Yamaguchi Kikue, Munakata Motohiro, Sato Daisuke, Kataoka Yu, Kawamata Ryota
Department of Implant Dentistry, Showa University School of Dentistry, 2-1-1, Kita-senzoku, Ota-ku, Tokyo 1458515, Japan.
Department of Dental Education, Showa University School of Dentistry, 1-8-5, Hatanodai, Shinagawa-ku, Tokyo 1428555, Japan.
Bioengineering (Basel). 2023 Sep 22;10(10):1110. doi: 10.3390/bioengineering10101110.
Maxillary sinus augmentation with a lateral approach (MSA) is a well-established treatment. In this prospective study, we evaluated risk factors for postoperative bone graft displacement and reported the clinical application of long-term resorbable L-lactic acid/-caprolactone (PLA/PCL) as a barrier membrane to cover the open window in the lateral wall in MSA. Twenty-four patients underwent MSA according to the relevant criteria; CT data obtained before and 1 week (1 w) and 5-6 months (5 m) post-MSA, bone height changes, bone height reduction rates at 1 w and 5 m post-MSA, bone graft displacement measurements, and risk factors were examined. All patients showed bone height increments ( < 0.005). However, no difference was observed between 1 w and 5 m post-MSA. Bone graft displacement was observed in eight patients; the reduction rate from 1 w to 5 m post-MSA was 8.38% ± 4.88%. Sex, septa, maxillary sinus floor-palatal bone distance, and maxillary sinus floor-maxillary ostium distance were associated with bone graft displacement ( < 0.05). The height from the maxillary sinus floor to the palatal bone and the sinus angle influenced the augmentation degree ( < 0.05). The PLA/PCL membrane is compared favorably with other membranes and may be useful as a barrier membrane for the MSA open window.
经外侧入路的上颌窦提升术（MSA）是一种成熟的治疗方法。在这项前瞻性研究中，我们评估了术后骨移植移位的危险因素，并报告了长期可吸收的左旋乳酸/己内酯（PLA/PCL）作为屏障膜覆盖MSA外侧壁开窗的临床应用。24例患者根据相关标准接受了MSA治疗；收集了MSA术前、术后1周（1w）和5 - 6个月（5m）的CT数据，检查了骨高度变化、MSA术后1w和5m时的骨高度降低率、骨移植移位测量值以及危险因素。所有患者均显示骨高度增加（P < 0.005）。然而，MSA术后1w和5m之间未观察到差异。8例患者观察到骨移植移位；MSA术后1w至5m的降低率为8.38% ± 4.88%。性别、鼻中隔、上颌窦底至腭骨距离以及上颌窦底至上颌窦口距离与骨移植移位相关（P < 0.05）。上颌窦底至腭骨高度和窦角影响了提升程度（P < 0.05）。PLA/PCL膜与其他膜相比具有优势，可能作为MSA开窗的屏障膜。
