上颌窦底提升术中的膜穿孔——用于截骨术的压电装置与传统旋转器械的对比：一项实验研究

Membrane perforation in sinus floor elevation - piezoelectric device versus conventional rotary instruments for osteotomy: an experimental study.

作者信息

Seoane Juan, López-Niño Javier, García-Caballero Lucía, Seoane-Romero Juan Manuel, Tomás Inmaculada, Varela-Centelles Pablo

机构信息

Senior lecturer, Stomatology Department, School of Medicine and Dentistry, University of Santiago de Compostela, Entrerríos s/n, Santiago de Compostela, A Coruña, Spain; PhD student, Stomatology Department, School of Medicine and Dentistry, University of Santiago de Compostela, Entrerríos s/n, Santiago de Compostela, A Coruña, Spain; postgraduate student, Stomatology Department, School of Medicine and Dentistry, University of Santiago de Compostela, Entrerríos s/n, Santiago de Compostela, A Coruña, Spain; PhD student, Stomatology Department, School of Medicine and Dentistry, University of Santiago de Compostela, Entrerríos s/n, Santiago de Compostela, A Coruña, Spain; senior lecturer, Stomatology Department, School of Medicine and Dentistry, University of Santiago de Compostela, Entrerríos s/n, Santiago de Compostela, A Coruña, Spain; lecturer, Stomatology Department, School of Medicine and Dentistry, University of Santiago de Compostela, Entrerríos s/n, Santiago de Compostela, A Coruña, Spain.

出版信息

Clin Implant Dent Relat Res. 2013 Dec;15(6):867-73. doi: 10.1111/j.1708-8208.2012.00447.x. Epub 2012 Feb 29.

DOI:10.1111/j.1708-8208.2012.00447.x

PMID:22376212

Abstract

PURPOSE

Sinus membrane perforation is the most common intraoperative complication of maxillary sinus floor elevation (MSFE) procedures and frequently causes postoperative problems. Piezoelectric devices have been claimed to reduce the frequency of membrane perforations although no clear evidence supports this view.

MATERIALS AND METHODS

Ten surgeons with different expertise levels performed 80 MSFEs in selected lamb heads, with rotary and piezoelectric instruments following standard protocols. After the procedures, specimens were coded and perforations or tears determined through a microscope.

RESULTS

No significant differences in terms of thickness either of the sinus lateral wall (xi -xj = 73.2; 95% confidence interval [CI] = 45.3-191.8) or the membrane (xi -xj = 24.2; 95% CI = -29.4 to 77.9) were identified between the specimens allocated to each group. Nine membrane perforations (11.2%) occurred during the study, all within the lower expertise group. Membrane elevation by hand instruments caused five perforations (40%) in the rotary instrument group and one in the piezoelectric group. Expert surgeons produced no membrane perforations, the size of the antrostomy that was smaller in the piezoelectric group being the only significant difference between the rotary and piezoelectric groups.

CONCLUSIONS

The use of piezoelectric material for MSFE reduces the frequency of membrane perforation among surgeons with a limited experience.

摘要

目的

鼻窦黏膜穿孔是上颌窦底提升术最常见的术中并发症，且常引发术后问题。尽管尚无明确证据支持，但有人声称压电设备可降低黏膜穿孔的发生率。

材料与方法

10名不同专业水平的外科医生按照标准方案，使用旋转器械和压电器械，在选定的羊头上进行了80次上颌窦底提升术。术后，对标本进行编码，并通过显微镜确定是否存在穿孔或撕裂。

结果

在分配到每组的标本中，未发现鼻窦外侧壁厚度（xi - xj = 73.2；95%置信区间[CI] = 45.3 - 191.8）或黏膜厚度（xi - xj = 24.2；95% CI = -29.4至77.9）有显著差异。研究期间发生了9次黏膜穿孔（11.2%），均出现在经验较少的组中。手动器械提升黏膜在旋转器械组导致5次穿孔（40%），在压电器械组导致1次穿孔。经验丰富的外科医生未造成黏膜穿孔，压电组开窗较小是旋转器械组和压电器械组之间唯一的显著差异。