Waldrop T C, Semba S E
Wilford Hall Medical Center, Department of Periodontics, Lackland Air Force Base, TX.
J Periodontol. 1993 Nov;64(11):1061-6. doi: 10.1902/jop.1993.64.11.1061.
Surgical intervention into the maxillary posterior area can lead to inadvertent communication with the maxillary sinus. Spontaneous healing of 1 to 2 mm openings can occur. However, in patients with larger oroantral communications and those with a history of sinus disease, surgical closure is often indicated. Acute and chronic oroantral fistula and sinusitis can occur as a result of inadequate treatment. The most common causes of complications include inadequate site preparation, flap closure, flap necrosis, infection, and patient non-compliance. A technique for the closure of oroantral communications using guided tissue regeneration is described. This technique utilizes an absorbable gelatin film (membrane), allogenic bone graft material (DFDBA), and non-resorbable expanded polytetrafluoroethylene (ePTFE) membrane. The gelatin membrane prevents displacement of graft material into the antrum and sinus epithelial cell migration, while the ePTFE membrane promotes selective cell population with subsequent regeneration of the osseous wall of the oroantral defect.
对上颌后牙区进行手术干预可能会导致意外与上颌窦相通。1至2毫米的开口可实现自愈。然而,对于口窦相通较大以及有鼻窦疾病史的患者,通常需要进行手术封闭。治疗不当可能会导致急性和慢性口窦瘘及鼻窦炎。并发症的最常见原因包括手术部位准备不充分、皮瓣关闭、皮瓣坏死、感染以及患者依从性差。本文描述了一种使用引导组织再生技术关闭口窦相通的方法。该技术使用可吸收明胶膜(屏障膜)、同种异体骨移植材料(脱矿冻干骨)和不可吸收的膨体聚四氟乙烯(ePTFE)膜。明胶膜可防止移植材料移位至窦腔以及鼻窦上皮细胞迁移,而ePTFE膜则促进选择性细胞增殖,随后使口窦缺损的骨壁再生。