| The emergence of dental implant restoration has provided new ideas and new methods for missing teeth for the majority of patients.It does not damage the healthy teeth and the unique advantages of fixation and chewing function make it occupy an important position in the repair of the defect of dentition and the loss of dentition.As implant dentures become more and more popular among patients,the number of patients who choose dental implant repair is increasing.For example,the patients with severe atrophy of the alveolar bone in the maxillary posterior teeth area.However,such patients often give up implant restoration because of the lack of residual alveolar bone,the complexity and risk of operation and the rejection of sinus floor lifting by fenestration,and choose movable denture or fixed bridge to repair.But from the aspect of masticatory function and tooth preservation,the latter is not the best way to repair it.In order to solve this problem,clinicians began to try the maxillary sinus floor lifting through the alveolarcrest approach,simultaneous bone graft and implant surgery.Later,according to the patient’s condition,the crown restoration method with adhesive retention or screw fixation was selected.This method is easy to operate,the operation trauma and postoperative reaction are small,the cost is low and patients are easy to accept.However,due to the high technology sensitivity and the limitation of traditional indications,the use of this method is not extensive,whether the long-term repair effect is stable,whether there is difference between the different repair modes,and so on.These problems still lack long-term follow-up study.The aim of this study is to explore the long-term repair effect and the effect of different repair methods of patients with severe alveolar bone atrophy and were treated with osteotome sinus floor elevation by 3 years of follow up.Objective:To explore whether the long-term effect of patients with maxillary posterior region severe alveolar bone atrophy,1.7<RBH≤5mm and were treated with osteotome sinus,bone graft and implant is stable,and whether there is a difference between different crowns prostheses.Methods:The patients with dentition defect in the maxillary posterior teeth area were collected,1.7<RBH≤5mm,from January 2015 to March 2017 at the department of Oral Implants.The osteotome sinus floor elevation,graft and implant were performed by the same surgeon,and the repair was completed.The repair method is divided into Wieland adhesive retainer full porcelain crown and polymerized porcelain screw solid crown.The imaging data of patients at different times were collected and analyzed,and the indexes of soft tissue index and patient satisfaction score at the time of revisit were studied to study the long-term repair effect of this type of patient and to compare the difference between the effects of different repair methods.Results:A total of 69 implants were implanted in 53 patients.30,27 and 20 were followed up for 1,2 and 3 years respectively(some implants were followed consecutively).During the follow-up,implant cumulative survival rate was 100% and the crown loosening rate was5.8%.In 1 years,2 years and 3 years,the medial marginal bone loss was 0.91±0.88 mm,0.86±0.99 mm,1.00±1.11 mm respectively,and the distal marginal bone loss was0.25±0.86 mm,0.78±1.00 mm,0.96±0.81 mm respectively,and the bone resorption of apical bone was 0.41±1.19 mm,0.55±1.00 mm,0.55±0.83 mm respectively.There were statistically significant differences in bone absorption between the medial and distal margin of the 1 years.The soft tissue index of the patients with follow-up,PD was3.19±0.91 mm,mPLI was 1.04±0.79,mSBI was 0.48 + 0.61,The index of gingival papilla was 1.01 + 0.68 and the VAS score was 7.57±0.93.The main factors that affect the score is food impaction and crown loosening / off.Comparison of the screw-retained group and cement-retained group,in addition to the probing depth of distal lingual sites cement-retained group(2.59±0.79)is larger than the screw-retained group(2.20±0.81),the difference was statistically significant,the differences of other indexes were not statistically significant.Conclusion:For patients with severe alveolar bone atrophy and 1.7<RBH≤5mm,it is stable and reliable to use the osteotome sinus floor elevation.the long-term repair effect is good after the load,and there is no significant difference between the screw fixation and the adhesion fixation when the suitable repair method is chosen.In summary,for patients with severe alveolar bone atrophy,use the osteotome sinus floor elevation with simultaneous bone graft and implant is safe and reliable by observing the implant marginal bone absorption,bone resorption of root,implant surrounding soft tissue index and patient satisfaction after the load.When the suitable repair method is selected,both the screw fixation and the cement fixation can achieve good repair effect,and there is no statistical difference between them. |
