| The emergence of maxillary sinus floor Elevation is good to solve the implant prosthesis problem of the lack of vertical bone mass maxillary when posterior teeth are lost, especially, because of the advantages of small surgical trauma, short treatment period, low treatment cost, Osteotome Sinus Floor Elevation(used in some literature as the Maxillary Sinus Lifting from the top of alveolar ridge. While there is no standard name, this article unified it using Osteotome Sinus Floor Elevation), is widely used in clinical. At the same time, it still has some limitations. Residual Bone height has been regarded as a method of Osteotome Sinus Floor Elevation for selecting the standard clinical indications. The references for choosing the clinical indications of Osteotome Sinus Floor Elevation: On the 4th consensus conference of ITI in 2008, it has became a standard that the residual bone height should be greater than 5 mm, suggesting that only when the residual bone height is greater than 5 mm, dentists can choose Osteotome Sinus Floor Elevation to increase vertical bone mass as an assistant method for implant prosthesis. Many clinical reports confirmed this is a safe and effective method, and it can obtain good long-term effects of implant prosthesis at the same time.In recent years, with the development of the planting technology, the progress of the implant surface treatment and the improvement of the plant equipment, many contraindications of the implant prosthesis had been broken. Implant prosthesis provides more and more patients who had missing teeth with great functional reconstructions. At the same time, while requiring the great functional reconstructions, patients ask for more and more minimally invasive wound, painless and economic interests in the process of treatment. Therefore, whether it is able to use Osteotome Sinus Floor Elevation to increase the vertical bone mass and complete the implant prosthesis when the residual bone height is less than or equal to 5 mm is an issue that is worthy to study. Under such premise, through the observation and analysis of the change of surrounding soft and hard tissue, as well as the stability coefficient of the implants, it can provide reference for clinical work. Part I: The Stability Study of Implants by Appling the Osteotome Sinus Floor Elevation When Residual Bone Height is Less Than 5 mmObjective: This study analysis the stability of using Osteotome Sinus Floor Elevation to implant when the residual bone height in posterior maxilla area is less than 5 mm, providing references in the use of Osteotome Sinus Floor Elevation in clinical treatment when the Alveolar Ridge in posterior maxilla area suffers severe atrophy.Methods: Separate the 65 patients who were treated by the same physician into two groups which received implantation and restoration by using Osteotome Sinus Floor Elevation during October 2013 to October 2014 in our department. The first group: patients with the residual bone height less than 5 mm, but larger than 2 mm. The second group: patients with residual bone height between 5—10 mm. Measure the Implant stability quotient of plants in the near, far, buccal, lingual both before the implant restoration modulus and after the implantation, then take the average record as the implant stability quotient, and make a comparison between these two groups to find if there is any difference in implant stability quotient both after the implantation and before restoration. Then, make an analysis on the differences of implants with different length and diameter in terms of stability.Results: The first group: implanted 30 implants(29 repaired), The second group: implanted 54 implants(all repaired), the survival rate of first group is 96.67%, while the second group was 100%. The residual bone height of first group is 3.89 + /- 0.72 mm, while the second group was 7.79 + /- 1.52 mm. The implant stability quotient of first group improved from 67.28 + /- 1.70 after implantation to 76.31 + /- 2.22 before the implant restoration, while the implant stability quotient of second group improved from 69.51 + /- 1.60 after implantation to 76.65 + /- 2.49 before the implant restoration. The implant stability quotient of implants with the length of 8 mm and 10 mm is 76.75 + /-2.71 and 2.71 + /- 2.37 before restoration, respectively. The implant stability quotient of implants with the Diameter of 4.1 mm and 4.8 mm is 76.62 + /- 2.39 and 2.39 + /- 2.40 before restoration, respectively.Conclusion: The stability of implants implanted can be expected within the period of this study, by using the method of Osteotome Sinus Floor Elevation when the residual bone height from the posterior teeth area is less than 5 mm, but larger than 2mm. Part II: The Retrospective Study of the Osteotome Sinus Floor Elevation When Residual Bone Height is Less Than 5 mm.Objective: This study is aiming to prove whether it is safe and reliable to use Osteotome Sinus Floor Elevation to implant when the residual bone height in posterior maxilla area is less than 5 mm, and with no tooth there.Methods: Collected data and information of the 34 patients who plant and repair the posterior maxilla area in our department by the same physician while their residual bone height of posterior teeth area is less than 5 mm, but larger than 2 mm by using Osteotome Sinus Floor Elevation from January, 2010 to July, 2014, as well as the imaging data and index of soft tissue implant weeks of that 34 patients who implanted implants of the same brand, and then do a retrospective study on these data. Take Measurements and analysis on the crest bone level、the apical bone height, as well as the soft tissue index at the time of postoperative and the follow-up visits.Results: 44 implants with an average length of follow-up visits in 24.8 + /- 11.5 months, while marginal bone loss was 1.43 + /- 0.76 mm, and apical bone height was 1.30 + /- 0.50 mm. The apical bone height was 1.18 + /- 0.49 mm during the follow-up visits, and it was reduced after the implants was implanted, while the difference has statistical significance. The index of 44 soft tissue mPLI was 1.43 + /- 0.76 during the follow-up visits. While mSBI was 1.25 + /- 0.81.Conclusion: The results are proved to be satisfactory to use Osteotome Sinus Floor Elevation to implant when the residual bone height in posterior maxilla area is less than 5 mm.To sum up, through the observation and analysis of the change of surrounding soft and hard tissue, as well as the stability coefficient of the implants, using the method of Osteotome Sinus Floor Elevation to increase the vertical bone mass and complete the implant prosthesis when the residual bone height is less than 5 mm, but larger than 2mm, and implant the implants to repair the missing teeth simultaneously, indeed, can be a safe and reliable method of denture restoration. |
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