CN110236710A - A method of promote bone-grafting material to promote postoperative skeletonization outside Dental implantion maxillary sinus - Google Patents
A method of promote bone-grafting material to promote postoperative skeletonization outside Dental implantion maxillary sinus Download PDFInfo
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- CN110236710A CN110236710A CN201810198795.XA CN201810198795A CN110236710A CN 110236710 A CN110236710 A CN 110236710A CN 201810198795 A CN201810198795 A CN 201810198795A CN 110236710 A CN110236710 A CN 110236710A
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- bone
- maxillary sinus
- grafting material
- skeletonization
- dental implantion
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
- A61C19/00—Dental auxiliary appliances
- A61C19/06—Implements for therapeutic treatment
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
- A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
- A61C8/0089—Implanting tools or instruments
- A61C8/0092—Implanting tools or instruments for sinus lifting
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
- A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
- A61C8/0093—Features of implants not otherwise provided for
Abstract
The present invention relates to a kind of methods that promotion bone-grafting material promotes postoperative skeletonization outside Dental implantion maxillary sinus, belong to medical field.A method of promote bone-grafting material to promote postoperative skeletonization outside Dental implantion maxillary sinus, includes the following steps: S1, the carrier for making maxillary sinus be built into bone-grafting material is in hyperbaric oxygen equipment；S2, hyperbaric oxygen equipment are run by parameters described below: oxygen content 100%, oxygen supply time 2 hours, pressure value 2ATA, pressure rising time are 30 minutes, voltage stabling control is 60 minutes, dip time is 30 minutes；S3, the carrier for making maxillary sinus be built into bone-grafting material leave hyperbaric oxygen equipment；S4, every 20-30 hours to repeat step S1 primary to step S3, and repeatedly 30-60 times altogether.The beneficial effects of the invention are as follows being reduced to conventional maxillary sinus interplantation bone healing time 5-9 weeks from 8-9 months, the healing and functional rehabilitation convenient for patient's early stage alveolar bone implant bed.
Description
Technical field
The present invention relates to a kind of methods that promotion bone-grafting material promotes postoperative skeletonization outside Dental implantion maxillary sinus, belong to medical treatment
Field.
Background technique
Oral cavity implanting tooth technology has become the repair mode for gradually substituting traditional defect of dentition and dentition defect patient.Face
In bed, when patient's maxillary molar region missing tooth, due to secondary after the alveolar bone extraction at the presence of maxillary sinus, maxillary sinus sinus bottom
Jawbone bone remodeling and maxillary sinus itself such as gasify at the reasons, decline the bone height of upper jaw backteeth host site, in implantation ideal length
Planting body when may cause mucous membrane of maxillary sinus perforation, cause secondary infection to fail, this limits reasonable kind to a certain extent
The selection and clinical application of implant length.In order to be implanted into ideal length planting body and reach reasonable biomethanics requirement, often need
Patient's maxillary sinus sinus bottom mucous membrane is promoted to ideal height, this operation referred to as Maxillary Sinus.According to patient's upper jaw
Operation is divided into being promoted in maxillary sinus and perform the operation two kinds with outer promotion by the condition of sinus base bone.The latter is able to solve maxillary molar region
The common problem of the Bone mineral change of base bone obtains conventional use in clinic.
Outside maxillary sinus promoted surgical procedure in, by mucous membrane of maxillary sinus from sinus bottom removing after raise, Sinus floor and by
Autologous bone bone or bone substitute are placed between the mucous membrane of maxillary sinus lifted, with increase upper jaw rear portion crest of alveolar ridge to sinus bottom height
Degree, this is to solve the effective ways of maxilla back Bone mineral change, and successfully function for later period dental implant and provide guarantee,
Finally enable bone grafting that reliable Integrated implant occurs with planting body completely, supports the dummy on planting body top.Suitable bone moves
Plant material material and bone formation performance directly influence the clinical effectiveness of Dental implantion after maxillary sinus disease, therefore inquire into Sinus floor and mention
Rise the hot spot that ideal bone-grafting material in art is domestic and foreign scholars' Recent study.
Now it is believed that autologous bone transplanting is considered as the optimal selection of bone collection, but in order to avoid due to having drawn from
Autologous bone causes to be opened up the second art area inside and outside patient mouthful and secondary postoperative pain, swelling, infection and nerve numb etc. are postoperative
Complication, scholars are seeking that the graft materials of autologous bone can be substituted always.Homogeneous allogenic bone, bone- xenograft and all kinds of ceramic materials
Material, polymer are all successively used in maxillary sinus disease as bone substitute.Currently, promoting art formula outside the maxillary sinus of standard
It is the unique method that Bone mineral change is planted caused by solving the huge maxillary sinus of maxillary molar region in conjunction with Bio-Oss bone grafting.Bio-Oss
It is the derived bone by removing removing protein and other organic components, creeps bracket as osteoblast, the structure and human body of Bio-Oss
The structure of bone is almost the same, good biocompatibility, has the function of excellent bone guided.However, since Bio-Oss lacks self-bone grafting
Performance, it is 8-9 months that patient, which needs to wait the conventional knitting phase, could form reliable tooth-implanting alveolar bone bed, organize
It learns inspection result and shows that New born formation is good, and extend at any time, the structure of bone gradually forms and maturation, after this could
Weight bearing or the embedment for carrying out implant.Due to skeletonization overlong time, patient's tooth-implanting function under the conditions of this kind of jawbone is seriously limited
Early recovery, an urgent demand clinician pursues the biomaterial updated and method shortens the knitting phase, promotes healing effect
Fruit and ability.
Summary of the invention
The present invention is mainly to find to rapidly promote the effective of the skeletonization effect after Bio-Oss bone grafting is promoted outside maxillary sinus
Method, solves that current healing time is too long, the bottleneck problem of functional rehabilitation too long.
To achieve the above object, the invention adopts the following technical scheme:
A method of promote bone-grafting material to promote postoperative skeletonization outside Dental implantion maxillary sinus, includes the following steps:
S1, the carrier for making maxillary sinus be built into bone-grafting material are in hyperbaric oxygen equipment；
S2, hyperbaric oxygen equipment are run by parameters described below: oxygen content 100%, oxygen supply time 2 hours, pressure value 2ATA, boosting
Time is 30 minutes, voltage stabling control is 60 minutes, dip time is 30 minutes；
S3, the carrier for making maxillary sinus be built into bone-grafting material leave hyperbaric oxygen equipment；
S4, every 20-30 hours to repeat step S1 primary to step S3, and repeatedly 30-60 times altogether.
The step S4 further includes, and when repeating step S1 to step S3 and reaching 20 times, stops 100-140 hours, later
Start the repetitive process of a new wheel step S1 to step S3 again.
The step S4, it is primary to step S3 to repeat within preferably every 24 hours step S1, and repeatedly 30-54 times altogether.
The step S4 stops 120 hours, starts again later preferably when repeating step S1 to step S3 and reaching 20 times
The repetitive process of a new wheel step S1 to step S3.
The bone-grafting material is Bio-Oss.Bio-Oss bone meal is produced by Gai Shi pharmaceutical Co. Ltd, Switzerland, trade name
Geistlich Bio-
The carrier is mammal, including animal and people.The animal is mouse, rabbit, cat, dog, pig etc..
It is acted on outside maxillary sinus by hyperbaric oxygen chamber and promotes postoperative patient, by controlling the oxygen concentration and pressure in oxygen cabin,
By boosting, pressure stabilizing and dip time and speed control, and implement the opportunity of hyperbaric oxygen therapy and the frequency, invention rapidly promote
Bio-Oss bone grafting promoted outside maxillary sinus after skeletonization effect effective ways, it is too long to solve current healing time, patient's function
Restore bottleneck problem too long.
The early stage application of mesohigh oxygen of the present invention is equally applicable to be promoted in maxillary sinus bone grafting operation and oral cavity jaw defect
Relevant osteanagenesis healing operation, can equally promote the early stage of knitting to realize.Various growth factors and bone-grafting material are same
Time window suitable for hyperbaric oxygen effect.
Art is promoted outside traditional maxillary sinus, at least 8-9 months normal healing time is needed after Bio-Oss bone grafting.At present
Research confirms: increasing oxygen concentration, facilitates the survival of BMSC and its to osteoblast differentiation, osteoblast, osteoclastic can be enhanced
Cell, fibroblast and endothelial cell proliferation and division, accelerate granulation tissue and proliferation of fibrous tissue, and calcium can be accelerated
It absorbs, to accelerate the formation and maturation of sclerotin.In fracture early stage, the vessel retraction effect of hyperbaric oxygen can make local organization blood flow
Amount is reduced, and vasopermeability reduces, and oedema is eliminated.In addition, there are also accelerate fracture and soft tissue injury position blood capillary for hyperbaric oxygen
Pipe new life and the effect for promoting offshoot circulation to establish.Due to the increase that blood supply and oxygen are supplied, local nutrition supply is improved,
Poroma mushrooms out, to promote union.This method makes full use of admissible evidence of the hyperbaric oxygen on limb fracture, will be high
Pressure oxygen therapeutic method early stage, which is applied to outside the maxillary sinus of oral cavity, to be promoted in conjunction with after Bio-Oss bone grafting operation, on the one hand can be greatly reduced
Because the abundant postoperative swelling being easy to cause of facial area blood flow and wound dehiscence, on the other hand pass through hyperbaric oxygen therapy pressure and work
It with the control of time and the frequency, is confirmed by histomorphometric analysis, hyperbaric oxygen can reach different in early promotion maxillary sinus
The effect of allosome skeletonization is planted, the similarity of the healing status of skeletonization advanceed to 5-9 weeks from 8-9 months in histology.Convenient for patient
The healing of early stage alveolar bone implant bed and functional rehabilitation.Using hyperbaric oxygen auxiliary Bio-Oss for promoting skeletonization outside maxillary sinus
The research of effective acting time window is a blank in the world at present.
Compared with promoting skeletonization technology outside traditional maxillary sinus, the beneficial effects of the invention are as follows make bone grafting in conventional maxillary sinus
Healing time was reduced to 5-9 weeks from 8-9 months, the healing and functional rehabilitation convenient for patient's early stage alveolar bone implant bed.
The present invention will be further described with reference to the accompanying drawings and detailed description, not limitation of the invention, all
This field equivalent replacement carried out according to the disclosure of invention, all belongs to the scope of protection of the present invention.
Detailed description of the invention
Fig. 1 is to be promoted and Bio-Oss bone grafting operation outside maxillary sinus
Fig. 2A and Fig. 2 B is tissue block sample taking-up after hyperbaric oxygen therapy
Fig. 3 is planting body implantation
Fig. 4 is BMP-2 (bone morphogenesis protein-2) positive expression in connective tissue
Fig. 5 is VEGF (vascular endothelial growth factor) positive expression in connective tissue
Fig. 6 is the positive expression of Runx2 (Runt associated transcription factor 2)
Fig. 7 is Osteocalcin (osteocalcin) positive expression inside freshman bone tissue
Specific embodiment
Embodiment 1
One, subjects
There are maxillary molar region missing tooth situations by patient in the present embodiment.Due to the presence of the maxillary sinus in maxilla,
The edentulous region needs to open a window (Fig. 1) in the lateral wall bone wall of maxillary sinus since the preparation alveolar bone bed of tooth-implanting is not high enough, will
The implantation of Bio-OSS bone meal, bone window are covered with Bio-Guide.It is divided into blank group, experimental group and control group.
Experimental group: T1 group (subgroup of 6 weeks nodes), postoperative progress hyperbaric oxygentherapy in 6 weeks
T2 group (subgroup of 9 weeks nodes), postoperative progress hyperbaric oxygentherapy in 9 weeks
T3 group (subgroup of 5 weeks nodes), postoperative progress hyperbaric oxygentherapy in 5 weeks
Control group: the postoperative patient healed spontaneously using traditional approach
Two, test method
1. promoting operation outside maxillary sinus: anesthesia is immersed in dark blue fiber crops part in art area, is lacked using 15C knife blade in upper jaw backteeth
The inclined palate lateral incision of tooth area crest of alveolar ridge, go directly periosteum.Notch near and far adjacent teeth gingival sulcus, quantity and the upper jaw according to missing tooth
Promote the size of windowing outside sinus, one tooth position of near and far each extensions, closely in do vertical incision and cross mucogingival junction；It is free-end in remote
When, the short vertical incision in cheek side is done, trapezoidal full thickness flap opens the outer side seam wall of exposed maxillary sinus.According to preoperative CBCT (dentistry cone art
CT), the windowing of bone wall is carried out using piezosurgery osteotomy.Windowing lower bound horizontal line notch is located on maxillary sinus base bone at 2-3 millimeters,
Add the principle of 2mm as bone wall windowing upper bound horizontal direction notch according to the length of maxillary sinus base bone height and planting body, it is close remote
Middle windowing osteotomy line is determined according to bone grafting range.Exposure mucous membrane of maxillary sinus, periosteum stripping is careful carry out sinus bottom mucous membrane upwards to
Interior removing, the filling of Bio-OSS little particle bone meal, the outer Bio-Guide periosteum covering bone wall windowing of hole wall, mucoperiosteum full thickness flap without
Tension apposition suture.
2. promoting postoperative conventional doctor's advice outside maxillary sinus: oral non-steroidal anti-inflammatory drugs after one week, 24 hours acetic acid chlorhexidine contain
It gargles, local cold compress 48 hours；It avoids swimming, blow one's nose and catching a cold；It takes a good rest.
3. Hyperbaric Oxygen for Treatment
It is promoted postoperative 24 hours outside maxillary sinus, starts to carry out conventional hyperbaric oxygentherapy.Patient enter before hyperbaric oxygen chamber by
The contraindication of doctor's exclusion hyperbaric oxygentherapy.Oxygen cabin technical parameter is provided that 100% oxygen under pressure 2ATA, before treatment
It boosts within 30 minutes, latter 30 minutes of pressure maintaining (pressure stabilizing) 60 minutes, treatment are depressured, and amount to hyperbaric oxygen (HBO) effect in 120 minutes, often
Its (24 hours) once, 10 days as a treatment course.
The subgroup (T3 group) of (1) 5 week node, HBO continue two course of therapy totally 20 days, stop 5 days, then carry out 10 days height
Pressure oxygen therapy terminates；
The subgroup (T1 group) of (2) 6 weeks nodes: HBO continues two courses for the treatment of 20 days, stops 5 days, then continues HBO treatment in 17 days
Stop；
The subgroup (T2 group) of (3) 9 weeks nodes: HBO continues two courses for the treatment of 20 days, stops 5 days, then persistently HBO is treated 20 days,
Stop 5 days, then continues 14 days.
Three, experimental result
Patient in the present embodiment is maxillary molar region missing tooth situation.It, should due to the presence of the maxillary sinus in maxilla
Edentulous region needs to open a window (Fig. 1) in the lateral wall bone wall of maxillary sinus, by Bio- since the preparation alveolar bone bed of tooth-implanting is not high enough
The implantation of OSS bone meal, bone window are covered with Bio-Guide, and after waiting bone normal healing 8-9 months, planting body implantation weight bearing carries out function
(Fig. 3) can be repaired.Fig. 2A and Fig. 2 B be hyperbaric oxygen therapy after, while producing bone specimen tissue block, carry out the preparation of implant bed.
After experiment, treatment site takes the detection of sample bone progress morphology and biochemical indicator, as a result extremely such as Fig. 4
Shown in Fig. 7.
Fig. 4 is positive expression figure in BMP-2 200-fold connective tissue.Fig. 4 A is Ctl six weeks, 48y；Fig. 4 B is
Treated1 (T1 group) six weeks, 72y；Fig. 4 C be Treated2 (T2 group), nine weeks, 62y；Fig. 4 D is Treated3 (T3 group) five
Week, 32y；Fig. 4 E is Traditional (control group) 13Mons, 60y；Fig. 4 F is each group BMP2 value.
Fig. 5 is positive region in VEGF100X connective tissue.Fig. 5 A is Ctl six weeks, 48y；Fig. 5 B is Treated1 (T1
Group) six weeks, 72y；Fig. 5 C be Treated2 (T2 group), nine weeks, 62y；Fig. 5 D is Treated3 (T3 group) five weeks, 32y；Fig. 5 E is
Traditional (control group) 13Mons, 60y；Fig. 5 F is each group VEGF value.
Fig. 6 is Runx2 200X figure, and more some more in nucleus, positive region is the cell that brown is dyed in figure.Fig. 6 A
It is Ctl six weeks, 48y；Fig. 6 B is Treated1 (T1 group) six weeks, 72y；Fig. 6 C be Treated2 (T2 group), nine weeks, 62y；Fig. 6 D
It is Treated3 (T3 group) five weeks, 32y；Fig. 6 E is Traditional (control group) 13Mons, 60y；Fig. 6 F is each group Runx2
Value.
Fig. 6 is positive expression figure inside Osteocalcin 100X freshman bone tissue.Fig. 7 A is Ctl six weeks, 48y；Fig. 7 B
It is Treated1 (T1 group) six weeks, 72y；Fig. 7 C be Treated2 (T2 group), nine weeks, 62y；Fig. 7 D is Treated3 (T3 group) five
Week, 32y；Fig. 7 E is Traditional (control group) 13Mons, 60y；Fig. 7 F is each group Osteocalcin value.
Go out as the result is shown, according to the difference of patient age and individual metabolism, is promoted after bone grafting 24 hours outside maxillary sinus, early stage
Hyperbaric oxygen, which acts on 5-9 weeks this time window, to be had the function of significantly promoting knitting.Convenient for the early stage of tooth-implanting alveolar bone bed
Healing.
Embodiment 2
A method of promote bone-grafting material to promote postoperative skeletonization outside Dental implantion maxillary sinus, includes the following steps:
S1, the carrier for making maxillary sinus be built into bone-grafting material Bio-Oss are in hyperbaric oxygen equipment；
S2, hyperbaric oxygen equipment are run by parameters described below: oxygen content 100%, oxygen supply time 2 hours, pressure value 2ATA, boosting
Time is 30 minutes, voltage stabling control is 60 minutes, dip time is 30 minutes；
S3, the carrier for making maxillary sinus be built into bone-grafting material leave hyperbaric oxygen equipment；
S4, it is primary to step S3 to repeat within every 24 hours step S1, repeatedly stops 120 hours after 30 times, the 20th time altogether, later
Start the repetitive process of a new wheel step S1 to step S3 again.
The carrier is behaved.
Embodiment 3
A method of promote bone-grafting material to promote postoperative skeletonization outside Dental implantion maxillary sinus, includes the following steps:
S1, the carrier for making maxillary sinus be built into bone-grafting material Bio-Oss are in hyperbaric oxygen equipment；
S2, hyperbaric oxygen equipment are run by parameters described below: oxygen content 100%, oxygen supply time 2 hours, pressure value 2ATA, boosting
Time is 30 minutes, voltage stabling control is 60 minutes, dip time is 30 minutes；
S3, the carrier for making maxillary sinus be built into bone-grafting material leave hyperbaric oxygen equipment；
S4, it is primary to step S3 to repeat within every 24 hours step S1, altogether repeatedly 54 times: first stop 120 hours after 20 times,
Process 20 times of step S1 to step S3 are repeated later, then are stopped 120 hours, repeat the mistake of step S1 to step S3 later
Journey 14 times.
The carrier is behaved.
Embodiment 4
A method of promote bone-grafting material to promote postoperative skeletonization outside Dental implantion maxillary sinus, includes the following steps:
S1, the carrier for making maxillary sinus be built into bone-grafting material Bio-Oss are in hyperbaric oxygen equipment；
S2, hyperbaric oxygen equipment are run by parameters described below: oxygen content 100%, oxygen supply time 2 hours, pressure value 2ATA, boosting
Time is 30 minutes, voltage stabling control is 60 minutes, dip time is 30 minutes；
S3, the carrier for making maxillary sinus be built into bone-grafting material leave hyperbaric oxygen equipment；
S4, it is primary to step S3 to repeat within every 24 hours step S1, repeatedly 37 times altogether, stops 120 hours after being repeated 20 times, it
Start the repetitive process of new wheel step S1 to step S3 again afterwards, totally 17 times.
The carrier is behaved.
Claims (8)
1. a kind of method for promoting bone-grafting material to promote postoperative skeletonization outside Dental implantion maxillary sinus, it is characterised in that: including following
Step:
S1, the carrier for making maxillary sinus be built into bone-grafting material are in hyperbaric oxygen equipment；
S2, hyperbaric oxygen equipment are run by parameters described below: oxygen content 100%, oxygen supply time 2 hours, pressure value 2ATA, pressure rising time
For 30 minutes, voltage stabling control be 60 minutes, dip time is 30 minutes；
S3, the carrier for making maxillary sinus be built into bone-grafting material leave hyperbaric oxygen equipment；
S4, every 20-30 hours to repeat step S1 primary to step S3, and repeatedly 30-60 times altogether.
2. a kind of method for promoting bone-grafting material to promote postoperative skeletonization outside Dental implantion maxillary sinus according to claim 1,
It is characterized by: the step S4 further includes, when repeating step S1 to step S3 and reaching 20 times, stop 100-140 hours, it
Start the repetitive process of a new wheel step S1 to step S3 again afterwards.
3. a kind of method for promoting bone-grafting material to promote postoperative skeletonization outside Dental implantion maxillary sinus according to claim 1,
It is characterized by: the step S4, it is primary to step S3 to repeat within every 24 hours step S1, repeatedly 30-54 times altogether.
4. promoting art outside Dental implantion maxillary sinus to a kind of promotion bone-grafting material described in any one of 3 according to claim 1
The method of skeletonization afterwards, it is characterised in that: the step S4 stops 120 preferably when repeating step S1 to step S3 and reaching 20 times
Hour, start the repetitive process of a new wheel step S1 to step S3 again later.
5. promoting art outside Dental implantion maxillary sinus to a kind of promotion bone-grafting material described in any one of 3 according to claim 1
The method of skeletonization afterwards, it is characterised in that: the bone-grafting material is Bio-0ss.
6. promoting art outside Dental implantion maxillary sinus to a kind of promotion bone-grafting material described in any one of 3 according to claim 1
The method of skeletonization afterwards, it is characterised in that: the carrier is mammal.
7. a kind of method for promoting bone-grafting material to promote postoperative skeletonization outside Dental implantion maxillary sinus according to claim 6,
It is characterized by: the mammal is behaved.
8. a kind of method for promoting bone-grafting material to promote postoperative skeletonization outside Dental implantion maxillary sinus according to claim 6,
It is characterized by: the mammal is people mouse, rabbit, cat, dog or pig.
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Cited By (1)
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| US20210154015A1 (en) * | 2019-11-27 | 2021-05-27 | Igor Roshkovan | Surgical Technique for alveolar ridge augmentation with maxillary sinus elevation (lateral approach) using a pre-portioned and ready pre-packaged graft composition in gelatin bag and method of producing it |
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