| Objective:With the development of technology and materials,implant denture has become the first choice in the treatment of dentition defect.The implant surgery of maxillary first molar was often affected for the bone mass.Absorption of alveolar bone and gasification of maxillary sinus along with missing teeth lead to the reduction of the position of the bottom of maxillary sinus in varying degrees,which results in impossibility for regular implant surgery due to the reduction of residual bone height,so maxillary sinus lifting is often required.Based on the measurement of the residual bone height of maxillary first molar and the statistical analysis,this research is intended to study the selection of implant surgery of the maxillary first molar under different residual bone height(RBH)and compare the RBH for two kinds of maxillary sinus elevations for clinical reference.Methods:The CBCT imaging data and clinical data of 57 patients undergoing maxillary first molar implantation from June 2017 to June 2018 in the Implant Dentistry Department of Tianjin Medical University Hospital of Stomatology were selected.Images were analyzed by Ka Vo e Xam Vision software for measuring residual bone height before implantation,comparing the bone height between different genders and different surgical methods.Statistical analysis was performed by SPSS Statistics 24.0.Results:1.In 57 cases of maxillary first molar implant surgeries,27 cases(47.37%)were treated with regular dental implantation and the mean RBH was 12.43±3.13 mm.There were 28 cases(49.12%)and 2 cases(3.51%)in transcrestal and lateral window sinus elevation,and the mean RBH was 6.46±1.60 mm and 3.13±0.18 mm.Rank-sum test was applied to the mean RBH of the three groups in pairs and among them showed that the four different P values were all smaller than 0.05,and the difference was statistically significant respectively.2.In this study,there were 33 male cases(57.89%)and 24 female cases(42.11%)with a mean RBH of 8.75±4.11 mm and 9.48±3.92 mm,respectively.P value was larger than 0.05 by rank-sum test,and the difference was not statistically significant.3.In this study,there were 28 cases of transcrestal sinus elevation,with an average elevation of bone height of 3.0±1.28 mm.Among them,13 cases were treated with an abutment and 15 cases were treated with a cover screw,tightly sutured.For the two cases of lateral sinus elevation,the bone height was elevated 7.5±2.12 mm on average,and the surgery areas were tightly sutured after implanting cover screws.4.There were two cases of lateral sinus elevation surgery with RBH of 3mm and3.25 mm respectively.After implating bone substitute materials,the implants with a length of 10 mm and a torque of 15N·cm were implanted simultaneously in the two cases and both of them had good initial stability.5.A total of 57 surgeries were selected in this study,including 27 regular surgeries and 28 transcrestal sinus lift surgeries,with an average implantation torque of 29.63±8.31N·cm and 25.71±9.79 N·cm.The implantation torque was 15 N·cm in two cases of lateral sinus elevation surgeries.Conclusions:1.The selection of method for implant surgery of maxillary first molar area is mainly based on the size of residual bone height(RBH).30 out of 57 cases in this study undergo maxillary sinus elevation.Statistically,the mean and minimal RBH of regular dental implantation,transcrestal and lateral sinus elevation are 12.43±3.13 mm,6.46±1.60 mm,3.13±0.18 mm and 8.50 mm,3.50 mm and 3.00 mm.There’re significant differences among three types of surgeries as well as the pair study of them.2.The RBH of maxillary first molar showed no significant difference in genders.3.In the selection of implantation in maxillary first molar region,sufficient width of residual bone and the RBH should be considered in the first place,combined with jaw bone density and the length and diameter of the implant and varies factors to make a surgical design comprehensively so as to obtain the best initial stability and prosthetic effect. |
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