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经侧方开窗术与经牙槽水力提升法行上颌窦底提升术的术中及术后效果比较:一项初步的随机对照试验。

Intraoperative and postoperative outcomes of sinus floor elevation using the lateral window technique versus the hydrodynamic transalveolar approach: a preliminary randomized controlled trial.

机构信息

Dental Biomaterials Research Unit (d-BRU), Faculty of Medicine, University of Liege, 4000, Liege, Belgium.

Department of Periodontology and Oral Surgery, Faculty of Medicine, University of Liege, 4000, Liege, Belgium.

出版信息

Clin Oral Investig. 2021 Sep;25(9):5391-5401. doi: 10.1007/s00784-021-03847-2. Epub 2021 Mar 10.

Abstract

OBJECTIVES

To compare the clinical and radiographic outcomes of two sinus floor elevation techniques: the conventional lateral window technique versus the transalveolar approach using a hydrodynamic ultrasonic device.

MATERIALS AND METHODS

The study was designed as a randomized controlled clinical trial, and participants were randomly allocated to the control group (lateral window: LW) or to the test group (hydrodynamic transalveolar approach: HTA). The intraoperative and postoperative data, including procedure duration and patient-reported outcome measures (PROMs), were collected during the surgery and up to 1 year post-surgery. Additionally, qualitative assessment of gained bone volumes and implant survival rates was recorded.

RESULTS

Twenty-two patients were included in the study. The mean surgical time was significantly longer in the HTA compared to the LW group (48.1 ± 11.2 min vs. 35.2 ± 9.1 min, P = 0.0011). Perforation of the Schneiderian membrane occurred in 2/11 and 5/11 patients in the LW and the HTA group, respectively (P = 0.36). Postoperatively, higher morbidity and consumption of nonsteroidal anti-inflammatory drugs (NSAIDs) were associated with the LW group. However, self-reported satisfaction with surgical procedures was similar in the two groups. At 1 year, implant survival rates of 80% in the HTA group and 100% in the LW group were recorded (P = 0.12).

CONCLUSIONS

Although the new transalveolar approach seems to reduce postoperative morbidity, an increased risk of intraoperative complications compared to the LW approach needs to be considered when choosing a technique.

CLINICAL RELEVANCE

Our results provide new insights regarding clinical and radiographic outcomes of HTA and may help further determine indications for its use.

TRIAL REGISTRATION

ClinicalTrivals.gov : NCT04499625.

摘要

目的

比较两种鼻窦提升技术的临床和影像学结果:传统的外侧壁开窗术与使用流体动力超声设备的经牙槽嵴入路。

材料与方法

该研究设计为随机对照临床试验,参与者被随机分配到对照组(外侧壁开窗术:LW)或实验组(流体动力经牙槽嵴入路:HTA)。术中及术后数据,包括手术时间和患者报告的结果测量(PROMs),在手术期间和术后 1 年收集。此外,还记录了获得的骨量和种植体存活率的定性评估。

结果

共有 22 名患者纳入研究。HTA 组的平均手术时间明显长于 LW 组(48.1 ± 11.2 分钟 vs. 35.2 ± 9.1 分钟,P = 0.0011)。LW 组和 HTA 组分别有 2/11 例和 5/11 例患者发生了筛状膜穿孔(P = 0.36)。术后,LW 组患者的发病率和非甾体抗炎药(NSAIDs)的使用率较高。然而,两组患者对手术过程的满意度相似。1 年后,HTA 组的种植体存活率为 80%,LW 组为 100%(P = 0.12)。

结论

尽管新的经牙槽嵴入路似乎降低了术后发病率,但与 LW 入路相比,术中并发症的风险增加,在选择技术时需要考虑。

临床相关性

我们的结果提供了关于 HTA 的临床和影像学结果的新见解,并可能有助于进一步确定其使用的适应证。

试验注册

ClinicalTrials.gov:NCT04499625。

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