| Objective: In the maxillary posterior region,due to alveolar bone resorption and maxillary sinus gasification after tooth loss,the vertical bone height is often insufficient,which poses a great challenge for implantation in this region.Therefore,the purpose of this study is to take PRF membrane as the only graft material during maxillary sinus lifting by bone chisel method,explore its osteogenic effect through CBCT,and provide clinical basis for the future application of PRF membrane in maxillary sinus lifting.Methods: A total of 18 patients admitted to the Department of Implantology,Hospital of Stomatology Affiliated to College of Stomatology of Dalian Medical University from September 2020 to January 2023 were selected in this study.Among them,9 males and9 females,average age,were implanted with 26 implants.CBCT was followed up and photographed before surgery and 3,6,and 12 months after surgery.Specific measurement indicators were as follows: Postoperative response,implant cumulative survival rate(CSR),implant stability quotient(ISQ),residual bone height(RBH),implant protrusions length(IPL),new bone height(NBH),apicial bone height(ABH),marginal bone loss(MBL),bone densities around implants(BDAI),and sinus grafting remodeling index(SGRI),masticatory efficiency and patient satisfaction.SPSS 23.0software was used for statistical analysis.Results: According to the case inclusion and exclusion criteria of preoperative design,a total of 26 implants were included.No maxillary sinus mucosa perforation was observed during the operation,and no obvious discomfort was observed in all patients except 2 patients with obvious pain after surgery.The implant retention rate was 100%one year after surgery.The ISQ values immediately after surgery and 6 months after surgery were 60.63±2.27 and 72.39±3.59,respectively,and there was statistical significance between the two groups(p < 0.05).Preoperative and 3,6,12 months after the operation of CBCT,measured preoperative proximal and distal sites of residual bone height of 4.33±0.39 mm and4.36±0.39 mm,respectively,there was no difference between the proximal and distal sites(p > 0.05).The proximal and distal sites of implant protrusions length were4.51±0.99 mm and 4.21±0.90 mm,respectively,and there was no difference between the proximal and distal sites(p > 0.05).The apical bone height at return visit was-2.33±2.00 mm,-0.65±1.40 mm,1.64±1.03 mm,respectively,and there was statistical significance among the three groups(p < 0.05).The height of new bone at return visit was 2.73±1.70 mm,4.59±1.43 mm,5.28±1.43 mm,respectively.Distal: 2.61±1.71 mm,4.00±1.77 mm,4.50±1.59 mm,there was no difference between the proximal and distal sites at the same time,6 months and 12 months(p > 0.05),and there was statistical significance between the proximal and distal sites at 3 and 6 months and 3 and 12months(p < 0.05).The marginal bone loss at 6 and 12 months after surgery were mesial:-0.05±0.07 mm and 0.11±0.08 mm,respectively.Distal:-0.06±0.06 mm,0.14±0.05 mm,there was no difference between the proximal and distal sites at the same time(p > 0.05),and there was statistical significance between the proximal and distal sites at 6 and 12months(p < 0.05).Bone densities around implants were 109.53±81.70,347.24±135.42,448.43±147.17,519.94±147.55 before surgery and 3,6 and 12 months after surgery,according to CBCT.The sinus grafting remodeling index increased gradually with the time of return visit,and most patients were grade 3 at 12 months after surgery.The prosthesis and periodontal indexes were measured at 1 week and 6 months after repair,and the masticatory efficiency was 56.76±7.49 and 76.81±8.23,respectively,with statistical significance between the two groups(p < 0.05).The probing depth was2.38±0.65 mm and 3.01±0.72 mm,respectively,and there was statistical significance between the two groups(p < 0.05).The modified sulcus bleeding index increased with time,and only 2 implants had more peripheral bleeding at 6 months after repair.Conclusions: In this study,a total of 26 implants were implanted in patients with residual bone height ≤5mm,all of which were treated with maxillary sinus lifting by bone chisel method.PRF membrane was used as the sole graft material and implants were implanted at the same time.The mean height of new bone >4mm one year after surgery,which proved that PRF membrane as an graft material showed good osteogenic effect and obtained a high implant retention rate in a short term,which has guiding significance for its application in maxillary sinus lifting in the future. |
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