Manor Yifat, Anavi Yakir, Gershonovitch Ron, Lorean Adi, Mijiritsky Eithan
Int J Periodontics Restorative Dent. 2018 November/December;38(6):e112–e118. doi: 10.11607/prd.3328. Epub 2018 Jun 12.
The article describes complications following dental implant dislocation into the maxillary sinus and their management and attempts to elucidate the reasons for these complications and their prevention. This retrospective study presents 55 cases of dental implant migration into the maxillary sinus. Patients were 30 men and 25 women with average age of 58 years. Oroantral communication was found in 46 cases, primarily in cases without prior bone augmentation, in patients aged older than 60 years (mean), and medically compromised patients (ASA > 1). The dislocated implant and the infected tissue were removed from the sinus in most cases by Caldwell-luc intervention. The oroantral communication was closed by local and regional flaps. In most of the cases, the oroantral communication was closed by a single intervention. The conclusion was that oroantral communication and maxillary sinusitis are common findings following dental implant migration and dislocation into the maxillary sinus. The risk factors for these complications were dental implantation in the posterior maxilla without sufficient alveolar bone, implantation without prior maxillary sinus augmentation, and older and medically compromised patients. Successful closure of the communication is usually performed with local or regional flaps.
本文描述了牙种植体移位至上颌窦后的并发症及其处理方法，并试图阐明这些并发症的原因及预防措施。这项回顾性研究呈现了55例牙种植体移入上颌窦的病例。患者中男性30例，女性25例，平均年龄58岁。46例发现有口腔上颌窦交通，主要见于未预先进行骨增量的病例、平均年龄大于60岁的患者以及有内科疾病的患者（美国麻醉医师协会分级>1级）。在大多数病例中，通过柯-陆氏手术从上颌窦取出移位的种植体和感染组织。口腔上颌窦交通通过局部和区域皮瓣关闭。在大多数病例中，口腔上颌窦交通通过单次干预得以关闭。结论是，口腔上颌窦交通和上颌窦炎是牙种植体移入并移位至上颌窦后的常见表现。这些并发症的危险因素包括在上颌后牙区牙槽骨不足时进行牙种植、未预先进行上颌窦增量以及年龄较大和有内科疾病的患者。通常采用局部或区域皮瓣成功关闭交通。
