122例外侧壁开窗式上颌窦底提升术相关并发症的研究  

A retrospective study of complications associated with 122 consecutive maxillary sinus augmentations via the lateral window approach

作　　者：黄国伟 陆薇[2] 程志鹏 王小凤 何福明 

机构地区：[1]浙江省上虞市人民医院口腔科,浙江上虞312300 [2]浙江大学附属口腔医院种植科,浙江杭州310006

出　　处：《口腔医学》2014年第6期427-431,共5页Stomatology

基　　金：浙江省自然科学基金(R2110374);浙江省医药卫生平台重点资助计划(2013ZDA013)

摘　　要：目的研究并讨论外侧壁开窗式上颌窦底提升术相关的并发症以及建议的治疗方法。方法 122例上后牙缺失并且骨量不足的患者于2010年8月1日至2013年7月15日接受了外侧壁开窗式上颌窦底提升手术,均已完成上部修复。测量记录术前剩余牙槽骨高度。记录所有术中或术后并发症,比如过量出血、上颌窦底黏膜穿孔、感染、创口裂开、急性上颌窦炎、移植骨吸收,以及统计种植体存留率。结果术中8例发生窦底黏膜穿孔,术后3例当晚少量鼻出血,术后1-2周3例伤口裂开,术后2周1例急性上颌窦炎伴化脓性感染;术后6个月内,有6例患者的移植骨出现部分吸收,6颗种植体发生松动或自行脱落。结论外侧壁开窗式上颌窦底提升术相关的并发症有黏膜穿孔、感染、创口裂开、移植骨吸收以及种植体松动、脱落,可通过术前周密检查、术中控制手术操作、修补穿孔黏膜、术后适当加大抗生素剂量、缝合裂开创口并配合使用漱口水及系统性抗生素治疗等方法预防及治疗相关并发症。Objective To study and discuss the complications that occurred during 122 consecutive maxillary sinus augmentations via the lateral window approach and to propose solutions to manage these complications. Methods This study evaluated 69 men and 53 women requiring 122 consecutive sinus elevation procedures between August 2010 and July 2013. All had already completed prosthodontics. Pretreatment residual bone heights were recorded. The incidences of any intraoperative or postoperative sinus complications such as excessive bleeding, membrane perforation, infection, wound dehiscence, acute sinusitis, loss of bone grafts were recorded and implant survival proportion was calculated. Results 8 intraoperative membrane perforations were noted. 3 patients had few nosebleed the night after surgery. 1 case of acute sinusitis and suppuration was noted 2 weeks after operation while wound dehiscence was observed in 3 cases 1 to 2 weeks after surgery. Partial loss of the bone grafts was identified in 6 of the patients and 6 implants became loose or fell off within 6 months after surgery. Conclusions Sinus floor elevation utilizing the lateral window approach may result in some compli- cations, including membrane tear, infection, wound dehiscence, loss of grafts, and implant failure. In order to prevent and manage these complications, clinicians may examine carefully before surgery, pay more attention to the operation, repair the perforated membrane, advisably increase the antibiotic dose, and suture the dehisced wound while utilizing gargle and systemic antibiotic treatment and so on.

关 键 词：并发症 侧壁开窗 上颌窦提升 上颌窦底 窦底黏膜 

分 类 号：R782.1[医药卫生—口腔医学]