Department of Periodontology, School of Dentistry, Kyung Hee University, Seoul 02771, Korea.
Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, Columbia University College of Dental Medicine, New York, NY 10032, USA.
Medicina (Kaunas). 2022 May 18;58(5):672. doi: 10.3390/medicina58050672.
Mucociliary clearance (MCC) allows ventilation of graft particles that are displaced through a perforated Schneiderian membrane during maxillary sinus augmentation (MSA). However, it is very rarely confirmed by cone-beam computed tomographic (CBCT) images. It is not yet known how long the dislodged bone graft particles remain in the maxillary sinus or how quickly they are ventilated after MSA. The purpose of these case reports is to introduce tomographic imaging of ventilation of bone graft particles displaced through a perforated Schneiderian membrane after MSA. Four patients, who needed implant placement in the posterior maxilla, received MSA, during which the Schneiderian membrane was perforated but was not repaired. Therefore, some bone graft particles were dislocated into the sinus cavity. The sizes of the perforated membranes were measured and recorded. CBCT scans were taken at multiple time points after the surgery to visualize and trace the ejected material. In addition, the time from when the bone graft substitute was delivered to the sinus until the CBCT scans were taken was recorded. The expelled bone graft particles migrated to the ostium along the sinus wall immediately after MSA on CBCT images taken immediately after the surgery. No displaced graft particles were observed in the maxillary sinus on CBCT scans after 1 week. The CBCT scans at 6 months showed no unusual radiographic images. Within the limitations of the case reports, tomographic imaging revealed an MCC system that allows displaced graft particles to be ventilated into the ostium very early during MSA healing and not stagnate in the maxillary sinus.
黏膜纤毛清除（Mucociliary clearance，MCC）允许通过上颌窦提升（Maxillary sinus augmentation，MSA）中穿孔的筛状膜移位的移植物颗粒通气。然而，通过锥形束计算机断层扫描（Cone-beam computed tomography，CBCT）图像确认这一点非常罕见。目前尚不清楚移位的骨移植物颗粒在上颌窦中停留多长时间，以及在 MSA 后它们有多快被通气。这些病例报告的目的是介绍通过 MSA 后穿孔的筛状膜移位的骨移植物颗粒通气的断层成像。四位需要在后上颌植入物的患者接受了 MSA，在此过程中，筛状膜穿孔但未修复。因此，一些骨移植物颗粒移位到窦腔中。测量并记录穿孔膜的大小。在手术后的多个时间点进行 CBCT 扫描，以可视化和追踪喷出的材料。此外，还记录了从将骨移植物替代物输送到窦腔到进行 CBCT 扫描的时间。在手术后立即进行的 CBCT 图像上，移植物颗粒在 MSA 后立即沿窦壁迁移到窦口。在 1 周后的 CBCT 扫描中，上颌窦中未观察到移位的移植物颗粒。6 个月的 CBCT 扫描显示无异常射线照相图像。在病例报告的限制范围内，断层成像显示 MCC 系统允许在 MSA 愈合过程中非常早期将移位的移植物颗粒通气到窦口，而不会在上颌窦中停滞。
