Irinakis Tassos, Dabuleanu Valentin, Aldahlawi Salwa
Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada.
Private practice, Dabuleanu Dental 2 Finch Avenue, West Toronto, ON, Canada.
Open Dent J. 2017 Mar 22;11:140-150. doi: 10.2174/1874210601711010140. eCollection 2017.
A new classification of maxillary sinus interfering septa based on its orientation is presented along with its relationship to the prevalence and severity of sinus membrane perforations. Additionally, the impact of membrane perforation on post-operative complications and marginal bone loss during the first year of loading is evaluated.
MATERIALS & METHODS: Retrospective chart review of 79 consecutive sinus lift procedures with lateral window technique and 107 implants. Preoperative Cone Beam Computed Tomography (CBCT) images were evaluated for the incidence and the direction of maxillary septa. Chart notes were examined for the incidence of membrane perforation and postoperative complications. Measurements of mesial and distal marginal bone levels and average bone resorption adjacent to each implant were calculated in intraoral radiographs taken at implant placement and during follow up appointments.
Interfering septa were identified in 48.1 percent of sinuses. 71.1 percent of them had the septum oriented in a buccal-lingual direction (Class I). The overall incidence of membrane perforation was 22.8 percent, and the presence of an interfering septum on CBCT scan was found to be significantly associated with the occurrence of a sinus membrane perforation (<0.001). The mean implant marginal bone loss for sinuses, which did not experience a membrane perforation, was 0.6±0.8mm, compared with 0.9 ± 0.9 mm for the sinuses that did experience a perforation ( = 0.325).
Septa should be identified, classified and managed with a meticulous attention to technical details. A classification based on the septal orientation is proposed since the orientation of the septa can complicate the surgical procedure and requires modification of the surgical technique.
提出一种基于上颌窦干扰隔的方向的新分类方法，并阐述其与窦膜穿孔的发生率和严重程度的关系。此外，评估膜穿孔对种植体植入后第一年加载过程中术后并发症和边缘骨丢失的影响。
回顾性分析79例连续采用侧窗技术进行的上颌窦提升术及107颗种植体的病历资料。术前锥形束计算机断层扫描（CBCT）图像用于评估上颌隔的发生率和方向。检查病历记录以确定膜穿孔的发生率和术后并发症。在种植体植入时及随访期间拍摄的口腔内X光片上，计算每颗种植体近中及远中边缘骨水平以及相邻种植体周围的平均骨吸收情况。
48.1%的鼻窦中发现有干扰隔。其中71.1%的隔呈颊舌向（I类）。膜穿孔的总体发生率为22.8%，CBCT扫描显示存在干扰隔与窦膜穿孔的发生显著相关（<0.001）。未发生膜穿孔的鼻窦中种植体边缘骨平均丢失为0.6±0.8mm，而发生穿孔的鼻窦中为0.9±0.9mm（P = 0.325）。
应细致识别、分类和处理隔，同时高度关注技术细节。鉴于隔的方向会使手术操作复杂化且需要调整手术技术，故提出一种基于隔方向的分类方法。
