상악동 골이식술을 동반한 임플란트 식립 시 골이식재의 높이 변화에 대한 방사선학적 평가

Abstract

The edentulous posterior maxilla generally provides a limited amount of bone height because of atrophy of the ridge and pneumatization of the maxillary sinus. Maxillary sinus augmentation is one of the surgical techniques for reconstruction of the severely resorbed posterior maxilla. The purpose of this study was to evaluate the survival rate of implants and the long-term changes of graft height after maxillary sinus augmentation by lateral window approach. From September 1996 to July 2004, maxillary sinus augmentation with mixed grafts of autograft, allograft, xenograft and alloplast were performed on 45 patients and 100 implants were placed. We evaluated the survival rate of implants and the changes of BL(bone length)/IL(implant length) according to time using panoramic radiographs. The survival rate of implants was 91.0% for follow-up period. The mean reduction of graft heights was 0.34mm(3.0%) for 6 months and 1.22mm(10.66%) for 3 years after augmentation. The total mean BL/IL was 1.34±0.21 during 5 year observation period after augmentation and decreased slightly over time. The result means that graft materials were stable above the implant apex. BL/ILs of 1 stage procedure were significantly decreased at 1-2 year, 3-4 year after augmentation and no statistically significant changes were observed in those of 2 stage procedure. The graft materials of both procedures were stable above the implant apex. No statistically significant changes of BL/IL were observed in the grafts combined with low amount of autogenous bone or without autogenous bone. The graft materials of both groups were stable above the implant apex. The results indicated that the placement of dental implants with maxillary sinus augmentation showed predictable clinical results and the grafts combined with low amount of autogenous bone or without autogenous bone had long-term resistance to resorption in maxillary sinus.