Makary Christian, Rebaudi Alberto, Menhall Abdallah, Naaman Nada
Int J Oral Maxillofac Implants. 2016 Mar-Apr;31(2):331-7. doi: 10.11607/jomi.4108. Epub 2015 Oct 16.
To radiographically monitor sinus membrane swelling after lateral sinus floor elevation surgery at short and long healing periods.
For 26 patients seeking posterior maxillary implant-supported reconstruction, 32 lateral sinus floor elevations were performed using Piezosurgery. Sinus membranes were grafted using synthetic calcium phosphate bone substitutes, and graft volume was measured in cubic centimeters for each case. Cone beam computed tomography (CBCT) examination was conducted preoperatively in all patients and for each grafted sinus at 1 day (n = 8), 2 days (n = 9), 3 days (n = 8), or 7 days (n = 7) after surgery. Control CBCT was then performed for all patients at 3, 6, and 12 months after surgery. Sinus membrane thickness was measured on cross-sectional CBCT images at nine standardized points per sinus, before lateral sinus floor elevation and at all postoperative examinations.
Mean sinus membrane thickness was 0.73 mm before surgery, and 5 mm, 4.1 mm, 5.9 mm, and 7 mm, respectively, at 1, 2, 3, and 7 days after surgery. First week combined postoperative CBCT measurements of membrane thickness was 5.4 mm, then 1.3, 0.68, and 0.39 mm at 3, 6, and 12 months, respectively, after surgery. Membrane thickness significantly increased the first week after surgery and gradually decreased significantly at 3, 6, and 12 months in all groups (P < .001). First-week postoperative measurements showed a significant increase in membrane thickness at 3 days compared with the 1- and 2-day results (P < .001) and at 7 days compared with all other time points (P < .001). Membrane thickness at 2 days did not change significantly compared with 1-day measurements. Larger graft volume was positively correlated with an increase in membrane thickness after surgery at all time points (n = 32; r = 0.527; P < .001).
After lateral sinus floor elevation surgery, transient swelling of sinus membrane is observed. It reaches a peak value 7 days after surgery and completely resolves over months. This swelling is correlated to the extent of sinus floor elevation.
通过影像学方法监测外侧上颌窦底提升术后短期和长期愈合阶段的上颌窦黏膜肿胀情况。
对26例寻求上颌后牙种植体支持重建的患者，采用超声骨刀进行了32次外侧上颌窦底提升术。使用合成磷酸钙骨替代物对上颌窦黏膜进行植骨，并测量每例患者的植骨体积（立方厘米）。所有患者术前均进行锥形束计算机断层扫描（CBCT）检查，术后1天（n = 8）、2天（n = 9）、3天（n = 8）或7天（n = 7）对每个植骨的上颌窦进行CBCT检查。然后在术后3、6和12个月对所有患者进行对照CBCT检查。在外侧上颌窦底提升术前以及所有术后检查时，在每个上颌窦的横断面CBCT图像上的九个标准化点测量上颌窦黏膜厚度。
术前平均上颌窦黏膜厚度为0.73mm，术后1、2、3和7天分别为5mm、4.1mm、5.9mm和7mm。术后第一周上颌窦黏膜厚度的综合测量值为5.4mm，术后3、6和12个月分别为1.3mm、0.68mm和0.39mm。所有组中，术后第一周黏膜厚度显著增加，在3、6和12个月时逐渐显著降低（P <.001）。术后第一周的测量结果显示，与术后1天和2天相比，术后3天黏膜厚度显著增加（P <.001），与所有其他时间点相比，术后7天黏膜厚度显著增加（P <.001）。与术后1天的测量结果相比，术后2天黏膜厚度无显著变化。在所有时间点，更大的植骨体积与术后黏膜厚度增加呈正相关（n = 32；r = 0.527；P <.001）。
外侧上颌窦底提升术后观察到上颌窦黏膜出现短暂肿胀。术后7天达到峰值，并在数月内完全消退。这种肿胀与上颌窦底提升的程度相关。
