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上颌窦侧壁骨增量术后上颌窦形态的放射学变化。

Radiological changes in maxillary sinus morphology after lateral sinus floor augmentation.

机构信息

Dental Medical Center of Bogomolets National Medical University, Kyiv, Ukraine.

Department of otorhinolaryngology Bogomolets National Medical University, Kyiv, Ukraine Katedra Otolaryngologii.

出版信息

Otolaryngol Pol. 2020 Jun 3;74(5):1-5. doi: 10.5604/01.3001.0014.1679.

Abstract

<b>Background:</b> Restoration of the masticatory function in patients with edentulous posterior maxilla is often challenging due to the severe atrophy of the alveolar ridges and proximity of the maxillary sinus, resulting in insufficient bone quantity for implant-supported dentures. <br><b>Aim:</b> The purpose of this study was to analyze the changes in Schneiderian membrane thickness after lateral sinus floor augmentation (LSFA) using cone beam computed tomography (CBCT). <br><b>Material and methods:</b> WLSFA procedures using different bone grafting materials were performed in 87 patients, operated on in two clinical institutions from 2016 to 2018. CBCT examination was performed in all patients before the LSFA procedure, at 1 month after surgery, and after 6 months, before implant placement or loading. <br><b>Results: </b>Minor r adiological changes in mucous membrane morphology were observed preoperatively in 17.1% of patients. Postoperative CBCT in the early postsurgical period demonstrated that the number of intact non-specific sinuses decreased significantly, i.e. from 86.7% to 26.7%. The number of cases with local hypertrophia of the mucous membrane increased from 20.3% to 26.7%. Mucosal thickening was observed in 41.7% vs 7.5%. The number of intact sinuses increased to 57.8%. The number of cases with local membrane hypertrophia also increased - to 37.4%. The number of cases with mucosal thickening or fluid accumulation decreased significantly to 11.8 and 5.3% respectively. In 2 cases the development of chronic sinusitis required secondary surgeries. <br><b>Conclusion:</b> The present retrospective study revealed that minor radiological changes in the morphology of the maxillary sinus mucosa were observed preoperatively in 17.1% of patients who underwent LSFA procedures. In the early and late postoperative period their frequency increased to 68.5% and 47.1%, respectively. However, the clinical signs of sinusitis developed only in 19.26% of patients. No significant correlations were found between the frequency and severity of postoperative radiological changes and residual bone height, sinus anatomy, initial state of the mucous membrane and type of the grafting material.

摘要

<b>背景:</b>由于牙槽嵴严重萎缩和上颌窦邻近,无牙后上颌的咀嚼功能恢复常常具有挑战性,导致用于种植体支持义齿的骨量不足。<br><b>目的:</b>本研究旨在使用锥形束计算机断层扫描(CBCT)分析外侧窦底提升(LSFA)后施密特氏膜厚度的变化。<br><b>材料与方法:</b>2016 年至 2018 年,在两个临床机构对 87 例患者进行了 WLSFA 手术,使用不同的骨移植材料。所有患者在 LSFA 术前、术后 1 个月和 6 个月,在植入物放置或负载之前进行 CBCT 检查。<br><b>结果:</b>术前 17.1%的患者有轻微的黏膜形态放射性改变。术后早期的 CBCT 显示,完整的非特异性窦数量明显减少,即从 86.7%降至 26.7%。局部黏膜肥厚的病例数从 20.3%增加到 26.7%。黏膜增厚在 41.7%和 7.5%之间。完整窦的数量增加到 57.8%。局部膜肥厚的病例数也增加到 37.4%。黏膜增厚或积液的病例数显著减少至 11.8%和 5.3%。有 2 例发展为慢性鼻窦炎,需要二次手术。<br><b>结论:</b>本回顾性研究显示,接受 LSFA 手术的患者术前有 17.1%存在上颌窦黏膜形态的轻微影像学改变。在术后早期和晚期,其频率分别增加到 68.5%和 47.1%。然而,只有 19.26%的患者出现了鼻窦炎的临床症状。术后影像学改变的频率和严重程度与残留骨高度、窦解剖、黏膜初始状态和移植物类型之间无显著相关性。

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