国际口腔医学杂志

国际口腔医学杂志 ›› 2026, Vol. 53 ›› Issue (2): 166-175.doi: 10.7518/gjkq.2026014

• 专家笔谈 • 上一篇    下一篇

牙保存相关上颌窦底提升术的局部风险因素分析

宋东哲1(),满毅2,黄定明1()   

  1. 1.口腔疾病防治全国重点实验室 国家口腔医学中心 口腔疾病国家临床医学研究中心 四川大学华西口腔医院牙体牙髓病科 成都 610041
    2.口腔疾病防治全国重点实验室 国家口腔医学中心 口腔疾病国家临床医学研究中心 四川大学华西口腔医院种植科 成都 610041
  • 收稿日期:2025-02-12 修回日期:2025-06-05 出版日期:2026-03-01 发布日期:2026-02-13
  • 通讯作者: 黄定明
  • 作者简介:宋东哲，口腔医学博士，四川大学华西口腔医院牙体牙髓病科副主任医师。四川省口腔医学会牙体牙髓病学专业委员会委员，四川省“卫生健康英才计划”中青年骨干人才，美国芝加哥大学医学中心访问学者。主要研究牙髓根尖周疾病诊疗新技术和牙髓损伤修复调控机制。主持国家及省部级科研项目4项，发表国际国内学术论文20余篇，获国家发明专利授权6项，担任《口腔种植规范化治疗清单——种植遇到邻牙根尖周病多学科联合治疗》副主编，参编《The Sinus Bone Graft》（Third Edition）、《牙体牙髓科诊疗与操作常规》等专著，获四川省科技进步一等奖1项。
    宋东哲，副主任医师，博士，Email：dongzhesong@scu.edu.cn|满毅，教授，四川大学华西口腔医院种植科主任，博士研究生导师。中华口腔医学会种植专业委员会侯任主任委员，口腔数字化产业分会侯任会长，国际种植学会（International Team for Implantology）中国分会候任主席，国际骨再生基金（Osteology Foundation）中国区执行委员会（NOG China）会长，四川省口腔种植专业委员会第3届和第4届主任委员。2007年毕业于四川大学华西口腔医学院，获博士学位。2010—2012年被美国Tufts大学牙学院聘为临床讲师，2011—2012年为美国哈佛大学访问学者。主要研究改良多种种植外科和修复技术，相关成果发表在国际种植学、外科学和修复学期刊上。主编和共同主编专著9部，获得11项国家发明专利，并实现转化。多次受邀在国际、国内会议上发表演讲，发表临床论文和科研论文70余篇，主持多项国际、国家、省部级课题。|黄定明，口腔医学博士，四川大学华西口腔医院教授，主任医师，博士研究生导师。国家口腔医学中心牙体牙髓专科联盟首届主任委员，中华口腔医学会牙体牙髓专业委员会常务委员，老年口腔医学专业委员会常务委员，四川省口腔医学会牙体牙髓专业委员会主任委员。《国际口腔医学杂志》常务编委、《北京口腔医学》编委、《Molecular Oral Microbiology》副主编、《International Endodontic Journal》编委。一直从事牙体牙髓根尖周病病因及现代诊治技术研究、教学和临床工作，利用现代理论知识和技术创新诊疗方法解决临床疑难问题。主持国家级、省部级科研项目10项，主编《口腔种植规范化治疗清单——种植遇到邻牙根尖周病多学科联合治疗》，参编国家规划本科教材《牙体牙髓病学》（第4、5版）和研究生教材《牙髓病学》（第1版），以及《实用牙体牙髓病治疗学》《牙体牙髓科诊疗与操作规范》等专著10部，在国内外本领域知名期刊发表牙体牙髓病诊治相关论文100余篇，获得国家科技进步二等奖1项、省部级科技进步一等奖3 项、中华医学科技三等奖1项。
  • 基金资助:
    成都市科学技术局技术创新研发项目(2024-YF05-00565-SN);成都市科学技术局技术创新研发项目(2024-YF05-02478-SN);四川大学华西口腔医院临床研究项目(LCYJ-MS-202304)

Local risk factor analysis of natural tooth-related maxillary sinus floor elevation

Dongzhe Song1(),Yi Man2,Dingming Huang1()   

  1. 1.State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Dept. of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
    2.State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Dept. of Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
  • Received:2025-02-12 Revised:2025-06-05 Online:2026-03-01 Published:2026-02-13
  • Contact: Dingming Huang
  • Supported by:
    Technological Innovation and Development Project Granted by Chengdu Science and Technology Bureau(2024-YF05-00565-SN);Clinical Research Program of West China Hospital of Stomatology, Si-chuan University(LCYJ-MS-202304)

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摘要：

牙保存相关上颌窦底提升术是在控制根管感染、治愈病变的基础上，以最大程度保存天然牙为目标的重要治疗技术。该术式以上颌牙-牙槽骨-上颌窦复合体为解剖基础，其成功实施依赖于对局部多重风险因素的系统评估。本文围绕患牙状态（如牙根位置及长度）、牙槽骨条件（如骨高度、腭大神经血管束）、上颌窦解剖特征（如窦底形态、黏膜厚度）以及牙根与上颌窦的位置关系等方面，系统分析可能影响手术安全性与疗效的局部风险因素，旨在为临床术前评估与方案制定提供依据，从而提升治疗的可预测性与长期成功率。

关键词: 上颌牙-牙槽骨-上颌窦复合体, 牙保存相关上颌窦底提升术, 风险因素

Abstract:

Natural tooth-related maxillary sinus floor elevation has emerged as an effective approach for maintaining natural teeth after the adequate control of endodontic infection and resolution of periapical disease. The procedure is performed within the anatomical context of the maxillary tooth-bone-sinus complex, and its success is largely determined by careful consideration of multiple local anatomical and biological factors. This article addresses tooth-related factors (such as root length and spatial position), alveolar bone conditions (including residual bone height and proximity to the greater palatine neurovascular bundle), and maxillary sinus ana-tomy (including sinus floor configuration and Schneiderian membrane thickness), in addition to the positional relationship between tooth roots and the maxillary sinus. By systematically evaluating these site-specific risk factors, this article aims to inform preoperative assessment and treatment planning and enhance surgical safety, cli-nical predictability, and long-term treatment outcomes.

Key words: maxillary tooth-bone-sinus complex, natural tooth-related maxillary sinus floor elevation, risk factors

中图分类号: 

  • R78

图 1

牙根与上颌窦间的垂直距离与水平距离A：垂直距离，指牙根根尖与上颌窦底平面的垂直距离；B：水平距离，指牙根根尖3 mm平面与上颌侧壁相邻处，与上颌窦侧壁间的距离。"

图 2

牙根与上颌窦间位置Ⅰ型分类示意图A：Ⅰa型；B：Ⅰb型。"

表 1

牙根与上颌窦间Ⅱ型分类"

测量指标Ⅱ型分类
垂直距离≤3 mm（a）>3 mm（b）
水平距离≤2 mm（c）>2 mm（d）
与窦底的位置近中（M）/远中（D）颊侧（B）/腭侧（P）

图 3

牙根与上颌窦间位置Ⅱ型分类示意图A：Ⅱac型；B：Ⅱad型；C：Ⅱbc型；D：Ⅱbd型。"

图 4

牙根与上颌窦间位置Ⅲ型分类示意图A：Ⅲa型；B：Ⅲb型。"

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