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牙槽窦提升术后,牙种植体意外迁移至筛窦。

Accidental migration of a dental implant into the ethmoid sinus following a transalveolar sinus elevation procedure.

机构信息

Department of Advanced Periodontics, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA.

出版信息

Clin Implant Dent Relat Res. 2015 Apr;17(2):360-4. doi: 10.1111/cid.12099. Epub 2013 Jun 13.

Abstract

BACKGROUND

Migration of a dental implant into the paranasal sinuses may be the result of sinus membrane perforation, loss of osseointegration, and lack of initial stability. The majority of displaced implants migrate into the maxillary sinus, which may cause sinusitis.

PURPOSE

The purpose of this study is to report an extremely rare ethmoid sinus migration of a dental implant after crestal approach in a resorbed posterior maxilla.

MATERIALS AND METHODS

A 60-year old Korean male with a noncontributory medical history was referred from a local clinic to remove the migrated dental implant in the right ethmoid sinus. The patient had symptoms of mild sinusitis. The implant had been placed 6 months earlier through the bone-added transalveolar approach in a severely resorbed maxilla.

RESULTS

The displaced implant was removed through the intraoral approach. A lateral window was made and an endoscopic surgery was performed to remove the implant. Healing was uneventful, and sinusitis symptom had ceased.

CONCLUSION

The crestal approach for severely resorbed posterior maxillae should be performed when there is a potential for primary stability. If bone quality is poor and initial stability cannot be achieved, lateral window sinus elevation procedure is a better option for successful implant placement. Migrated implant may be removed with antrostomy and endoscopic surgery.

摘要

背景

种植体迁移至副鼻窦可能是由于窦膜穿孔、骨整合丧失和初始稳定性不足所致。大多数移位的种植体迁移到上颌窦,可能导致鼻窦炎。

目的

本研究旨在报告一例极为罕见的牙槽嵴顶入路种植体在后牙缺失严重萎缩的上颌骨中向筛窦迁移的病例。

材料与方法

一名 60 岁的韩国男性,无明显病史,因右侧筛窦内迁移的种植体被当地诊所转介至我院。患者有轻度鼻窦炎症状。该种植体于 6 个月前通过牙槽骨增量经牙槽嵴顶入路植入严重萎缩的上颌骨。

结果

通过口腔内入路取出移位的种植体。切开外侧骨窗,行内镜下手术取出种植体。愈合顺利,鼻窦炎症状消失。

结论

对于严重萎缩的后牙区上颌骨,当存在初始稳定性的可能性时,应采用牙槽嵴顶入路。如果骨质质量差且无法获得初始稳定性,外侧骨窗窦提升术是成功植入种植体的更好选择。对于迁移的种植体,可通过上颌窦切开术和内镜手术进行取出。

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