Department of Periodontology and Implant Dentistry, College of Dentistry, New York University, New York, NY, USA.
J Periodontol. 2013 Aug;84(8):1094-9. doi: 10.1902/jop.2012.120458. Epub 2012 Nov 23.
The maxillary sinus augmentation procedure (SAP) using the lateral window technique has been documented to be a highly predictable procedure. However, the most common intraoperative complication has been reported to be maxillary sinus membrane perforation (MSMP). The present study evaluates the percentage of vital bone and implant survival in sinuses that had perforations repaired during surgery versus a non-perforated sinus group.
Data were obtained retrospectively from an Institutional Review Board-approved anonymous database at New York University, Kriser Dental Center, Department of Periodontology and Implant Dentistry, New York, New York, from 23 patients who had undergone SAP with a total of 40 treated sinuses. Sinuses were grafted with mineralized cancellous bone allograft, anorganic bovine bone matrix, or biphasic calcium phospate. Perforation complications occurred in 15 sinuses with 25 non-perforated sinuses. All perforations were repaired during surgery with absorbable collagen membrane barriers. Histologic cores were taken from all treated sinuses 26 to 32 weeks after surgery. The implant success rate of 79 placed implants was recorded.
The average percentage of vital bone was 26.3% ± 6.3% in the perforated (repaired) sinuses versus 19.1% ± 6.3% in the non-perforated sinuses. The differences were statistically significant (SS). The implant success rate was 100% (35 of 35) compared to 95.5% (43 of 45) in the perforated/repaired vs. non-perforated sinuses, respectively. There was no SS difference in implant failure rates.
The augmented sinuses in this study that exhibited MSMPs that occurred during the SAP (which were treated during surgery) show SS greater vital bone percentages compared with the non-perforated sinus group. There were no SS differences in implant survival in the perforated versus non-perforated groups. In this study, sinus MSMPs, when properly repaired during surgery, do not appear to be an adverse complication in terms of vital bone production or implant survival.
经外侧开窗技术的上颌窦提升术（SAP）已被证明是一种高度可预测的手术。然而，最常见的术中并发症是上颌窦黏膜穿孔（MSMP）。本研究评估了在术中修复穿孔与未穿孔窦之间，有穿孔修复的窦中有活力骨和植入物存活率的百分比。
从纽约大学克里泽牙科中心牙周病学和种植牙科系的机构审查委员会批准的匿名数据库中回顾性地获得了数据，该数据库来自 23 名接受 SAP 治疗的患者，共涉及 40 个治疗窦。窦用矿化松质骨移植物、无机牛骨基质或双相磷酸钙进行移植。15 个窦出现穿孔并发症，25 个窦无穿孔。所有穿孔均在术中用可吸收胶原膜屏障修复。术后 26-32 周从所有治疗窦中取出组织学核心。记录了 79 个植入物的植入成功率。
穿孔（修复）窦中的平均有活力骨百分比为 26.3%±6.3%，而非穿孔窦中的平均有活力骨百分比为 19.1%±6.3%。差异具有统计学意义（SS）。植入物成功率为 100%（35/35），与穿孔/修复窦（分别为 95.5%（43/45）相比，差异无统计学意义（SS）。植入物失败率无统计学差异。
本研究中，SAP 过程中出现的 MSMP 增强了窦，这些窦（在术中进行了治疗）与非穿孔窦组相比，SS 有更高的有活力骨百分比。穿孔组与非穿孔组之间，植入物存活率无 SS 差异。在本研究中，当在术中正确修复时，窦 MSMP 似乎不是影响有活力骨生成或植入物存活的不利并发症。
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