Vercellotti T, De Paoli S, Nevins M
Private Practice, Genova, Italy.
Int J Periodontics Restorative Dent. 2001 Dec;21(6):561-7.
All of the surgical techniques to elevate the maxillary sinus present the possibility of perforating the schneiderian membrane. This complication can occur during the osteotomy, which is performed with burs, or during the elevation of the membrane using manual elevators. The purpose of this article is to present a new surgical technique that radically simplifies maxillary sinus surgery, thus avoiding perforating the membrane. The piezoelectric bony window osteotomy easily cuts mineralized tissue without damaging the soft tissue, and the piezoelectric sinus membrane elevation separates the schneiderian membrane without causing perforations. The elevation of the membrane from the sinus floor is performed using both piezoelectric elevators and the force of a physiologic solution subjected to piezoelectric cavitation. Twenty-one piezoelectric bony window osteotomy and piezoelectric sinus membrane elevations were performed on 15 patients using the appropriate surgical device (Mectron Piezosurgery System). Only one perforation occurred during the osteotomy at the site of an underwood septa, resulting in a 95% success rate. The average length of the window was 14 mm; its height was 6 mm, and its thickness was 1.4 mm. The average time necessary for the piezoelectric bony window osteotomy was approximately 3 minutes, while the piezoelectric sinus membrane elevation required approximately 5 minutes.
所有提升上颌窦的手术技术都存在穿破施奈德氏膜的可能性。这种并发症可能发生在使用牙钻进行截骨术时，或在使用手动剥离器提升骨膜的过程中。本文的目的是介绍一种全新的手术技术，该技术能从根本上简化上颌窦手术，从而避免穿破骨膜。压电式骨窗截骨术能够轻松切割矿化组织而不损伤软组织，压电式上颌窦骨膜提升术能分离施奈德氏膜而不造成穿孔。利用压电式剥离器以及受到压电空化作用的生理溶液的力量，将骨膜从窦底提升起来。使用合适的手术设备（美创压电手术系统）对15例患者进行了21次压电式骨窗截骨术和压电式上颌窦骨膜提升术。在截骨术过程中，仅在安德伍德氏隔处出现了1次穿孔，成功率为95%。骨窗的平均长度为14毫米；高度为6毫米，厚度为1.4毫米。压电式骨窗截骨术平均所需时间约为3分钟，而压电式上颌窦骨膜提升术大约需要5分钟。
