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上颌窦内移位的医源性牙科异物——一项回顾性研究的安全性和有效性分析

Foreign Bodies of Dental Iatrogenic Origin Displaced in the Maxillary Sinus - A Safety and Efficacy Analysis of a Retrospective Study.

作者信息

Tilaveridis Ioannis, Stefanidou Anatoli, Kyrgidis Athanassios, Tilaveridis Stavros, Tilaveridou Sofia, Zouloumis Lambros

机构信息

Department of Oral and Maxillofacial Surgery, Dental School, Aristotle University of Thessaloniki, Thessaloniki, Greece.

出版信息

Ann Maxillofac Surg. 2022 Jan-Jun;12(1):33-38. doi: 10.4103/ams.ams_190_21. Epub 2022 Aug 16.

Abstract

INTRODUCTION

Foreign bodies (FB) of the paranasal sinuses are an uncommon clinical entities with the maxillary sinuses being those most frequently affected. According to the literature, 60% of paranasal sinus FB are of iatrogenic origin, while 25% are of traumatic origin. This article aims to present an iatrogenic origin series of cases of FB displaced or projecting into the maxillary sinus.

MATERIALS AND METHODS

In this retrospective study, the presence of the foreign body was revealed with radiologic methods and confirmed during the operation with macroscopic or later with histopathologic examination. All cases were treated with osteoplasty with vascularised pedicled bone flap or through minimally invasive intraoral procedure.

RESULTS

A total of 27 patients were included in our study, 14 men and 13 women. The age range was 18-65 years with mean age of 46.14 (standard deviation = 10.35) years. Foreign body was displaced fragments of teeth in 11 patients (40.27%), complete teeth in four patients (14.81%), dental implants in five patients (18.51%), dental impression material in 2 cases (7,40%), gutta percha cone in two patients (7.40%), endodontic sealer associated with aspergillosis in two patients (7.40%), and dental burr in one patient (3.7%). The time between dental foreign body displacement and the surgical intervention for its removal was critical for the occurrence of sinusitis. All operated patients remained asymptomatic during a follow-up of at least 1 year.

DISCUSSION

Prompt intervention for removal of FB eliminates the risk for chronic inflammation of the affected maxillary sinus and reduces the odds for sequelae.

摘要

引言

鼻窦异物是一种不常见的临床病症,其中上颌窦最常受累。根据文献,60%的鼻窦异物起源于医源性,而25%起源于创伤性。本文旨在介绍一系列起源于医源性的上颌窦异物移位或突入病例。

材料与方法

在这项回顾性研究中,通过放射学方法发现异物存在,并在手术中通过肉眼或随后的组织病理学检查得以证实。所有病例均采用带血管蒂骨瓣的骨成形术或通过微创口内手术进行治疗。

结果

我们的研究共纳入27例患者,其中男性14例,女性13例。年龄范围为18至65岁,平均年龄为46.14(标准差 = 10.35)岁。异物为牙齿碎片移位的患者有11例(40.27%),完整牙齿的患者有4例(14.81%),牙种植体的患者有5例(18.51%),牙科印模材料的患者有2例(7.40%),牙胶尖的患者有2例(7.40%),与曲霉病相关的根管封闭剂的患者有2例(7.40%),牙科钻的患者有1例(3.7%)。牙齿异物移位至手术取出的时间对于鼻窦炎的发生至关重要。所有接受手术的患者在至少1年的随访期间均无症状。

讨论

及时干预取出异物可消除受影响上颌窦慢性炎症的风险,并降低后遗症的几率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/43be/9527830/64198c1b81c4/AMS-12-33-g001.jpg

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