Sarmast Nima D, Wang Howard H, Ma Rui, Carrion Julio A, Iacono Vincent J
Department of Periodontics and Dental Hygiene, University of Texas School of Dentistry at Houston, Houston, TX.
Department of Periodontology, Stony Brook University School of Dental Medicine, Stony Brook, NY.
Clin Adv Periodontics. 2016 Nov;6(4):175-181. doi: 10.1902/cap.2016.150086.
Asymptomatic displacement of dental implants into the maxillary sinus after a transcrestal sinus augmentation is a rare complication that can occur when there is poor bone quality and minimal residual bone height. Patient compliance with postoperative appointments and failure to comply with denture-wearing instructions are critical contributing factors. To the best of the authors' knowledge, no cases of implant dislodgement attributable to a removable prosthesis have been reported in the literature, although some studies have suggested that improper occlusal forces can cause a long-standing implant to develop peri-implantitis and subsequent displacement of an implant into the sinus cavity.
A 71-year-old female presented 6 months after undergoing transcrestal sinus lift and implant surgery that involved a modified Summers technique using mineralized solvent-dehydrated cancellous bone allograft and placement of six maxillary implants. A displaced dental implant was retrieved from the right maxillary sinus, which had an intact Schneiderian membrane. The patient was asymptomatic and infection free. The displaced implant was accessed and retrieved via a lateral window sinus technique. No clinical signs of sinus infection were evident, and there were no additional complications during the 2-year follow-up period.
This case report demonstrates a technique for the retrieval of implants that have been dislodged and migrated into the maxillary sinus cavity caused by an ill-fitting denture and improper masticatory forces.
经牙槽嵴上颌窦提升术后牙种植体无症状性移位至上颌窦是一种罕见的并发症,当骨质质量差且剩余骨高度极小时可能发生。患者对术后复诊的依从性以及未遵守戴假牙指示是关键的促成因素。据作者所知,文献中尚无因可摘义齿导致种植体移位的病例报道,尽管一些研究表明,不当的咬合力会使长期存在的种植体发生种植体周围炎,进而导致种植体移位至窦腔。
一名71岁女性在接受经牙槽嵴上颌窦提升及种植手术6个月后前来就诊,该手术采用改良的Summers技术,使用矿化溶剂脱水松质骨异体骨并植入6颗上颌种植体。从右侧上颌窦取出一枚移位的牙种植体,其施耐德膜完整。患者无症状且无感染。通过外侧开窗鼻窦技术取出移位的种植体。无鼻窦感染的临床迹象,在2年随访期内也无其他并发症。
本病例报告展示了一种取出因义齿不合适和咀嚼力不当而移位并迁移至上颌窦腔的种植体的技术。