Kozuma Ayako, Sasaki Masanori, Seki Katsuhiro, Toyoshima Takeshi, Nakano Hiroyuki, Mori Yoshihide
Section of Oral and Maxillofacial Surgery, Division of Maxillofacial Diagnostic and Surgical Sciences, Graduate School of Dental Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
Division of Oral & Maxillofacial Surgery and Implant Center, Kyushu Central Hospital of the Mutual Aid Association of Public School Teachers , Fukuoka, Japan.
Oral Maxillofac Surg. 2017 Jun;21(2):193-200. doi: 10.1007/s10006-017-0611-8. Epub 2017 Mar 22.
Among intra/postoperative complications of sinus augmentation from a lateral approach, postoperative infection and implant loss are particularly important because they have irreversible consequences. The purpose of this study was to determine the causes of postoperative infection and implant loss after a lateral approach and to determine the appropriate prophylaxis and therapy.
In total, 109 patients (121 sinuses, 252 implants) were included in this study. The correlation between postoperative infection and implant loss and clinical variables was assessed using logistic regression analyses.
Postoperative infection and implant loss occurred in 8/121 sinuses (6.6%). Infection had the strongest correlation to preoperative chronic sinusitis (p = 0.007), followed by timing of implant insertion. Implant loss had the strongest correlation to preoperative chronic sinusitis (p = 0.007), followed by sex, diabetes, postoperative use of dentures, and intraoperative perforation of the sinus membrane.
Preoperative chronic sinusitis could be a significant cause of postoperative infection and implant loss when using sinus augmentation from a lateral approach. For appropriate prophylaxis and therapy, it is necessary to diagnose the presence of chronic sinusitis that should be treated with proper methods prior to sinus augmentation.
在外侧入路鼻窦增量术的术中和术后并发症中，术后感染和种植体丢失尤为重要，因为它们会产生不可逆的后果。本研究的目的是确定外侧入路术后感染和种植体丢失的原因，并确定适当的预防措施和治疗方法。
本研究共纳入109例患者（121个鼻窦，252颗种植体）。采用逻辑回归分析评估术后感染、种植体丢失与临床变量之间的相关性。
121个鼻窦中有8个（6.6%）发生了术后感染和种植体丢失。感染与术前慢性鼻窦炎的相关性最强（p = 0.007），其次是种植体植入时间。种植体丢失与术前慢性鼻窦炎的相关性最强（p = 0.007），其次是性别、糖尿病、术后义齿使用情况以及术中鼻窦黏膜穿孔。
采用外侧入路进行鼻窦增量术时，术前慢性鼻窦炎可能是术后感染和种植体丢失的重要原因。为了进行适当的预防和治疗，有必要在鼻窦增量术前诊断慢性鼻窦炎的存在，并采用适当的方法进行治疗。
