Lateral Pencere Yöntemi Uygulanarak Gerçekleştirilen Maksiller Sinüs Yükseltme Prosedüründe Membran Kullanması Gerçekten Gerekli midir?

Yıl 2022, Cilt: 9 Sayı: 2, 568 - 573, 24.08.2022

Hakan Ocak , Umut Demetoğlu , Burcu Gürsoytrak , Halis Ali Çolpak , Gülsün Yıldırım

https://doi.org/10.15311/selcukdentj.887681

Öz

Amaç
Sinüs tabanı yükseltme operasyonlarında lateral pencere üzerine membran yerleştirilmesi kemik formasyonunu hızlı bir şekilde başlatsa da membran kullanılmadan gerçekleştirilen sinus yükseltme işlemlerininde başarılı ve öngürülebilir sonuçlanacağı ile ilgili literatürde kanıtlar bulunmaktadır. Bu çalışmamızın amacı lateral pencerede membran uygulaması kullanılan veya kullanılmayan iki grupta antrostomi alanında yumuşak doku invazyonuna bağlı oluşabilecek defektlerin varlığını araştırarak gerçekten membran kullanımına gerek olup olmadığını kanıtlamaktır.

Gereç ve Yöntem
Çalışma için 40 hasta seçildi ve membran uygulaması kullanılan (çalışma grubu) veya kullanılmayan (kontrol grubu) iki gruba randomize edildi. İşlemden 12 ay sonra Konik Işınlı Volümetrik Bilgisayarlı Tomografi kullanılarak bölgenin görüntüleri çekildi. Gruplarda implant sağkalımı ve kemik oluşum miktarları karşılaştırmaları araştırıldı.

Bulgular
Kemik çapı açısından gruplar arasındaki fark bağımsız t testi ile değerlendirildi. Gruplarda lateral pencere bölgesinde radyografik olarak defektli alan bulunmadı. Kontrol grubunun ortalama kemik çapı 13.063 mm (± 2.4 mm) ve çalışma grubunun kemik çapı 14.10 mm (± 5.8 mm) olarak ölçüldü. Kemik çapı açısından gruplar arasında anlamlı bir fark yoktu. Her iki gruba da yerleştirilen implantların hiçbirinde kayıp olmadı.

Sonuç
Lateral pencere açılarak gerçekleştirilen sinüs yükseltme işlemlerinde lateral pencere üzerine kapatmak için bir membran kullanılması, kemik kusurlarının oluşumunda önemli bir rol oynamamıştır. Membran kullanılmadan da sinüs yükseltme işlemleri başarılı olabilmektedir.

Anahtar Kelimeler

Maksiller Sinüs, Membranlar, Dental İmplant

Destekleyen Kurum

Destekleyici herhangi bir kurum bulunmamaktadır.

IS MEMBRANE USAGE REALY NECESSARY FOR SINUS LIFTING OPERATION IN LATERAL WINDOW TECHNIQUE

Öz

Background
Although the placement of a membrane after sinus floor augmentation promotes faster initialization of bone formation, there is evidence that these procedures may be successful and predictable without membrane barriers. The aim of this study was to investigate the presence of defects that might occur due to soft tissue invasion in the antrostomy area in two groups where membrane application was used or not used on the lateral window.

Methods
Comparisons of implant survival in the groups and the amounts of bone generation were also investigated. Forty patients were selected for the study, and they were randomized into two groups in which membrane application was used (study group) or not used (control group). Twelve months following the procedure, images of the region were taken with computerized dental volumetric tomography.

Results
The difference between the groups in terms of bone diameter was evaluated with an independent t test. No defect areas were found radiographically in the lateral window region in the groups. The mean bone diameter of the control group was 13.063 mm (±2.4 mm) and that of the study group was 14.10 mm (±5.8 mm). There was no significant difference between the groups in bone diameter. There were no losses in any of the implants that were placed in either group.

Conclusion
The use of a membrane to close the lateral window did not play any important role in the formation of bone defects.

Anahtar Kelimeler

Maxillary sinus, Membranes, Dental Implants

Kaynakça

• Referans1. Esposito M, Grusovin MG, Rees J, et al. Interventions for replacing missing teeth: augmentation procedures of the maxillary sinus. Cochrane Database Syst Rev 2010; 3: CD008397.
• Referans2. Hirsch J, Ericsson I. Maxillary sinus augmentation using mandibular bone grafts and simultaneous installation of implants. A surgical technique. Clinical oral implants research. 2002;2:91–96.
• Referans3. Valentini P, Abensur D. J. Maxillary sinus grafting with anorganic bovine bone: a clinical report of long-term results. International Journal of Oral and Maxillofacial Implants. 2003;18: 556–560.
• Referans4. Jung RE, Thoma DS, Hammerle CHF. Assessment of the potential of growth factors for localized alveolar ridge augmentation: a systematic review. Journal of Clinical Periodontology. 2008; 35: 255–281.
• Referans5. Buser D, Br€agger, U, Lang N, Nyman S. Regeneration and enlargement of jaw bone using guided tissue regeneration. Clinical oral implants research. 2002; 1: 22–32.
• Referans6. Tarnow DP, Wallace SS, Froum SJ, Rohrer MD, Cho SC. Histologic and clinical comparison of bilateral sinus floor elevations with and without barrier membrane placement in 12 patients: part 3 of an ongoing prospective study. International Journal Periodontics and Restorative Dentistry. 2000; 20: 117–125.
• Referans7. Wallace SS, Froum SJ. Effect of maxillary sinus augmentation on the survivalof endosseous dental implants. A systematic review. Annals of Periodontology. 2003;8:328–343.
• Referans8. Suárez-López del Amo F, Ortega-Oller I, Catena A, Monje A, Khoshkam V, Torrecillas-Martinez L, Galindo-Moreno P. Effect of barrier membranes on the outcomes of maxillary sinus floor augmentation: a meta-analysis of histomorphometric outcomes. International Journal of Oral & Maxillofacial Implants, 2015; 30(3).
• Referans9. Barone A, Ricci M, Grassi RF, Nannmark U, Quaranta A, Covani U. A 6-month histological analysis on maxillary sinus augmentation with and without use of collagen membranes over the osteotomy window: randomized clinical trial. Clin Oral Implants Res. 2013;24:1-6.
• Referans10. Marchionni FS, Alfonsi F, Santini S, Marconcini S, Covani U, Barone A. Maxillary sinus augmentation: collagen membrane over the osteotomy window. A pilot study. Journal of Osseointegration 2015; 7(1): 15-20.
• Referans11. Lupi SM, Rodriguez y Baena A, Todaro C, Ceccarelli G, Rodriguez y Baena R. Maxillary sinus lift using autologous periosteal micrografts: A new regenerative approach and a case report of a 3-year follow-up. Case reports in dentistry, 2018.
• Referans12. Tawil G, Mawla M. Sinus floor elevation using a bovine bone mineral (Bio-Oss)with or without the concomitant use of a bilayered collagen barrier (Bio-Gide): a clinicalreport of immediate and delayed implant placement. The International Journal of Oral & Maxillofacial Implants. 2001;16: 713.
• Referans13. Torres Garcia-Denche J, Wu X, Martinez P-P, Eimar H, Ikbal DJ-A, Hernandez G, et al. Membrane over the lateral window in sinus augmentation procedures: a twoarm and split-mouth randomized clinical trials. J Clin Periodontol 2013;40:1043-1051.
• Referans14. Choi K, Kan J, Boyne PJ, Goodacre CJ, Lozada JL Rungcharassaeng K. The effects of resorbable membrane on human maxillary sinus graft: a pilot study. Int J Oral Maxillofac Implants 2009;24:73.
• Referans15. McAllister BS, Margolin MD, Cogan AG, Buck D, Hollinger JO, Lynch SE. Eighteen-month radiographic and histologic evaluation of sinus grafting with anorganic bovine bone in the chimpanzee. The International Journal of Oral & Maxillofacial Implants. 1999; 14: 361.
• Referans16. Pjetursson BE, Tan WC, Zwahlen M, Lang NP. A systematic review of the success of sinus floor elevation and survival of implants inserted in combination with sinus floor elevation. Journal Clinical Periodontoogy.2008;35:216–240
• Referans17. Dimitriou R, Mataliotakis GI, Calori GM, Giannoudis PV. The role of barrier membranes for guided bone regeneration and restoration of large bone defects: current experimental and clinical evidence. BMC Medicine. 2012;10:81.
• Referans18. Misch CE, Dietsh F. Autogenous bone grafts for endosteal implants–indications and failures.International Journal Oral Implantology.1991;8:13–20.
• Referans19. McAllister B.S, Margolin M.D, Cogan A.G, Taylor M, Wollins J. Residual lateral wall defects following sinus grafting with recombinant human osteogenic protein-1 or Bio-Oss in the chimpanzee. International Journal Periodontics Restorative Dentistry. 1998;18:227–239.
• Referans20. Scala A, Botticelli D, Rangel I.G, Oliveira J.A, Okamoto R, Lang N.P. Early healing after elevation of the maxillary sinus flor applying a lateral access: a histological study in monkeys. Clinical Oral Implants Research. 2010 21: 1320–1326.