| Background and purposeThe dentition defect in the maxillary posterior region is a common oral disease,which seriously affects the normal exercise of oral function.Implant denture repair is mostly used to treat this disease in clinic,but the deficiency of residual bone height(RBH)limits their applications.Concentrated growth factor(CGF)is rich in a large amount of growth factor(GF)and high concentration of CD34+cells,which could improve the bone mass around the implant combined with bone substitute materials.Meantime,hydraulic maxillary sinus lifting has gradually gained the favor of clinicians in recent years due to its advantages of small surgical trauma and comfortable operation process.Currently,the operation of “combined CGF and Bio-Oss bone powder for CGF and Bio-Oss bone powder” is not widely used in clinical.This study is mainly to investigate the clinical effect of this operation with the dentition defect in the maxillary posterior region and RBH < 5 mm.MethodsAccording to the case selection criteria,the patients with dentition defects in the maxillary posterior region who were treated in the Dental Implant Department of Affiliated Hospital of Yangzhou University from September 2020 to December 2022 and would like to receive implant repair treatment were selected.Before the operation,the patients’ general health and oral specialty were evaluated in detail,the indications and contraindications of the operation were assured,and the operation plan was formulated based on the preoperative evaluation results and the patients’ treatment intention,while the operation plan was explained in detail for the patients,and their consent letters were signed.Preoperative preparations,such as preparation of CGF,were performed.After lifting the mucoperiosteal of the maxillary sinus with hydraulic method during the operation,the mixture of CGF and Bio-Oss bone powder was used as the bone graft material,which was transported to the raised area with the delivery instrument and implanted into the implant at the same time.The general and specialized examinations,clinical manifestations,and imaging results of patients before,immediately after,and 3,6,and 12 months after operation were record and collected,and their clinical effects were further evaluated.Specific evaluation indicators are as follows: whether there are biological or mechanical complications during and after operation;postoperative pain degree;implant retention rate;implant stability coefficient(ISQ)immediately and 3months after operation;soft tissue condition around the implant 12 months after operation,including the modified sulcus bleeding index(m SBI),the modified plaque index(m PLI),and the probing depth(PD);pre-implant RBH measured by imaging,the gray value of bone density around the implant,peri-Implant bone level(IBL),the new bone height(NBH),the marginal bone level(MBL)and the marginal bone resorption(MBR)at 3,6and 12 months after operation measured by imaging;and patients’ subjective satisfaction.SPSS26.0 software was used for descriptive statistical analysis in this study.ResultsThe clinical information of 12 patients and 25 implants was collected in this study.Among them,one patient with missing teeth underwent maxillary sinus mucoperiosteal perforation(SMP)during maxillary sinus lifting surgery,and then underwent maxillary sinus external lifting surgery;with missing teeth underwent maxillary sinus mucoperiosteal perforation(SMP)during maxillary sinus lifting surgery,and then underwent maxillary sinus external lifting surgery.The observation results of other implants are as follows:(1)Except for 3 patients with mild and moderate swelling of buccal facial soft tissue in the implant area and other routine postoperative reactions,all patients did not have symptoms such as acute maxillary sinusitis and benign paroxysmal positional vertigo(BPPV);(2)There were no mechanical complications such as loosening of prosthesis or abutment,screw breakage,etc.for 25 implants;(3)The patients were graded according to the degree of pain after surgery;among them,8 patients had a degree of pain of grade 1,and 4 patients had a degree of pain of grade 2;no patients felt severe or severe pain;(4)One year after the operation,the patients were followed up and found that the implants were in normal use with a retention rate of 100%;(5)The ISQ was 71.00 ± 5.22 immediately after implantation and changed to 75.17± 4.77 after three months of implantation;(6)The soft tissue condition around the implant showed that: the m PLI was 1.60 ±0.76;m SBI was 0.43 ± 0.26;PD(buccal median)was 2.40 ± 0.91 mm,PD(buccal median)was 2.64 ± 1.03 mm,PD(palatal median)was 2.56 ± 1.04 mm,PD(palatal median)was2.72 ± 1.02 mm,PD(buccal median)was 2.24 ± 0.66 mm,and PD(palatal median)was2.28 ± 0.67 mm;(7)The imaging measurement results showed that: the pre-operative RBH was 4.09± 0.75 mm;the HU values of pre-operative and post-operative follow-up were 161.00 ±134.76,602.28 ± 84.18,806.64 ± 103.22,939.48 ± 97.96;the PIL value immediately after operation was 4.76 ± 0.52 mm;the IBL of each follow-up was 9.45 ± 1.01 mm,9.20 ±1.03 mm and 9.00 ± 1.01 mm,respectively;the NBH of each follow-up was 5.36 ± 0.69 mm,5.11 ± 0.69 mm and 4.90 ± 0.67 mm,respectively;the CBR of each follow-up was0.30 ± 0.62 mm and 0.34 ± 0.39 mm,respectively;(8)The patients were invited to evaluate the treatment during the follow-up one year after the operation,and the results showed that the patient satisfaction rate was 100%.ConclusionThe results of this study showed that,when the RBH is less than 5 mm,all the operation results of “combined CGF and Bio-Oss bone powder for hydraulic maxillary sinus lifting and simultaneous implantation” were ranged in the range of normal parameters with an excellent level.This result provides a new way to solve similar cases in clinical practice: in the treatment case of patients who suffer a defect of maxillary posterior dentition with RBH < 5 mm and need to be repaired with implant dentures,the above operation methods could be selected,which not only achieves the purpose of safe and effective operation with the comfort of patients,but also ensures the excellence of clinical and imaging observation indicators after operation. |
PDF Full Text Request