【作者】 仲维剑； 陈斌科； 马国武；

【Author】 ZHONG Wei-jian,CHEN Bin-ke,MA Guo-wu (College of Stomatology,Dalian Medical university,Liaoning Dalian,China 116044)

【机构】 大连医科大学口腔医学院；

【摘要】 目的:探讨种植体穿通上颌窦不同高度后,对窦底骨质和粘膜的影响以及种植体顶端与周围组织结合的生物学变化。方法:健康成年杂种犬8只,拔除两侧的上颌第一磨牙进行即刻种植。随机选择进行穿通上颌窦1mm、2mm、3mm各四侧,不穿通的四侧作对照。5个月后,通过大体观察、X线检查、粘膜石蜡切片以及带种植体的骨磨片等手段,观察上颌窦粘膜的病理变化以及种植体顶端与骨的结合情况。结果:穿通上颌窦1mm、2mm的种植体顶端均被窦底粘膜覆盖,种植体顶端螺纹处覆盖致密的骨质。与种植体顶端相邻的上颌窦粘膜上皮层增厚、纤维组织增多,无炎症表现;骨磨片显示种植体顶端与上颌窦底骨质形成了良好的骨结合。结论:种植体穿通上颌窦不影响上颌窦粘膜的健康以及种植体与窦底的骨结合。讨论:本研究提示,对意外穿入上颌窦内的种植体可以观察随诊,不必立刻取出。这个结论还有待更多的临床研究资料加以证实。更多还原

【Abstract】 Objectives:To investigate the changes of bone and mucosa around the apex of the implants after the sinus floors were deliberately penetrated by these dental implants in different heights.Methods:After the maxillary first molars of eight adult mongrel dogs were extracted on both sides,immediate implant placements were performed.A split-mouth design was used:every four implants which were randomly penetrated into sinus cavity for 1mm,2mm,3mm were classified as group A,B,C and four implants which were positioned within the confines of alveolar bone were considered as the control(D) group.The animals were sacrificed five months after surgery.The specimens were undergone general observation,X - ray radiographic examination,histological evaluation for implants osseointegration and pathological changes of sinus membrane.Results:The apexes of implant,which penetrated into sinus cavity for 1mm and 2mm,were covered with membrane and the apical threads were embraced with dense bone.There were no differences on the appearance of sinus membrane between penetrated areas(1mm,2mm) and the intact areas.Histological observation exhibited the thickening layer of epithelium of sinus membrane around the penetrated implant apex and the increased amount of fiber tissue in the lamina propria No signs of inflammation were found.Ground section of bone with implant indicated the successful osseointegration between all implants and sinus floor.Conclusions: Penetration of dental implants into maxillary sinus did not compromise the healthy status of sinus membrane and did not damage osseointegration between implant and bone of sinus floor.Discussion:The results indicate that it is unnecessary to take out the implant that has accidentally penetrated into the maxillary sinus,but more clinical evidence is needed to support the presumption.更多还原