Abstract:

Due to dental caries and severe periodontal disease，alveolar ridge resorption in posterior maxillary area and maxillary sinus pneumatization are the most common problem，and it becomes a major challenge to inserting implants in this area. To gain efficient bone，numerous maxillary sinus floor elevation procedures are used to improve the success rate of dental implant. It is always a hot issue to explore a much simple，rapid and effective technique for maxillary sinus augmentation. The crestal approach is much preferable technique for posterior maxillary implant placement. It provides a more conservative and less invasive manner. Also，it reduces the duration of surgery and the incidence of intraoperative and postoperative complications. However，minor perforation of maxillary sinus membrane is the common complication and maxillary sinusitis occasionally occurs. Thus it is of great significance to explore a much safer and more reliable sinus lift technique. This article introduced the indications，contraindications，complications and its management，and the main clinical technical points of three minimally invasive crestal sinus lift approach according to the clinical data in Department of Oral Implantology，Peking University School and Hospital of Stomatology. It may provide the reference for the clinical usage of the crestal sinus lift techniques.

Key words: dental implants, posterior maxilla, maxillary sinus floor elevation, crestal approach

摘要：

因龋病、牙周病等原因导致的上颌后牙缺失通常伴有牙槽骨的缺失，而牙齿缺失后上颌窦腔的气化、扩大加重了牙槽骨的吸收，导致剩余骨量不足是上颌后牙区行种植修复遇到的主要难题。临床上可通过上颌窦底提升植骨增加骨量为提高种植修复成功率创造有利条件。简单、快速、有效的上颌窦提升植骨种植技术一直是临床上研究的热点。与经上颌窦外侧壁开窗入路植骨种植技术相比，经牙槽嵴顶入路上颌窦提升植骨种植技术具有创伤更小、手术时间缩短、并发症更少等优点，但存在着术中微小黏膜穿孔不易被发现的缺点，故寻找更安全可靠的技术也是临床上研究的重点之一。文章结合北京大学口腔医院种植科临床病例研究对临床上3种经牙槽嵴顶入路微创上颌窦底提升植骨种植技术的方法、技术要点、并发症及处理措施进行报告，为上颌后牙缺失患者的种植修复治疗提供参考。

关键词: 牙种植, 上颌后牙区, 上颌窦底提升, 牙槽嵴顶入路