Faculty of Medicine and Pharmacy, Oral Health Research Group (ORHE), Vrije Universiteit Brussel (VUB), Brussels, Belgium.
Faculty of Medicine and Health Sciences, Department of Periodontology and Oral Implantology, Dental School, Ghent University, Ghent, Belgium.
Clin Implant Dent Relat Res. 2019 Apr;21(2):301-309. doi: 10.1111/cid.12730. Epub 2019 Feb 11.
A sinus floor augmentation may be indicated when a lack of hard tissue impedes implant placement. Although clinically successful, evidence supporting the long-term three-dimensional stability of the grafted volume is scarce. Second, evidence on the patient's acceptance of this type of treatment is limited.
First is to evaluate the changes in graft volume after lateral wall sinus lifting based on superimposed cone beam computed tomography (CBCT) images and then to assess patient-reported outcome measures (PROMs) and clinical outcomes.
Partially edentulous patients in need of a sinus lift and fixed reconstruction on at least two neighboring implants were selected for a prospective case series. Lateral wall sinus augmentation was performed using deproteinized bovine bone mineral (DBBM) as the only filling material. Volumetric changes were quantified on the basis of a preoperative CBCT and three postoperative CBCTs (at 2 weeks, 3 months, and 2 years). PROMs and clinical parameters were registered.
Twenty-two patients (7 males, 15 females; mean age 59 years) participated of which three patients dropped out during the follow up. Graft volumes amounted to 1418.26 mm at 2 weeks, 1201.21 mm at 3 months, and 1130.13 mm at 2 years postoperative pointing to a relative graft volume stability of 79.7%. Swelling was the leading symptom during the first week. A peak in visual analogue scale scores was observed for pain, swelling, and hematoma the day of surgery and 1 day postoperation with a statistically significant decline between days 3 and 7. Hemorrhage and nose bleeding occurred in 18.2% and 27.3% of the subjects, respectively. About 95.5% of the subjects would undergo the treatment again. All implants integrated successfully and demonstrated healthy clinical conditions.
Lateral wall sinus augmentation using DBBM as the only filling material is a viable treatment concept given limited graft resorption, good patients' tolerance, and clinical outcomes.
当硬组织不足妨碍植入物放置时，可能需要进行鼻窦底提升。虽然临床效果成功，但支持移植体积长期三维稳定性的证据很少。其次，关于患者对这种治疗类型的接受程度的证据有限。
首先，基于重叠的锥形束计算机断层扫描 (CBCT) 图像评估侧壁窦提升后的移植物体积变化，然后评估患者报告的结果测量 (PROM) 和临床结果。
选择需要鼻窦提升和至少两个相邻植入物固定修复的部分无牙患者进行前瞻性病例系列研究。使用脱蛋白牛骨矿物质 (DBBM) 作为唯一填充材料进行侧壁窦提升。根据术前 CBCT 和术后三个 CBCT（2 周、3 个月和 2 年）定量体积变化。记录 PROM 和临床参数。
22 名患者（7 名男性，15 名女性；平均年龄 59 岁）参与了研究，其中 3 名患者在随访过程中脱落。移植物体积在 2 周时为 1418.26mm，在 3 个月时为 1201.21mm，在 2 年时为 1130.13mm，提示相对移植物体积稳定性为 79.7%。肿胀是术后第一周的主要症状。手术当天和术后 1 天疼痛、肿胀和血肿的视觉模拟量表评分达到峰值，术后第 3 天至第 7 天显著下降。出血和鼻出血分别发生在 18.2%和 27.3%的受试者中。约 95.5%的受试者会再次接受该治疗。所有植入物均成功整合，显示出健康的临床状况。
使用 DBBM 作为唯一填充材料的侧壁窦提升是一种可行的治疗概念，因为移植物吸收有限，患者耐受性良好，临床效果良好。
