目的:分析基于椎间盘上窦铰刀(DSR)的内窦底抬高植入后10年植入物周围的骨重建,并探讨不同因素对植入物固位的影响。
方法:从口腔种植科收集基于DSR的窦底抬高同时植入的患者的临床和影像学资料,青岛大学附属医院2008年1月至2011年12月。采用全景胶片和CBCT测量不同时期种植体周围骨量的变化。采用Kaplan-Meier和Log-rank检验,利用SPSS26.0软件包分析不同因素对种植体固位的影响。
结果:该研究包括98名患者,总共128个植入物。在0-168个月的随访中,7个植入物失败,剩下的形成了良好的骨整合和功能,10年累计留存率为94.53%。75个植入部位的骨形成高度在顶部为(0.29±0.15)mm,在鼻窦为(2.74±0.66)mm,术后十年获得了完整的影像学数据。Kaplan-Meier和Log-rank检验显示,包括初始骨高度在内的8个因素,骨高度升高,粘膜穿孔,植入物长度,植入物扭转,糖尿病,吸烟和牙周炎对种植体固位有显著影响。
结论:基于DSR的内窦底抬高结合植入是治疗上颌骨后区垂直骨缺损的一种可靠、稳定的增骨手术。10年累计留存率不低于94%。初始骨高度,骨高度升高,粘膜穿孔,植入物长度,植入物扭转,糖尿病,吸烟和牙周炎是影响种植体长期保留率的重要因素。
OBJECTIVE: To analyze the bone remodeling around the implant 10 years after disk-up sinus reamer(DSR)-based internal sinus floor elevation with implantation and to investigate the influence of different factors on implant retention.
METHODS: The clinical and imaging data of patients undergoing DSR-based sinus floor elevation with simultaneous implantation were collected from the Department of Dental Implantology, Affiliated Hospital of Qingdao University from January 2008 to December 2011. Panoramic film and CBCT were used to measure the changes of bone mass around implant in different periods. Kaplan-Meier and Log-rank tests were used to analyze the effects of different factors on implant retention with SPSS 26.0 software package.
RESULTS: The study included 98 patients with a total of 128 implants. During the follow-up of 0-168 months, 7 implants failed, and the remaining formed good osseointegration and functioned, with a 10-year cumulative retention rate of 94.53%. The height of bone formation was (0.29±0.15) mm at the top and (2.74±0.66) mm in the sinus of 75 implant sites with complete imaging data obtained ten years after surgery. Kaplan-Meier and Log-rank tests showed that 8 factors including initial bone height, elevated bone height, mucosal perforation, implant length, implant torsion, diabetes, smoking and periodontitis had significant effects on implant retention.
CONCLUSIONS: The DSR-based internal sinus floor elevation with implantation is a reliable and stable bone augmentation operation for vertical bone defect in maxillary posterior region, with a 10-year cumulative retention rate of no less than 94%. Initial bone height, elevated bone height, mucosal perforation, implant length, implant torsion, diabetes, smoking and periodontitis are the important factors affecting the long-term retention rate of implants.