Oral Health Prev Dent. 2024 Jul 30;22:357-364. doi: 10.3290/j.ohpd.b5638110.
To compare short-term outcomes between membrane perforation and non-perforation patients after simultaneous external elevation with implantation.
In this retrospective observational study, 60 maxillary posterior tooth-loss patients with an insufficient amount of residual bone for direct implantation were enrolled. All patients underwent simultaneous external elevation and implantation, and were divided into perforation and non-perforation groups according to the postoperative Schneiderian membrane status.
Of the 60 patients, 30 cases (35 implants) were assigned to the membrane perforation group, and 30 (44 implants) were allocated to the non-perforation group. There were no statistically significant differences in baseline data (p>0.05). In the perforation group, the mean vertical bone gain (VBG) at 6 and 12 months was 6.02±2.14 mm and 5.37±2.22 mm, resp., compared to 6.78±2.59 mm and 6.42±2.64 mm in the non-perforation group, resp. (both p>0.05). Preoperative median Schneiderian membrane thickness (SMT) in the perforation group was 0.77 mm, which was statistically significantly thinner than the 1.24 mm measure in the non-perforation group (p< 0.05); however, there was no statistically significant difference between two groups at 12 months postoperatively (0.80 mm vs 1.25 mm, p>0.05). The marginal bone loss at 1 year after implant restoration in the perforation and non-perforation groups was 0.16±0.10 mm and 0.22±0.12 mm, resp. During postoperative follow-up, the implant survival rate was 100% in the two groups. The incidence of postoperative nasal bleeding in the perforation group was statistically significantly higher compared with that in the non-perforation group (50% vs 16.7%, p<0.05), whereas no statistically significant differences were observed in the incidence of facial swelling, intraoral bleeding, wound dehiscence and acute/chronic sinusitis between the two groups (p>0.05).
Schneiderian membrane perforation after simultaneous external elevation and implantation do not adversely affect short-term clinical and radiographic outcomes.
比较同期外提升加植入术后膜穿孔和非穿孔患者的短期疗效。
本回顾性观察研究纳入了 60 例上颌后牙缺失且剩余骨量不足以直接植入的患者。所有患者均行同期外提升加植入术，并根据术后的黏膜状态分为穿孔组和非穿孔组。
60 例患者中，30 例（35 枚种植体）归入膜穿孔组，30 例（44 枚种植体）归入非穿孔组。两组基线资料差异无统计学意义（p>0.05）。穿孔组术后 6 个月和 12 个月的平均垂直骨增量（VBG）分别为 6.02±2.14mm 和 5.37±2.22mm，而非穿孔组分别为 6.78±2.59mm 和 6.42±2.64mm，两组间差异均无统计学意义（均 p>0.05）。穿孔组术前中鼻甲黏膜厚度（SMT）中位数为 0.77mm，显著低于非穿孔组的 1.24mm（p<0.05）；但两组术后 12 个月时差异无统计学意义（0.80mm 比 1.25mm，p>0.05）。穿孔组和非穿孔组种植体修复后 1 年的边缘骨吸收量分别为 0.16±0.10mm 和 0.22±0.12mm。两组术后均无种植体失败，随访期间种植体存留率均为 100%。穿孔组术后鼻腔出血发生率显著高于非穿孔组（50%比 16.7%，p<0.05），两组间面部肿胀、口腔内出血、创口裂开和急性/慢性鼻窦炎的发生率差异均无统计学意义（p>0.05）。
同期外提升加植入术后发生中鼻甲黏膜穿孔不会对短期临床和影像学结果产生不良影响。
