Private Clinic Schloss Schellenstein, Am Schellenstein1, 59939, Olsberg, Germany.
Department of Oral and Maxillofacial Surgery, University of Münster, Münster, Germany.
Int J Implant Dent. 2024 Nov 4;10(1):48. doi: 10.1186/s40729-024-00568-5.
The sinus lift procedure has become the most common method for maxillary bone augmentation. The most frequently observed intraoperative complication is the perforation of the Schneiderian membrane. Various treatment options have been proposed for managing these perforations, including the use of resorbable membranes, centrifugated blood products as PRF, or PRGF, suturing, and fibrin glue application. While long-term studies exist for the use of resorbable membranes to close perforations, there is limited data on the long-term outcomes of suturing or gluing the perforated sinus membrane. The aim of this retrospective study is to evaluate the long-term outcomes of suturing and/or applying fibrin glue to repair perforated sinus mucosa during sinus floor elevation procedures. Between 2005 and 2009, a total of 692 patients underwent 923 sinus lift surgeries, and Schneiderian membrane perforation occurred in 202 sinus floor elevations (21.98%) across 168 patients. The main documented causes of perforations, which ranged from 2 to 10 mm in diameter, were the presence of septa, followed by thin and adherent membranes. Of the perforations, 100 (49.5%) were treated with microsurgical suturing combined with fibrin glue, 78 (38.6%) were treated with fibrin glue alone, and 24 (11.9%) were treated exclusively with suturing. Sinus grafting was performed using autogenous bone in combination with a biomaterial, following the layering technique. All surgeries resulted in primary healing without complications, enabling all patients to undergo restoration as planned. The long term clinical and radiological evaluations of 44 randomly selected patients who followed the recall program up to 10 years post operative confirmed the effectiveness of this treatment approach.
窦提升术已成为上颌骨增加最常用的方法。最常观察到的术中并发症是施氏膜穿孔。已经提出了各种治疗选择来处理这些穿孔，包括使用可吸收膜、离心血液制品作为 PRF 或 PRGF、缝合和纤维蛋白胶应用。虽然有长期研究可用于使用可吸收膜封闭穿孔，但关于缝合或粘合穿孔窦膜的长期结果的数据有限。本回顾性研究旨在评估在窦底提升术中缝合和/或应用纤维蛋白胶修复穿孔窦黏膜的长期结果。在 2005 年至 2009 年间，共有 692 例患者接受了 923 例窦提升手术，168 例患者中有 202 例（21.98%）发生了施氏膜穿孔。穿孔的主要记录原因是存在隔，其次是薄而黏附的膜，穿孔直径为 2 至 10 毫米。其中 100 例（49.5%）采用显微缝合联合纤维蛋白胶治疗，78 例（38.6%）采用纤维蛋白胶单独治疗，24 例（11.9%）仅采用缝合治疗。在分层技术中，使用自体骨与生物材料联合进行窦植骨。所有手术均无并发症，一期愈合，使所有患者均能按计划进行修复。对 44 名随机选择的患者进行了长达 10 年的术后回顾性临床和影像学评估，这些患者均遵循召回计划，证实了这种治疗方法的有效性。
