Aimetti Mario, Massei Giampiero, Morra Matteo, Cardesi Enrico, Romano Federica
Department of Periodontology, University of Torino, Torino, Italy.
Int J Oral Maxillofac Implants. 2008 Nov-Dec;23(6):1128-32.
The most common complication during sinus graft surgery is tearing or perforation of the Schneiderian membrane. Perforations are most likely to occur if the sinus membrane is thin. Preoperative prediction of the antral membrane thickness may be of practical importance during maxillary sinus augmentation procedures. The purpose of this investigation was to analyze a possible association between gingival phenotypes and thickness of the healthy sinus mucosa.
Twenty consecutive patients without preoperative anamnestic, clinical, or radiologic signs of maxillary sinus pathologies were enrolled in the study. During otorhinolaringologic surgical interventions, maxillary mucosal biopsy specimens were endoscopically obtained from the sinus floor, and gingival thickness was measured at the maxillary anterior teeth.
Eleven out of 20 individuals had thick gingival tissues, and the remaining 9 presented with thin gingival phenotype. The average thickness of the Schneiderian membrane was 0.97 +/- 0.36 mm with a wide inter-individual variability. Thickness of the sinus mucosa amounted to 1.26 +/- 0.14 mm in individuals with thick gingival architecture and 0.61 +/- 0.15 mm in subjects with thin gingival tissues. The association between thickness of the antral mucosa and periodontal phenotypes was statistically significant (P < .0001).
Gingival thickness seems to represent a reliable parameter to predict sinus membrane thickness. Further investigations are needed to support these preliminary data.
鼻窦植骨手术中最常见的并发症是施奈德膜撕裂或穿孔。如果鼻窦膜较薄,穿孔最容易发生。在上颌窦增高手术中,术前预测上颌窦膜厚度可能具有实际意义。本研究的目的是分析牙龈表型与健康鼻窦黏膜厚度之间可能存在的关联。
连续纳入20例术前无上颌窦病变的既往史、临床或放射学征象的患者。在耳鼻喉科手术干预期间,通过内镜从鼻窦底部获取上颌黏膜活检标本,并测量上颌前牙处的牙龈厚度。
20例个体中有11例牙龈组织较厚,其余9例表现为牙龈薄型。施奈德膜的平均厚度为0.97±0.36mm,个体间差异较大。牙龈结构较厚的个体鼻窦黏膜厚度为1.26±0.14mm,牙龈组织较薄的个体为0.61±0.15mm。上颌窦黏膜厚度与牙周表型之间的关联具有统计学意义(P<.0001)。
牙龈厚度似乎是预测鼻窦膜厚度的可靠参数。需要进一步的研究来支持这些初步数据。