Stacchi Claudio, Vercellotti Tomaso, Toschetti Annamaria, Speroni Stefano, Salgarello Stefano, Di Lenarda Roberto
Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy.
Clin Implant Dent Relat Res. 2015 Jan;17 Suppl 1:e117-25. doi: 10.1111/cid.12136. Epub 2013 Aug 22.
The aim of this study was to assess the prevalence of intraoperative complications during maxillary sinus elevation with lateral approach using a piezoelectric device with two different surgical techniques.
Antrostomies were randomly performed by outlining a window (group A, 36 patients) or by eroding the cortical wall with a grinding insert until the membrane was visible under a thin layer of bone, before outlining the window (group B, 36 patients). Occurrence of membrane perforation, laceration of vascular branches, and surgical time was recorded.
Seventy-two patients underwent sinus floor elevation: four perforations (11.1%) were observed in group A (two occurred during elevation with hand instruments) and zero perforations in group B (p < .05). No evidence of vascular lacerations was registered in both groups. A clinically insignificant but statistically shorter surgical time was recorded in group A (9.2 ± 3.7 minutes) than in group B (13.3 ± 2.4 minutes; p < .05).
Within the limits of the present study, it may be concluded that ultrasonic erosion of the lateral wall of the sinus is a more predictable technique than piezoelectric outlining of a bone window in preventing from accidental perforations of Schneiderian membrane during sinus augmentation procedures.
本研究旨在评估使用压电装置经外侧入路进行上颌窦提升术时，两种不同手术技术下术中并发症的发生率。
随机进行上颌窦开窗，一组（A组，36例患者）通过勾勒出一个窗口进行，另一组（B组，36例患者）在勾勒窗口前先用磨头侵蚀皮质骨壁直至在薄层骨下可见黏膜，然后再勾勒窗口。记录黏膜穿孔、血管分支撕裂的发生情况以及手术时间。
72例患者接受了窦底提升术：A组观察到4例穿孔（11.1%）（2例在手用器械提升过程中发生），B组未观察到穿孔（p < 0.05）。两组均未发现血管撕裂的证据。A组记录到的手术时间在临床上无显著差异，但在统计学上比B组短（A组9.2 ± 3.7分钟，B组13.3 ± 2.4分钟；p < 0.05）。
在本研究的范围内，可以得出结论，在鼻窦增大手术中，与通过压电装置勾勒骨窗相比，鼻窦侧壁的超声侵蚀是一种在预防施耐德膜意外穿孔方面更可预测的技术。
