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鼻窦侧壁开窗提升术中鼻窦黏膜穿孔的危险因素和纵向再生结果:长达 9 年的回顾性分析。

Risk factors and longitudinal regenerative outcomes of sinus membrane perforation during lateral window sinus floor elevation: A retrospective analysis up to 9 years.

机构信息

Private practice, Seattle, Washington, USA.

Department of Periodontics, University of Washington School of Dentistry, Seattle, Washington, USA.

出版信息

J Periodontol. 2023 Aug;94(8):1045-1054. doi: 10.1002/JPER.22-0424. Epub 2023 Feb 23.

Abstract

BACKGROUND

Lateral-window sinus floor elevation (LSFE) is a reliable procedure to reconstruct the posterior maxilla for implant therapy. This retrospective study aimed to investigate risk factors associated with Schneiderian membrane perforation (SMP) occurrence during LSFE and longitudinal regenerative outcomes following LSFE up to 9 years.

METHODS

Patients who had LSFE between 2010 and 2019 were included. All demographic and surgical-related data were retrieved from existing electronic health records. Radiographs were used to evaluate the vertical dimensional changes of ridge and graft materials and the potential anatomic factors of SMP.

RESULTS

A total of 122 LSFE procedures in 99 patients were included in the study. Mean ridge height gain and graft shrinkages were 9.5 ± 3.47 and 1.57 ± 2.85 mm. The influence of the healing period on graft shrinkage showed a positive trend; the longer the healing period, the greater the graft shrinkage (p = 0.09). The pathology in the sinus showed a positive correlation with SMP (p = 0.07). However, other anatomical factors did not negatively impact SMP and subsequent ridge height gain (p > 0.05).

CONCLUSIONS

With inherent limitation, the findings with up to 9 years of follow-up indicate a consistent ridge remodeling lasting for about 3 years after LSFE procedures. SMP or membrane thickening may not significantly affect the ridge gain following LSFE. The healing period had the most significant influence on graft shrinkage, showing that the longer the healing time between LSFE and implant placement, the greater the graft shrinkage.

摘要

背景

外侧窗窦底提升(LSFE)是一种可靠的方法,可用于对后上颌骨进行重建以进行种植体治疗。本回顾性研究旨在调查 LSFE 过程中与硬脑膜穿孔(SMP)发生相关的风险因素,以及 LSFE 后长达 9 年的纵向再生结果。

方法

纳入 2010 年至 2019 年期间进行 LSFE 的患者。所有人口统计学和手术相关数据均从现有的电子健康记录中检索。使用 X 光片评估牙槽嵴的垂直尺寸变化和移植物材料以及 SMP 的潜在解剖因素。

结果

本研究共纳入 99 例患者的 122 例 LSFE 手术。平均牙槽嵴高度增加和移植物收缩分别为 9.5±3.47mm 和 1.57±2.85mm。愈合期对移植物收缩的影响呈正趋势;愈合期越长,移植物收缩越大(p=0.09)。窦内病理与 SMP 呈正相关(p=0.07)。然而,其他解剖因素对 SMP 及随后的牙槽嵴高度增加没有负面影响(p>0.05)。

结论

在长达 9 年的随访中,具有固有局限性的研究结果表明,LSFE 手术后约 3 年持续进行一致的牙槽嵴重塑。SMP 或膜增厚可能不会显著影响 LSFE 后的牙槽嵴增加。愈合期对移植物收缩的影响最大,表明 LSFE 和种植体植入之间的愈合时间越长,移植物收缩越大。

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