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上颌窦内移位牙种植体的取出:一项回顾性单中心研究。

Removal of dental implants displaced into the maxillary sinus: a retrospective single-center study.

机构信息

School of Dentistry, Department of Health Sciences, Magna Graecia University of Catanzaro, Viale Europa, 88100, Catanzaro, Italy.

Unit of Maxillofacial Surgery, Academic Hospital of Magna Graecia University of Catanzaro, Catanzaro, Italy.

出版信息

Head Face Med. 2022 Nov 17;18(1):34. doi: 10.1186/s13005-022-00339-w.

Abstract

BACKGROUND

The use of dental implants in the prosthetic rehabilitation of the posterior atrophic maxilla might be a challenge procedure because of low bone quantity and quality. This study aimed to report cases of implant displacement or migration into the maxillary sinus treated from 2008 to 2021.

MATERIALS AND METHODS

All patients with unintentional insertion and/or displacement of dental implants into the maxillary sinus cavity that underwent surgical removal were included. Variables assessed included the patients' characteristics, past medical history, clinical and radiological findings at presentation, surgical approach (transoral, transnasal, combined), and outcome.

RESULTS

A total of forty patients (23 male, 17 female) underwent surgical removal of dental implant displaced in the maxillary sinus. The mean age was 52,3 + 11,3 years. Seven patients presented with oro-antral fistula (OAF). In 15 cases, an ostium obstruction was diagnosed. Twenty-five patients underwent transoral surgery under local anesthesia. Eleven patients were treated solely via transnasal endoscopic approach, and four patients who had an associated OAF underwent surgery through a combined transnasal and transoral approach. All patients healed uneventfully without complications.

CONCLUSION

These results and recent literature validate that transoral and transnasal approach, or a combination of these procedures, can be used safely to treat complications following displacement/migration of dental implants in the maxillary sinus. Early surgical removal minimizes sinus inflammation and prevents more invasive procedures. Each procedure presents specific indications that must be carefully evaluated prior to treatment choice to optimize intervention outcomes.

摘要

背景

由于骨量和质量较低,在后萎缩的上颌骨中使用牙种植体进行修复可能是一个具有挑战性的程序。本研究旨在报告 2008 年至 2021 年期间治疗的种植体移位或迁移到上颌窦的病例。

材料和方法

所有因意外插入和/或牙种植体移位到上颌窦腔而接受手术切除的患者均被纳入研究。评估的变量包括患者的特征、既往病史、就诊时的临床和影像学发现、手术方法(经口、经鼻、联合)和结果。

结果

共有 40 名患者(23 名男性,17 名女性)接受了已移位至上颌窦的牙种植体的手术切除。平均年龄为 52.3±11.3 岁。7 名患者出现口-窦瘘(OAF)。15 例诊断为窦口阻塞。25 例患者在局部麻醉下经口手术。11 例患者仅通过经鼻内镜治疗,4 例有 OAF 的患者通过经鼻和经口联合手术治疗。所有患者均未出现并发症,顺利愈合。

结论

这些结果和最近的文献证实,经口和经鼻入路,或这些方法的联合使用,可以安全地治疗牙种植体移位/迁移到上颌窦后的并发症。早期手术切除可最大限度地减少窦炎并防止更具侵袭性的手术。每种手术都有特定的适应证,在选择治疗方案之前必须仔细评估,以优化干预结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e9b/9670493/3af62d29e319/13005_2022_339_Fig1_HTML.jpg

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