| Objective: To repair the patients with insufficient implant height in the posterior maxillary sinus area by improved maxillary sinus floor elevation.To observe the short-term osteogenesis effect in maxillary sinus through CBCT image data,in order to provide a comfortable,economical and effective improved operation for the patients with insufficient implant height in the posterior maxillary sinus.Methods: The subjects were implant patients who visited the Department of Stomatology of Hefei Second People’s Hospital from January 2021 to December 2022.It is required that the maxillary posterior teeth are missing and the bone height is not enough for direct implant repair,and the maxillary sinus floor should be lifted and then implanted at the same time.Sixteen patients were included in this study according to the inclusion conditions,including 10 males and 6 females,with a total of 22 implants.All implants are Korean Mega Gen implants,with a diameter of 4.3 mm and a length of 9.0mm.The surgical methods used were improved maxillary sinus lifting,disc drilling combined with hydraulic pressure to lift the mucosa at the bottom of maxillary sinus,and then some small piece of absorbable collagen sponge was implanted in the maxillary sinus lifting space instead of bone graft material,and the implant was implanted at the same time.The basic data of patients were collected before operation,including age,sex and implantation site.After operation,the patients’ mucosal perforation,pain score and infection were recorded.Record whether the implant remained six months after operation.Using CBCT images taken before operation,immediately after implantation and six months after operation,the relevant data were measured,including the Residual Alveolar Bone Height,Alveolar Crest Tip Width,Implant Protrusion Length and Endo-Sinus Bone Gain.The data obtained were statistically analyzed and the conclusion was drawn.All the data were statistically analyzed by SPSS 22.0 software,and the description of metrological variables was expressed by mean standard deviation.The multiple linear regression equation was established for the influencing factors(residual alveolar bone height,alveolar crest tip width,implant protrusion length)that may affect the osteogenesis effect in sinus.Pearson test is used to test the correlation between the two variables,and t test is used to compare the two groups of variables;When P < 0.05,the result was considered statistically significant.Results: 1.No perforation of maxillary sinus mucosa occurred in all patients during the operation,and the perforation rate was 0%.The postoperative reaction was mild,and the average postoperative pain score was 3.63 ± 0.62.No maxillary sinus inflammation or other infections occurred.Six months after operation,the implant bone was well combined and loaded,and the survival rate of the implant was 100% in a short time.2.The ACTW of all implant sites is 7.32 mm,the widest is 10.85 mm,and the average width is 9.27±0.86 mm;The RBH is 4.28 mm,the maximum is 6.11 mm,and the average height is 4.86±0.46 mm;The shortest IPL is 3.43 mm,the longest IPL is4.81 mm,and the average height is 4.24±0.40 mm.The shortest ESBG1 is 5.98 mm and8.07 mm at the highest,with an average elevation of 7.24±0.61 mm.Six months later,CBCT image data measured that the elevation of maxillary sinus ESBG2 is the lowest4.26 mm and the highest 7.38 mm,with an average elevation of 5.22±0.79 mm.3.Independent sample T-test was used to verify the influence of different groups on the final osteogenic height in sinus.The results showed that the bone height of female group was higher than that of male group,and the result was significant(P<0.05),but different implantation sites and different ages had no effect on the final osteogenic height in sinus(P> 0.05).Pearson correlation test showed that the residual bone height and residual alveolar ridge width were not related to the final osteogenic height in sinus.The multiple linear regression equation was established for the factors that may affect the final osteogenic effect in the sinus.The results showed that the height of residual alveolar ridge and the height of implant protruding into the sinus had influence on the osteogenic height in the sinus(P< 0.05),and they were positively correlated(B> 0).Conclusion: In this study,maxillary sinus lifting was performed by disc drilling combined with hydraulic pressure.Without any osteogenic materials,only collagen sponge was implanted into the space obtained after maxillary sinus lifting.The improved operation itself has good maneuverability,which can effectively avoid maxillary sinus mucosal perforation and reduce complications.In a short period of time,a good osteogenic height in sinus and osseointegration of implant were obtained,and the final repair effect was good.The improved operation can expand the indications of implant surgery for patients with insufficient bone height in edentulous maxillary posterior teeth area,reduce the implant cost of patients and obtain a good implant experience.It is an economical,safe and effective method,which is worth popularizing and implementing in clinic. |
