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牙源性鼻窦炎伴发于牙种植体的特征。

Features of Odontogenic Sinusitis Associated With Dental Implants.

机构信息

Department of Otorhinolaryngology-Head and Neck Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.

Department of Otorhinolaryngology-Head and Neck Surgery, Inha University School of Medicine, Incheon, South Korea.

出版信息

Laryngoscope. 2023 Feb;133(2):237-243. doi: 10.1002/lary.30069. Epub 2022 Feb 18.

Abstract

OBJECTIVES

With the increase in dental implants for tooth loss, odontogenic sinusitis following maxillary dental implants is frequently encountered in otorhinolaryngology practice. The authors aimed to reveal the association between implant extrusion into maxillary sinus, along with implant-related complications in patients diagnosed with implant-related odontogenic sinusitis (IR-ODS).

STUDY DESIGN

Case-control study.

METHODS

This study enrolled 60 patients who received functional endoscopic sinus surgery due to IR-ODS. The preoperative sinus computed tomography was retrospectively reviewed. Among the 120 maxillary sinuses of the 60 patients, 68 sides were diagnosed with IR-ODS sides, whereas 27 sides showed no clinical or radiological evidence of this condition after the implant insertion and were defined as the control sides. Statistical analysis between these two groups was conducted, in addition to odds ratio (OR) calculations for associations with IR-ODS.

RESULTS

The mean age of the IR-ODS subjects was 59.5 ± 19.1, with a male to female ratio of 32/28 (53.3%/46.7%). Implants extruding by more than 4 mm into the maxillary sinus, peri-implantitis, bone graft disruption-extrusion were associated with a significantly higher incidence in the IR-ODS (p = 0.035, p = 0.003, p = 0.011, respectively). The IR-ODS sides showed an adjusted-OR (95% confidence interval) of 27.4 (2.7-276.5) for extrusion length >4 mm, 11.8 (3.0-46.5) for peri-implantitis, and 34.1 (3.3-347.8) for bone graft disruption (p = 0.005, p < 0.001, and p = 0.003, respectively).

CONCLUSION

Maxillary dental implants extruding more than 4 mm into the maxillary sinus, peri-implantitis, and disrupted-extruded bone grafts show significant association with IR-ODS.

LEVEL OF EVIDENCE

4 Laryngoscope, 133:237-243, 2023.

摘要

目的

随着牙缺失患者中种植牙数量的增加,上颌种植牙后发生牙源性鼻窦炎在耳鼻喉科实践中越来越常见。作者旨在揭示与种植体挤压上颌窦以及与种植体相关的并发症之间的关联,这些并发症与诊断为种植体相关性牙源性鼻窦炎(IR-ODS)的患者有关。

研究设计

病例对照研究。

方法

本研究纳入了 60 名因 IR-ODS 接受功能性内镜鼻窦手术的患者。回顾性分析术前鼻窦计算机断层扫描。在这 60 名患者的 120 个上颌窦中,68 侧被诊断为 IR-ODS 侧,而 27 侧在植入种植体后无临床或影像学证据表明存在这种情况,被定义为对照侧。对这两组进行了统计学分析,并计算了与 IR-ODS 相关的优势比(OR)。

结果

IR-ODS 组患者的平均年龄为 59.5±19.1 岁,男女比例为 32/28(53.3%/46.7%)。种植体挤压上颌窦超过 4mm、种植体周围炎、骨移植破裂-挤出与 IR-ODS 发生率显著相关(p=0.035、p=0.003、p=0.011)。IR-ODS 侧的挤压长度>4mm 的调整后 OR(95%置信区间)为 27.4(2.7-276.5),种植体周围炎为 11.8(3.0-46.5),骨移植破裂-挤出为 34.1(3.3-347.8)(p=0.005、p<0.001 和 p=0.003)。

结论

上颌种植牙挤压超过 4mm 进入上颌窦、种植体周围炎和破裂-挤出的骨移植与 IR-ODS 有显著关联。

证据水平

4 级喉镜,133:237-243,2023 年。

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