Pommer Bernhard, Unger Ewald, Sütö Daniel, Hack Niklas, Watzek Georg
Department of Oral Surgery, Bernhard Gottlieb School of Dentistry, Medical University of Vienna, Vienna, Austria.
Clin Oral Implants Res. 2009 Jun;20(6):633-7. doi: 10.1111/j.1600-0501.2008.01686.x. Epub 2009 Mar 4.
Perforation of the Schneiderian membrane (maxillary sinus mucosa) is a common complication of maxillary sinus graft procedures. Membrane perforation increases the chance of postoperative sinusitis and endangers graft as well as implant survival. The aim of the present study was to explore the mechanical properties of the Schneiderian membrane.
Three test methods were performed on sinus specimen of 20 fresh human cadavers: one- and two-dimensional membrane elongation as far as perforation, as well as membrane detachment from the adherent bone.
Perforation of the Schneiderian membrane (mean thickness: 90 mum) occurred at a mean tension of 7.3 N/mm(2). The membrane could be stretched to 132.6% of its original size in one-dimensional elongation, and to 124.7% in two-dimensional elongation. Thicker membranes demonstrated significantly higher load limits (P<0.001). The mean modulus of elasticity accounted 0.058 GPa, the mean adhesion force between sinus membrane and bone surface was 0.05 N/mm.
Respecting the mechanical properties of the Schneiderian membrane may help reducing the complication rates and thus patient morbidity in minimally invasive maxillary sinus floor elevation.
上颌窦黏膜穿孔是上颌窦植骨手术常见的并发症。膜穿孔增加了术后鼻窦炎的几率，并危及植骨以及种植体的存活。本研究的目的是探究上颌窦黏膜的力学性能。
对20具新鲜人类尸体的鼻窦标本进行了三种测试方法：一维及二维膜拉伸直至穿孔，以及膜与附着骨的分离。
上颌窦黏膜（平均厚度：90μm）穿孔时的平均张力为7.3N/mm²。在一维拉伸中，膜可拉伸至其原始大小的132.6%，在二维拉伸中可拉伸至124.7%。较厚的膜显示出显著更高的负荷极限（P<0.001）。平均弹性模量为0.058GPa，鼻窦膜与骨表面之间的平均粘附力为0.05N/mm。
了解上颌窦黏膜的力学性能可能有助于降低微创上颌窦底提升术中的并发症发生率，从而降低患者的发病率。
