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拔牙和手术引流后鼻窦黏膜增厚的变化:锥形束 CT 研究。

Changes in sinus mucosal thickening in the course of tooth extraction and lateral sinus augmentation with surgical drainage: A cone-beam computed tomographic study.

机构信息

Department of Periodontology, Kyung Hee University, College of Dentistry, Private Practice in Periodontics and Implant Dentistry, Seoul, South Korea.

Biostatistical Consulting and Research, Medical Research Collaborating Center, Industry-University Cooperation Foundation, Hanyang University, Seoul, South Korea.

出版信息

Clin Oral Implants Res. 2023 Feb;34(2):95-104. doi: 10.1111/clr.14019. Epub 2022 Nov 16.

DOI:10.1111/clr.14019
PMID:36336985
Abstract

OBJECTIVES

The objective of the study was to evaluate the radiographic changes in sinus mucosal thickness (SMT) in patients with mucosal thickening of odontogenic origin after maxillary molar extraction and lateral sinus augmentation with simultaneous surgical drainage and implant placement.

MATERIALS AND METHODS

Forty-six patients were included in this study. The changes in SMT were evaluated using cone-beam computed tomography images produced at four time points: before extraction (T0), before surgery (T1), immediately after surgery (T2), and after prosthesis delivery (T3), and statistical differences between time points were analyzed. The changes in SMT and augmented bone height (ABH) regarding the reason of extraction, smoking, ostial patency, and the presence of postoperative sinusitis were also evaluated.

RESULTS

Over time points, SMT gradually decreased (T0: 19.44 ± 9.22 mm, T1: 15.10 ± 8.89 mm, T2: 8.42 ± 6.01 mm, and T3: 4.16 ± 4.91 mm) (p < .05). Five out of 6 patients with ostial obstruction at T1 presented ostial patency at T3. Two patients developed postoperative sinusitis but recovered with medication. Ostial patency at T1, SMT at T1, and reason of extraction did not statistically significantly influence SMT at T3. SMT at T1 had no statistically significant impact on ABH change between T2 and T3.

CONCLUSION

Sinus mucosal thickness was gradually reduced by extraction of compromised teeth and drainage during lateral sinus augmentation. The drainage contributed more to the reduction in SMT.

摘要

目的

本研究旨在评估因牙源性原因导致上颌磨牙拔除后、同期行外侧窦提升术及外科引流并植入种植体的患者,其窦黏膜厚度(SMT)的放射影像学变化。

材料与方法

本研究纳入 46 例患者。使用锥形束 CT 图像,在 4 个时间点评估 SMT 的变化:拔牙前(T0)、术前(T1)、术后即刻(T2)和修复体戴入后(T3),并分析各时间点之间的统计学差异。还评估了 SMT 及提升骨高度(ABH)的变化与拔牙原因、吸烟、窦口通畅情况以及术后窦炎的关系。

结果

随着时间的推移,SMT 逐渐减少(T0:19.44±9.22mm,T1:15.10±8.89mm,T2:8.42±6.01mm,T3:4.16±4.91mm)(p<0.05)。T1 时窦口阻塞的 6 例患者中有 5 例在 T3 时窦口通畅。2 例患者发生术后窦炎,但经药物治疗后恢复。T1 时窦口通畅、T1 时 SMT 以及拔牙原因均与 T3 时 SMT 无统计学显著相关性。T1 时的 SMT 对 T2 至 T3 之间的 ABH 变化无统计学显著影响。

结论

经牙源性原因导致的患牙拔除及外侧窦提升术中引流,窦黏膜厚度逐渐减少。引流对 SMT 减少的贡献更大。

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