Franceschetti Giovanni, Rizzi Alessandro, Minenna Luigi, Pramstraller Mattia, Trombelli Leonardo, Farina Roberto
Research Centre for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Ferrara, Italy.
Operative Unit of Dentistry, University-Hospital of Ferrara, Ferrara, Italy.
Clin Oral Implants Res. 2017 Feb;28(2):156-162. doi: 10.1111/clr.12774. Epub 2016 Jan 8.
Based on the hypothesis that maxillary sinus floor elevation with a transcrestal approach (tSFE) does not increase the morbidity of implant surgery, the study evaluated the patient-reported outcomes as well as the type and incidence of complications when implants are placed either concomitantly with tSFE (performed according to Trombelli et al. 2008, 2010a,b) or entirely in native bone.
Data from the record charts of patients undergone implant placement for single-tooth rehabilitation in the posterior maxilla were retrospectively obtained from four clinical centers. Cases for tSFE group were included if they showed an extent of sinus lift ≥4 mm concomitantly to implant placement. Cases for N group were included when implant placement was performed entirely in native bone. Patient-reported outcomes had been assessed using 100-mm visual analog scales (postoperative pain, VAS ) and visual rating scales (level of discomfort, VRS ; willingness to undergo the same surgery, VRS ). The dose of analgesics had been self-recorded.
A convenience sample of 14 patients and 17 patients (contributing with one implant site each) treated with tSFE and N, respectively, was obtained for this study. Membrane perforation occurred in 1 tSFE case, without compromising the completion of the procedure. VAS remained low (<12) in both groups. A tendency of VAS to decrease with time was observed in both groups. The area under the curve for VAS (AUC ), indicating the level of pain experience through the first week following surgery, was 18.0 (IR: 8.5-85.0) and 11.5 (IR: 4.5-18.5) in tSFE and N groups, respectively, with no significant inter-group differences (P = 0.084). The dose of analgesics was similarly low between groups. No significant inter-group difference in VRS and VRS was observed.
Implant placement performed either concomitantly with tSFE (according to Trombelli et al. 2008, 2010a,b) or entirely in native bone is associated with limited incidence of complications, low postoperative pain and medication and are both well tolerated.
基于经牙槽嵴入路上颌窦底提升术（tSFE）不会增加种植手术发病率的假设，本研究评估了患者报告的结果以及在种植体与tSFE同时植入（按照Trombelli等人2008年、2010年a、b的方法进行）或完全植入天然骨时并发症的类型和发生率。
从四个临床中心回顾性获取上颌后牙单颗牙种植修复患者的病历数据。tSFE组病例纳入标准为种植体植入时窦底提升程度≥4mm。N组病例纳入标准为种植体完全植入天然骨。使用长度为100mm的视觉模拟量表（术后疼痛，VAS）和视觉评分量表（不适程度，VRS；愿意再次接受相同手术的程度，VRS）评估患者报告的结果。患者自行记录镇痛药的用量。
本研究分别获得了14例接受tSFE治疗和17例接受N治疗的患者（每个患者贡献一个种植位点）的便利样本。1例tSFE病例发生了膜穿孔，但未影响手术的完成。两组VAS均保持在较低水平（<12）。两组均观察到VAS随时间有下降趋势。tSFE组和N组术后第一周疼痛体验水平的VAS曲线下面积（AUC）分别为18.0（四分位数间距：8.5 - 85.0）和11.5（四分位数间距：4.5 - 18.5），组间差异无统计学意义（P = 0.084）。两组间镇痛药用量同样较低。VRS和VRS组间差异无统计学意义。
种植体与tSFE同时植入（按照Trombelli等人2008年、2010年a、b的方法进行）或完全植入天然骨时，并发症发生率有限，术后疼痛和用药量低，且患者耐受性良好。
