关键词: 上颌窦提升, 牙种植, 骨增量, 同期种植, 口腔生物材料

Abstract:

BACKGROUND: After maxillary posterior tooth missing, height of the remaining alveolar bone at the bottum of maxillary sinus occurred shortage displayed in some cases. How to do a simple, quick and effective restoration is the subject of exploration which dentists work hard to achieve. Shorter treatment cycles and increase of the success rate by titanium plate or titanium mesh fixed dental implant to obtain enough initial stage stability in operation is under exploration.
OBJECTIVE: To investigate feasibility of applying titanium plate or titanium mesh fixed dental implant to increase the initial stage stability in the sinus surgery at the same time dental implantation to solve extreme shortage of bone height at the bottom of the maxillary sinus (1-3 mm).  
METHODS: Twenty-four cases of maxillary posterior tooth loss, with remaining maxillary alveolar bone at the bottom of maxillary sinus about 1-3 mm, underwent bone graft surgery outside the maxillary sinus, 63 Straumann implants were embedded at the same time. Titanium meshes were applied to increase the initial stage stability in operation. Upper structure was restored 6 months after operation. Follow-up remained 30 months.
RESULTS AND CONCLUSION: Torque of implants have reached more than 10 N•cm in operation. Compared with those implants without connection titanium meshes, the difference of torque values was statistically significant (P < 0.05); implant ISQ value was 69.78±4.78 after 6 months; the thickness of implant end bone was (2.53±0.36) mm after loading for 24 months, compared with the values during just implantation, there was no significant difference (P > 0.05); implant marginal bone resorption was (1.07±0.40) mm; none of these cases exhibited rupture of maxillary sinus mucosa in operation. Implants were stable during observation period, its surrounding tissues were healthy without any loss. The patients were satisfactory for masticatory function after upper structure restoration. X-ray examination showed bone and grafts linked closely together, without peri-implant bone density shadow or maxillary sinus inflammation images. Two cases were lost in follow-ups after upper structure restoration. Results demonstrated that when patients have two or more maxillary posterior teeth missed and under extreme shortage (1-3 mm) of bone height at the bottom of the maxillary sinus, it is recommended to apply large-diameter Straumann mucosa immediate implant, at the same time, utilizing titanium meshes as an assist to achieve the initial stability of implants. Sinus surgery complying with dental implantation could obtain ideal short-term clinical results.