改良式无侧窗多牙后上颌牙槽骨段骨折术用于分期种植的临床与影像学结果：一项前瞻性病例系列研究

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中文摘要

背景/目的： 本前瞻性病例系列研究评估了改良式无侧窗多牙后上颌牙槽骨段骨折术是否允许进行分期种植体植入。方法：在评估的53例患者中，排除8例，25例拒绝；连续纳入20例符合条件的同意参与的非吸烟者，并在26个位点进行治疗。在连续三颗牙拔除后，通过口侧椭圆形骨切开术将包含拔牙窝的单一骨块松动、向上移位并进行增量。在增量前、6个月时以及负载后1年时获取锥形束计算机断层扫描。结果：所有26个位点在6个月时均接受了两枚种植体；所有52枚种植体在1年负载期内均存活。平均估计移位为7.2 mm。平均承载种植体的矿化组织高度在6个月时为12.9 mm，在负载随访时为12.8 mm；个体配对测量值和离散度不可获得。疼痛持续4.7 ± 2.3天。10/20例患者发生小至中度血肿。26个位点未报告裂开或临床怀疑的膜穿孔；20例患者中未报告临床怀疑的鼻窦炎或再手术。结论：研究结果支持在选定患者中的可行性，而非比较有效性、已确认的膜完整性或个体维度稳定性。需要具有可重复影像学和更长随访的对照研究。

英文摘要

Background/Objectives: This prospective case series evaluated whether modified multi-tooth posterior maxillary alveolar segment infracture without a lateral window permitted staged implant placement. Methods: Of 53 patients assessed, 8 were excluded and 25 declined; 20 eligible consenting non-smokers were enrolled consecutively and treated at 26 sites. Following three adjacent extractions, a single bone block containing the extraction sockets was mobilized through an oral-side oval osteotomy, displaced superiorly, and augmented. Cone-beam computed tomography was obtained before augmentation, at 6 months, and 1 year after loading. Results: All 26 sites received two implants at 6 months; all 52 implants survived through 1 year of loading. Mean estimated displacement was 7.2 mm. Mean implant-bearing mineralized-tissue heights were 12.9 mm at 6 months and 12.8 mm at loaded follow-up; individual paired measurements and dispersion were unavailable. Pain lasted 4.7 ± 2.3 days. Small-to-moderate hematoma occurred in 10/20 patients. No dehiscence or clinically suspected membrane perforation was reported at 26 sites; no clinically suspected sinusitis or reoperation was reported in 20 patients. Conclusions: The findings support feasibility in selected patients, not comparative effectiveness, confirmed membrane integrity, or individual dimensional stability. Controlled studies with reproducible imaging and longer follow-up are required.