinus floor without grafting materials. Methods55 cases with tooth lost in maxillary posterior were taken CBCT;the objects that would be taken sinus floor elevation using osteotome technique without grafting materials were decided by the analysis of bone height results,then to evaluate the clinical results after the restoration of the tooth.Results45 cases were detected with a lacking of maxillary posterior alveolar bone height,and 1 case was diagnosed as maxillary radicular cyst,2 cases were found as sinus mucosal hyperplasia,and 4 cases whose sinus alveolar bone height were less than 4mm recommended the using of maxillary sinus wall of windows surgery, 38 patients completed the sinus floor elevation using Osteotome Technique and finished the restorations at last. The success rate was 100% within one year.Conclusion CBCT has an important role in determining the quality of the bone in maxillary posterior and in preoperative guidance before the implant operation.
Key words:CBCT;maxillary sinus floor elevation;dental implant
种植修复已经成为牙列缺损和缺失的常规修复方法，然而上颌后牙区由于上颌窦的存在，影响了种植修复上颌后牙区对骨量需求的准确判断。目前，随着种植外科技术的突飞猛进，采用闭合式上颌窦内提升技术在种植领域已经广泛运用。即当上颌窦底距离牙槽嵴顶骨高度8～10mm时，使用上颌窦底冲顶术，即牙槽嵴顶入路的窦底内提升技术，将上颌窦底轻度抬高2～4mm，不穿透窦腔粘膜，植入10～12mm长的种植体从而完成种植修复方案[1]。有些学者认为机体本身修复功能强大，当窦底牙槽骨可用高度5～7mm，仍然可以使用此方法 ......
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