Berengo M, Sivolella S, Majzoub Z, Cordioli G
Department of Oral Surgery, University of Padova, Institute of Clinical Dentistry, via Giustintiani, 2, 35100 Padova, Italy.
Int J Oral Maxillofac Surg. 2004 Mar;33(2):189-94. doi: 10.1054/ijom.2002.0459.
Sinus floor augmentation using the bone-added osteotome technique (BAOSFE) has been advocated as a predictable procedure when initial residual bone height is 4-6mm. In this report, 16 Osseotite implants were placed using the BAOSFE procedure in eight patients under endoscopic control. Intraoperative graft positioning, potential displacement of the graft material, Schneiderian membrane integrity and distension pattern were evaluated. A small-sized perforation of the sinus membrane was visualized during sinuscopic monitoring in two implant sites without significant loss of graft material confinement. Membrane vertical distension was restricted to the area surrounding the implant apices in four implant sites while a larger detachment of the membrane enfolding the implant tips, the in-between and circumferantial areas was observed in the remaining 12 sites. The two perforated sites demonstrated a localized vertical pattern of membrane distension limited to implant apices. None of the cases complicated by perforation showed clinical signs of ongoing sinus pathology throughout the follow-up period. This limited report suggests that: (1) the BAOSFE procedure in combination with implant placement yields various patterns of sinus membrane elevation; (2) potential membrane perforation may be expected when distension follows a localized vertical augmentation pattern; and (3) small membrane perforations during the BAOSFE procedure are compatible with clinically healthy postoperative sinus conditions.
当初始剩余骨高度为4 - 6mm时，使用添加骨的骨凿技术（BAOSFE）进行窦底增高术被认为是一种可预测的手术方法。在本报告中，在内镜控制下，对8例患者采用BAOSFE手术植入了16枚Osseotite种植体。评估了术中移植物的定位、移植物材料的潜在移位、施耐德膜的完整性和扩张模式。在鼻窦镜监测过程中，在两个种植部位观察到窦膜有小的穿孔，但移植物材料的封闭没有明显损失。在四个种植部位，膜的垂直扩张仅限于种植体根尖周围区域，而在其余12个部位观察到围绕种植体尖端、中间和圆周区域的膜有较大的分离。两个穿孔部位显示出仅限于种植体根尖的局部垂直膜扩张模式。在整个随访期间，没有一例因穿孔而并发的病例出现持续鼻窦病变的临床症状。这份有限的报告表明：（1）BAOSFE手术结合种植体植入会产生多种窦膜抬高模式；（2）当扩张遵循局部垂直增高模式时，可能会出现潜在的膜穿孔；（3）BAOSFE手术期间的小膜穿孔与术后鼻窦临床健康状况相符。
