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目的:探讨比格犬上颌窦侧壁开窗术的路径并分析植入人工骨代用品的效果,为建立该类实验动物模型提供科学依据.方法:选用11只雄性比格犬(犬龄17个月,体重12～14 kg),共计22个上颌窦.拔除上颌后牙建立动物模型前,静脉麻醉下行双侧锥形束CT(CBCT),以确定上颌窦位置和拔牙计划,并分析侧壁解剖结构,测量窦腔高度和前后径.拔牙后2个月行第2次CBCT,测量双侧窦腔高度和前后径,以确定人工骨替代品体积和量,测量底嵴距,并进行手术路径分析.气管插管全麻下行上颌窦侧壁开窗术,根据实验设计分为3组,分别植入3种人工骨替代品(BioCap涂层组、BioCap组、Bio-Oss组).术后3个月行第3次CBCT,检测双侧上颌窦变化,处死动物并取样,进行相关检查.采用SPSS 19.0软件包对数据进行统计学分析.结果:CBCT发现比格犬的上颌窦外侧有粗大的眶下神经血管束,出现率为100％;上颌窦位于上颌尖牙远中和第三磨牙近中牙根上方;拔牙前上颌窦高度为(8.10±1.05)mm,前后径为(20.87±1.51)mm;拔牙后2个月高度为(8.15±1.01)mm,前后径为(20.89±1.21)mm,窦底中点底嵴距(4.16±0.85)mm;根据测量,植入人工骨替代品体积均为2.0 mL;开窗术后3个月CBCT测量前后径为(20.86±1.27)mm,窦底中点底嵴距(7.16±0.76)mm.BioCap涂层组的成骨百分比为85.15％±6.76％,BioCap组为35.14％±6.13％,Bio-Oss组为33.16％±6.75％.统计学分析表明,开窗术后上颌窦底嵴距显著高于开窗术前(P＜0.05),BioCap涂层组的成骨百分比显著高于BioCap组和Bio-Oss组(P＜0.01),BioCap组和Bio-Oss组相比,差异无显著性(P＞0.01).结论:比格犬上颌窦侧壁外方有一粗大的眶下神经血管束,行侧壁开窗术需要打开两层骨窗;比格犬上颌窦侧壁开窗植入人工骨替代品能显著增加底嵴距,可作为动物模型,进行各种上颌窦手术的研究.“,”PURPOSE:To establish a Beagle model,which was used to explore a new surgical pathway of sinus augmentation and analyze the effect of implantation of artificial bone substitutes.METHODS:Eleven male Beagle dogs (17 months,weighing 12-14 kg) were chosen with 22 maxillary sinus.Bilateral cone-beam CT (CBCT)scans were taken under intravenous anesthesia,to locate the range of the maxillary sinus,analyze the anatomical structure of the maxillary sinus wall,so as to make a plan of teeth extraction and measure the height and anteroposterior diameter of the sinus.A second CBCT scan was performed 2 months after extraction,to measure the height and the anteroposterior diameter of the bilateral maxillary sinus,in order to determine the volume of the artificial bone substitute,measure the distance from the bottom of the sinus to the crest (hereinafter referred to as the distance from B to C),and analyze the pathway.Fenestration of the maxillary sinus wall was conducted under general anesthesia and tracheal intubation,and the subjects were divided into 3 groups by implanting 3 kinds of artificial bone substitutes as designed (BioCap coating group,BioCap group and Bio-Oss group).The animals were sacrificed after taking the third CBCT scan 3 months after operation to test the bilateral maxillary sinus and sampled for analysis.The differences were analyzed with SPSS 19.0 software package for LSD test.RESULTS:It was found that the presence rate of thick infraorbital nerve bundles outside the maxillary sinus on CBCT was 100％.The maxillary sinus was located above the maxillary canine and the mesial root of third molar.The height of sinus was (8.10±1.05) mm,the anteroposterior diameter was (20.87±1.51)mm before teeth extraction.The height was (8.15±1.01)mm,the anteroposterior diameter was (20.89±1.21)mm,the distance from B to C in the middle of the sinus was (4.16±0.85)mm 2 months after teeth extraction.1.2 mL artificial bone substitute were implanted into each sinus.The anteroposterior diameter was (20.86±1.27) mm,the distance from B to C in the middle of the sinus was (7.16±0.76)mm,the osteogeuesis percentage was 85.15％±6.76％ in BioCap coating group,35.14％±6.13％ in BioCap group,and 33.16％± 6.75％ in Bio-Oss group,3 months after windowing.Statistical analysis showed that the distance from B to C after surgery was significantly higher than that before surgery (P＜0.01).Osteogenic percentage in BioCap coating group was significantly higher than that in BioCap group and Bio-Oss group (P＜0.01).There was no significant difference between BioCap group and Bio-Oss group (P＞0.05).CONCLUSIONS:There was a large infraorbital nerve vascular bundle outside the maxillary sinus of Beagle dog which needed to open two layers of bone window to get into the sinus.Implanting artificial bone substitutes by opening a window outside the maxillary sinus of Beagle dogs could significantly increase the distance from the bottom to the crest,and could be used as animal models for maxillary sinus surgery.