【摘要】 目的探讨倾斜种植体联冠桥修复上颌后牙游离缺失伴上颌窦底骨量不足患者的临床疗效。方法收集上颌后牙游离缺失2颗以上、上颌窦底剩余牙槽骨高度2～7mm的患者13例,术前X线片评估,并制作手术导板,导板引导下在上颌窦前后壁倾斜植入种植体,1.5～3.0个月后行上部结构联冠桥修复,负载后1、3、6、9、12、18、24个月定期复查。结果负载后24个月观察期内28颗种植体稳固,无一松动脱落,种植体周围牙龈组织健康,无探诊出血,数字全景片检查显示种植体周围未见骨低密度影,无上颌窦炎症影像,负载24个月时,种植体近、远中牙槽骨高度与刚植入时的差异无统计学意义(t=1.54,t=1.63,P>0.05)。上部结构修复后除6例患者出现桥体处食物嵌塞但容易自行清除外,咀嚼功能恢复满意。结论采用倾斜种植体联冠桥可有效修复部分上颌窦底骨量不足患者的上颌后牙游离缺失,避免行上颌窦提升手术。更多还原

【Abstract】 Objective Research on the clinical effect about united crowns or bridges for restoration of posterior tooth with insufficient maxillary bone by means of tilted dental implants. Methods Selecting 13 cases with more than two maxillary posterior tooth loss, whose height of residual alveolar bone at the site of maxillary sinus bottoms were 2-7 mm. With application of surgical guideplate for dental implantation, 28 dental implants were embedded into the front or posterior wall of maxillary sinus, shaping like the reversed character "V". United crowns or bridges were applied after 1.5-3.0 months. Regular exams after loading were obtained in 1st, 3rd, 6th, 9th, 12th, 18th and 24th month. Results In 24 months observation period after loading, 28 dental implants were stable with healthy peri-implant gingival tissue and without bleeding when probing and it was showed in panoramic images that there were no low-density peri-implant shadow or images of maxillary sinus inflammation. Otherwise, there were no significant difference between one day after operation and 24th month after loading (P>0.05). Six cases suffered from food impaction at proximal contacts of FPD’s bridges, but easy to remove that by themselves. The masticatory function of upper structures was satisfied by all patients. Conclusion It is feasible to serve united crowns or bridges for restoration of posterior tooth with insufficient maxillary bone by means of tilted dental implants. Otherwise, the maxillary sinus lifting operation is avoided.更多还原