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外侧上颌窦底提升术后上颌窦黏膜厚度及窦腔健康状况的变化:比较术前黏膜厚度<5mm和>5mm的情况

Changes in the Maxillary Sinus Membrane Thickness and Sinus Health Following Lateral Sinus Floor Elevation: Comparing Preoperative Mucosal Thicknesses of < 5 mm and > 5 mm.

作者信息

Khiabani Kazem, Nourbakhshian Farzaneh, Amirzade-Iranaq Mohammad Hosein

出版信息

Int J Oral Maxillofac Implants. 2024 Dec 11;39(6):867-874. doi: 10.11607/jomi.10839.

Abstract

PURPOSE

To investigate the effect of lateral sinus floor elevation (LSFE) on sinus membrane (SM) thickness and sinus health in mucosa thickness < 5 mm and > 5 mm.

MATERIALS AND METHODS

LSFE was performed in a prospective controlled clinical trial on two groups with < 5 mm and > 5 mm SM thickness (Groups A and B, respectively) and followed for 6 months. Using preoperative and 6-month postoperative CBCT scans and clinical evaluation, SM thickness changes (primary outcome variable), sinus health, augmented bone height and length (augmentation adequacy), membrane-related variables, and operation time were measured.

RESULTS

Forty unilateral sinus augmentations (n = 20 for both groups) were performed on 40 subjects (72.5% men, mean age of 48.8 ± 7.6 years), and 52 implants were simultaneously placed. The mean preoperative and 6-month SM thicknesses were 1.4 ± 0.9 mm and 1.3 ± 0.6 mm in Group A, respectively, and were 6.8 ± 1.0 and 3.4 ± 1.7 mm in Group B, respectively. The mean postoperative SM thickness significantly decreased (P < .001) only in Group B. The mean SM thickness changes also revealed a noticeable difference between the two groups (P < .001). Augmentation adequacy and membrane perforation rate were similar in both groups. Clinical and radiographic rhinosinusitis was not detected in any of the patients. Bleeding during separation and resistance to elevation were significantly higher in Group B than in Group A (P = .003, P = .001). Surgical time was longer in Group B (12.08 ± 8.26 minutes) than in Group A (8.64 ± 3.70 minutes), without reaching significance (P = .097).

CONCLUSIONS

LSFE in thickened mucosa (< 10 mm) and thinner mucosa (< 5 mm) does not cause abnormal changes in the SM and sinus health. LSFE in thickened mucosa results in adequate sinus augmentation. The thickened membrane does not appear to be a contraindication to LSFE.

摘要

目的

探讨在黏膜厚度<5mm和>5mm的情况下,外侧鼻窦底提升术(LSFE)对鼻窦黏膜(SM)厚度及鼻窦健康的影响。

材料与方法

在一项前瞻性对照临床试验中,对两组SM厚度分别<5mm和>5mm的患者(分别为A组和B组)进行LSFE,并随访6个月。利用术前和术后6个月的锥形束计算机断层扫描(CBCT)以及临床评估,测量SM厚度变化(主要观察变量)、鼻窦健康状况、植骨增高量和长度(植骨充足情况)、与黏膜相关的变量以及手术时间。

结果

对40例受试者(男性占72.5%,平均年龄48.8±7.6岁)进行了40例单侧鼻窦植骨术(每组20例),并同期植入52枚种植体。A组术前和术后6个月的平均SM厚度分别为1.4±0.9mm和1.3±0.6mm,B组分别为6.8±1.0mm和3.4±1.7mm。仅B组术后平均SM厚度显著降低(P<.001)。两组间平均SM厚度变化也存在显著差异(P<.001)。两组的植骨充足率和黏膜穿孔率相似。所有患者均未检测到临床和影像学鼻窦炎。B组分离过程中的出血量和提升阻力显著高于A组(P=.003,P=.001)。B组手术时间(12.08±8.26分钟)长于A组(8.64±3.70分钟),但差异无统计学意义(P=.097)。

结论

在增厚黏膜(<10mm)和较薄黏膜(<5mm)中进行LSFE不会引起SM和鼻窦健康的异常变化。增厚黏膜中的LSFE可实现充分的鼻窦植骨。增厚的黏膜似乎并非LSFE的禁忌证。

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