Stacchi Claudio, Lombardi Teresa, Cusimano Paolo, Berton Federico, Lauritano Floriana, Cervino Gabriele, Di Lenarda Roberto, Cicciù Marco
*Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste †Private Practice, Cassano allo Ionio ‡Private Practice, Palermo §Department of Biomedical and Dental Sciences, Morphological and Functional Images, School of Dentistry, University of Messina, Messina, Italy.
J Craniofac Surg. 2017 Jul;28(5):1191-1196. doi: 10.1097/SCS.0000000000003636.
The purpose of this investigation is to evaluate 2 different methods for reducing cortical wall thickness in sinus floor augmentation surgery. A manual bone scraper was compared in terms of efficacy, speed, and safety to an ultrasonic insert for osteoplasty, in a randomized controlled clinical trial with a split-mouth design. Twenty-five patients with severe posterior maxillary atrophy were treated with bilateral sinus floor elevation with lateral approach. Antrostomies were randomly performed by eroding the cortical wall with a manual bone scraper (test site) or with an ultrasonic insert (control site) until the membrane was visible under a thin layer of bone, before outlining the window with a piezoelectric device. Occurrence of membrane perforation, laceration of vascular branches, and surgical time were recorded. Mean surgical time of the antrostomy in the test sites was 9'18", while in the control sites was 9'47". No significant differences were found in terms of surgical time, incidence of membrane perforation during antrostomy (4.3% in both groups), or other intraoperative complications between the 2 techniques. Both surgical approaches represent effective options for performing lateral antrostomies during sinus floor elevation procedures in a safe and predictable way.
本研究的目的是评估在鼻窦底提升手术中减少皮质骨壁厚度的两种不同方法。在一项采用分口设计的随机对照临床试验中，将手动骨刮匙在疗效、速度和安全性方面与用于骨成形术的超声插入器进行了比较。25例严重上颌后牙区骨萎缩患者接受了双侧外侧入路鼻窦底提升术。在使用压电装置勾勒窗口之前，通过用手动骨刮匙（试验部位）或超声插入器（对照部位）侵蚀皮质骨壁，随机进行窦口开放，直到在薄层骨下可见黏膜。记录黏膜穿孔、血管分支撕裂的发生情况以及手术时间。试验部位窦口开放的平均手术时间为9分18秒，而对照部位为9分47秒。在手术时间、窦口开放期间黏膜穿孔的发生率（两组均为4.3%）或两种技术之间的其他术中并发症方面，未发现显著差异。两种手术方法都是在鼻窦底提升手术中以安全、可预测的方式进行外侧窦口开放的有效选择。
