PDF(Pubmed)
Abstract：
Background: Maxillary sinus lift is a well-documented and accepted technique in the rehabilitation of the posterior maxilla. Schneiderian membrane perforation is the most common complication and may occur in between 7% and 56% of cases. Different materials and techniques have been described to achieve reparation of the perforation. The aim of this study was to establish whether the perforation of the Schneiderian membrane and its repair during maxillary sinus lift surgery results in a lower implant survival rate compared to those cases where the membrane has not been perforated. Materials and methods: A systematic review and meta-analysis of studies assessing the survival rate of implants placed in regenerated sinus using the lateral window approach, where the perforation of the Schneiderian membrane occur, was carried out. Statistical analysis was performed with Open Meta-Analyst, calculating the odds ratio of implants placed in perforated sinuses and non-perforated sinuses. Results: Ten articles were included in the qualitative analysis and seven articles in the quantitative analysis or meta-analysis. A total of 1224 maxillary sinus augmentation surgeries were performed without perforation of the Schneiderian membrane and 2725 implants were placed; 62 implants failed during the follow-up period with an overall survival rate of 97.7%. In 480 perforated sinuses, 1044 implants were placed, of which 30 failed; the overall survival rate was 97.1%. There were no significant differences between the implant survival rate of the implants in the two groups (OR = 0.78; CI = 0.49-2.23; p = 0.28 and I2 heterogeneity: 0%, p = 0.44). Conclusions: Schneiderian membrane perforation, as long as it is repaired, does not appear to negatively influence implant survival rate. Membrane perforation should not be considered a reason to abort the procedure or an absolute contraindication to implant placement.
摘要：
背景：上颌窦提升术是一种有据可查且公认的后上颌骨康复技术。施耐德膜穿孔是最常见的并发症，可能发生在7％至56％的病例中。已经描述了不同的材料和技术来实现穿孔的修复。这项研究的目的是确定与未穿孔的情况相比，上颌窦提升手术中施耐德膜的穿孔及其修复是否会导致较低的植入物存活率。材料和方法：对评估使用外侧窗方法放置在再生窦中的植入物的存活率的研究进行系统回顾和荟萃分析，施耐德膜穿孔发生的地方，进行了。使用开放式荟萃分析师进行统计分析，计算置入穿孔鼻窦和非穿孔鼻窦的植入物的比值比。结果:共纳入10篇文献进行定性分析,7篇文献进行定量分析或荟萃分析。共进行了1224例上颌窦增强手术，未发生Schneiderian膜穿孔，并放置了2725个植入物；随访期间有62个植入物失败，总生存率为97.7％。在480个穿孔鼻窦中，放置了1044个植入物，其中30例失败；总生存率为97.1％。两组种植体生存率差异无统计学意义(OR=0.78;CI=0.49-2.23;p=0.28,I2异质性:0%,p=0.44）。结论:Schneiderian膜穿孔,只要修好了,似乎不会对植入物的存活率产生负面影响。膜穿孔不应被视为中止手术的原因或植入物放置的绝对禁忌症。
