Department of Oral and Maxillofacial Surgery, International University of Africa, Khartoum, Sudan.
Department of Prosthodontics, RAK College of Dental Sciences, Ras Al-Khaimah, United Arab Emirates, Phone: +00971508094225, e-mail:
J Contemp Dent Pract. 2023 Jun 1;24(6):357-363. doi: 10.5005/jp-journals-10024-3521.
The aim of this retrospective study is to investigate the effect of corticobasal implant penetration in the nasal and maxillary sinuses on sinus health and implant survival rate in cases of severely atrophid ridges.
This retrospective study was conducted on thirty patients with 172 implants who underwent corticobasal implant treatment between 2014 and 2018. Implants were divided into two groups according to the penetration depths (Group A, <4 mm; Group B, 4 mm). Inclusion criteria for the study included: (A) patients with severe maxillary ridge resorption with an immediately loaded corticobasal implant-supported prosthesis that showed implant protrusion inside the maxillary sinus on cone-beam computed tomography (CBCT); and (B) patients with a preoperative and postoperative follow-up CBCT scan using the same standard technique and machine. (C) Patients without any history of sinusitis before implant insertion patients who fulfilled the inclusion criteria were recalled for follow-up. The presence of sinus complications was clinically assessed according to the clinical practice guidelines for adult sinusitis of the American Academy of Otolaryngology-Head and Neck Surgery and Radiologically using CBCT. Moreover, patient satisfaction was evaluated using yes-or-no questions. The result was statistically analyzed using Fisher's Exact test.
Despite the differences in implant penetration depths, no clinical signs of sinusitis were evident in any patient. One patient presented with transient epistaxis after the surgery, and 2 patients with nine implants revealed nonsignificant thickening of the sinus membrane radiologically ( = 0.055). All implants showed optimum bone-implant contact with a 100% survival rate. A significant relationship was reported between the thickness of the membrane and the patient's gender, hypertension, and smoking habits. ( = 0.001*, = 0.002*, and = 0.034*, respectively).
Penetration of corticobasal implants in the maxillary sinus did not compromise the health of the maxillary sinus or implant survival rate.
Limited posterior maxillary bony support and maxillary sinus pneumatization present challenges in implant dentistry and increase the possibility of implant protrusion inside the maxillary and nasal cavities. Hence, studying the effect of this protrusion on the maxillary sinuses' health and implant survival is highly significant.
本回顾性研究旨在探讨严重牙槽嵴萎缩患者中皮质基底植入物穿透鼻腔和上颌窦对窦健康和植入物存活率的影响。
本回顾性研究纳入了 2014 年至 2018 年间接受皮质基底植入物治疗的 30 名患者的 172 个植入物。根据穿透深度将植入物分为两组（A 组，<4mm；B 组，4mm）。研究纳入标准包括：（A）接受严重上颌骨嵴吸收的患者，采用即刻负载皮质基底植入物支持的义齿，锥形束 CT（CBCT）显示植入物在上颌窦内突出；（B）术前和术后均使用相同标准技术和机器进行 CBCT 扫描的患者；（C）无植入前鼻窦炎病史且符合纳入标准的患者被召回进行随访。根据美国耳鼻喉头颈外科学会成人鼻窦炎临床实践指南进行临床评估，并使用 CBCT 评估窦并发症的存在。此外，使用是/否问题评估患者满意度。使用 Fisher 确切检验对结果进行统计学分析。
尽管植入物穿透深度存在差异，但任何患者均未出现明显的窦炎临床症状。1 例患者术后出现短暂鼻出血，2 例患者 9 个植入物出现窦膜轻微增厚（=0.055）。所有植入物均显示出最佳的骨-植入物接触，存活率为 100%。报道了膜的厚度与患者的性别、高血压和吸烟习惯之间存在显著关系（=0.001*，=0.002和=0.034，分别）。
皮质基底植入物穿透上颌窦不会影响上颌窦的健康或植入物的存活率。
上颌后牙区骨量有限和上颌窦气化增加了植入物在上颌窦和鼻腔内突出的可能性，从而增加了植入物突出的风险。因此，研究这种突出对上颌窦健康和植入物存活率的影响具有重要意义。
