| Summary: | 碩士 === 高雄醫學大學 === 口腔衛生學系碩士在職專班 === 102 === Background
One-stage osteotome sinus floor elevation has several advantages over
the lateral window approach, which include reduction of operation time,
trauma, and postoperative morbidity. With the convenience of using
dental cone beam computed tomography, three- dimensional radiographs
provided quantitative information on maxillary sinus anatomy before
surgery. According to the evolution of the surgical technique, some
studies declare that the residual bone height less then 4 mm also has high
implant survival rate which was limitation at least 5 mm historically. In
bone graft material, there are few reports about how much graft shrinkage
in sinus cavity after crestal approach with different graft material.
However, gain of new bone could be detected at healing time of sinus
floor elevation without utilizing grafting material.
Purpose
The purpose of this study is to measure and compare the mean radiographic
graft shrinkage rate and radiographic new bone gain after one-stage osteotome
sinus floor elevation treatment at least 24 months loading period.
Materials and Methods
During the period of January, 2007 to December, 2012, total 71 patients at the
implant center of one hospital in southern Taiwan. 41 men and 30 women,
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mean age 55±12 years old. Total 91 Straumanns dental implants (Straumann,
Basel, Switzerland) were inserted using the one-stage osteotome sinus floor
elevation technique. For 15 patients or 16 implants, no grafting material was
utilized (G0). For 28 patients or 37 implants, bovine bone mineral (BBM) with
a particle size of 0.25mm- 1 mm was used as the grafting material. The
remaining 28 patients or 38 implants, received â-tricalcium phosphate (â-TCP)
(Cerasorb○R) grafting material. Panorexradiographs were obtained before
operation, implant installed and after prosthetic loading a period of at least 24
months. The radiographic endo-sinus new bone formation of three groups and
graft shrinkage rate of G1 and G2 were measured and compared. All statistical
analyses were performed with the SPSS version 12.0 (SPSS Inc., Chicago,
Illinois).
Results
After a period of at least 24 months, the overall implant survival rate is 100%.
In radiographic graft shrinkage rate was 34.1%±31.4% for G1(BBM) and
64.0%±27.2% for G2(â-TCP); The mean radiographic new bone gain was
2.08±1.76 mm, The implants placed with BBM grafting material elevated the
sinus demarcation significantly more than the implants placed without grafting
material, 3.09±1.80 mm(G1) vs. 0.71±1.02 mm(G0) , respectively. (P<
0.001); However, there was no significant difference between without grafting
and with â-TCP grafting material in radiographic new bone gain evaluation.
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Conclusion
In conclusion, the osteotome technique with bovine bone mineral will obtain a
substantial radiographic new bone image. In graft shrinkage rate, the â-TCP
grafting material was higher than BBM. For the â-TCP, the outcome of
the new bone gain is similar to the non-grafting implant. Howerver, the
Implant survival rate at least 24 months are all 100%.
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