Borgonovo A, Fabbri A, Boninsegna R, Dolci M, Censi R
Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy.
Minerva Stomatol. 2010 Jan-Feb;59(1-2):45-54.
Dental implants placed in the maxilla risk failure because of the low density of the maxillary bone and the shortness of the maxillary ridge. Moreover, inadequate implant preparation, drilling or installation can easily lead to complications related to the maxillary sinuses. Displacement of dental implants into the maxillary sinus can cause serious complications, but there are few reports of such cases. The aim of this paper is to present three cases of a migrated dental implants into the maxillary sinus: in the first two cases the dental implant was found close to the medial wall of the maxillary sinus and was removed through a surgical approach, whereas in the third case the dental implant was spontaneously expelled from the nasal cavities through the mucociliary clearance. The most frequent adverse effect is the local infection of tissue around the implant. For this reason, implants placed close to the maxillary sinus offer a route for infection from the oral cavity to the sinus. While in some cases implant migration causes sinusitis in other, the patients remain asymptomatic; anyway, the treatment depends on the symptoms of maxillary sinusitis. In the third case the dental implant was spontaneously expelled from the nasal graves. Our report illustrates that a powerful mechanism of mucociliary action can cause relatively heavy objects within the maxillary sinus to migrate naturally to the sinus ostia against gravitational force and then to be expelled from the nasal cavities.
由于上颌骨密度低且上颌牙槽嵴短，在上颌植入牙种植体有失败的风险。此外，种植体准备、钻孔或安装不当容易导致与上颌窦相关的并发症。牙种植体移位至上颌窦可引起严重并发症，但此类病例报道较少。本文旨在介绍3例牙种植体移位至上颌窦的病例：在前两例中，牙种植体位于上颌窦内侧壁附近，通过手术方法取出；而在第三例中，牙种植体通过黏液纤毛清除作用从鼻腔自行排出。最常见的不良反应是种植体周围组织的局部感染。因此，靠近上颌窦放置的种植体为感染从口腔蔓延至鼻窦提供了一条途径。在某些情况下，种植体移位会导致鼻窦炎，而在其他情况下，患者无症状；无论如何，治疗取决于上颌窦炎的症状。在第三例中，牙种植体从鼻腔自行排出。我们的报告表明，强大的黏液纤毛作用机制可使上颌窦内相对较重的物体克服重力自然移向窦口，然后从鼻腔排出。
