The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, Hangzhou, China.
Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, China.
Clin Oral Implants Res. 2022 Nov;33(11):1098-1113. doi: 10.1111/clr.13993. Epub 2022 Sep 12.
To retrospectively compare multilevel volumetric changes in both hard and soft tissues between antral pseudocyst (AP) removal and retainment before maxillary sinus floor augmentation (MSFA) and immediate implant placement.
Twenty-six patients with 38 implants placed from 2016 to 2021 were included and divided according to a cohort design as follows: 13 removing the cyst (RC group) and 13 "leaving alone" the cyst (LC group). 3D radiographic parameters (primary outcome), 2D parameters and clinical records (secondary outcome) involving both hard and soft tissues were evaluated for four periods (T1: immediate postoperative, T2: 6-month, T3: 12-month, and T4: 2- to 5- year follow-up). Possible confounding factors, including sinus anatomical features and implant distribution, were also analyzed to eliminate their disturbance.
The 3D volumetric change rate of bone grafts in the RC group (-9.32% ± 10.01%) from T2 to T3 was significantly lower than that in the LC group (-19.8% ± 10.59%) (p < .05). The change rate of apical bone height (ABH), endo-sinus bone gain (ESBG) and other 2D parameters were not significantly different between the two groups. 5.3% implants in RC group and 9.1% implants in LC group failed during follow-ups. 0% postoperative complications were observed in RC group. The Schneiderian membrane of RC group was significantly thinner than that of LC group at two measuring points in sinus.
The present study demonstrated that compared to AP retainment, AP removal before MSFA and immediate implant placement can obtain higher bone graft volumetric stability and favorable prognosis.
回顾性比较上颌窦底提升（MSFA）及即刻种植前经窦内入路去除与保留窦底假性囊肿（AP）在硬组织和软组织方面的多层容积变化。
本研究共纳入了 2016 年至 2021 年期间 26 名患者的 38 个种植体，根据队列设计分为两组：13 例患者（RC 组）行囊肿切除术，13 例患者（LC 组）保留囊肿。对两组患者的 3D 影像学参数（主要结局）、硬组织和软组织的 2D 参数及临床记录（次要结局）进行评估，共分为四个时期（T1：术后即刻，T2：术后 6 个月，T3：术后 12 个月，T4：2 至 5 年随访）。同时还分析了可能影响结果的鼻窦解剖特征和种植体分布等混杂因素。
RC 组患者在 T2 至 T3 期间，骨移植的 3D 容积变化率（-9.32%±10.01%）明显低于 LC 组（-19.8%±10.59%）（p<.05）。两组间根尖骨高度（ABH）、窦底骨增量（ESBG）等 2D 参数的变化率无显著差异。RC 组有 5.3%的种植体在随访过程中失败，LC 组有 9.1%的种植体失败。RC 组术后无并发症发生，而 LC 组有 1 例发生术后感染。RC 组患者的窦黏膜在两个测量点均显著薄于 LC 组。
与保留 AP 相比，MSFA 及即刻种植前去除 AP 可获得更高的骨移植体积稳定性和更有利的预后。
