施耐德膜增厚对上颌窦底提升术影响的研究进展

doi:10.3969/j.issn.1005-4979.2021.02.010

《口腔颌面外科杂志》 ›› 2021, Vol. 31 ›› Issue (2): 114-119. doi: 10.3969/j.issn.1005-4979.2021.02.010

施耐德膜增厚对上颌窦底提升术影响的研究进展

杨阳¹(), 张歆缘², 满毅²(), 屈依丽³()

¹ 四川大学华西口腔疾病研究国家重点实验室，四川成都 610041
² 四川大学华西口腔医学院修复学系教研室，四川成都 610041
³ 口腔疾病研究国家重点实验室，四川大学华西口腔医院修复科，四川成都 610041

收稿日期:2020-01-29 修回日期:2020-06-04 出版日期:2021-04-28 发布日期:2021-04-26
通讯作者: 满毅，教授. E-mail: manyi780203@126.com；屈依丽，副教授. E-mail: quyili@gmail.com
作者简介:
杨阳（1997—），女，陕西人，硕士研究生. E-mail: 846720602@qq.com
基金资助:
国家重点研发计划(2016YFC1102700/2016YFC1102705)

Recent advances of Schneiderian membrane thickening and the effect of maxillary sinus floor augmentation

YANG Yang¹(), ZHANG Xinyuan², MAN Yi²(), QU Yili³()

¹ Department of Prosthodontics, State Key Laboratory of Oral Diseases & Department of Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan Province, China
² Department of Prosthodontics, West China School of Stomatology, Sichuan University, Chengdu 610041, Sichuan Province, China
³ Department of Prosthodontics, Chengdu 610041, Sichuan Province, China

Received:2020-01-29 Revised:2020-06-04 Online:2021-04-28 Published:2021-04-26

摘要/Abstract

摘要：

上颌窦窦底内衬的施耐德膜是上颌窦底提升术的解剖基础，它与窦底骨皮质的疏松附着和良好的抗张强度是手术进行的关键因素。术前对患者进行锥形束计算机断层摄影（cone-beam computed tomography，CBCT）检查时，常常可以观察到施耐德膜厚度异常的状态，包括黏膜增厚、囊肿和息肉等。施耐德膜厚度异常对手术效果影响如何，它是否是上颌窦底提升术的禁忌证，目前仍有一定争议。本文将介绍施耐德膜的结构、功能及判断黏膜厚度的参考因素，并将黏膜厚度增加对手术影响的相关研究进展进行综述，以期为临床医生的临床决策提供参考。

关键词: 施耐德膜, 上颌窦底提升术, 牙种植

Abstract:

The Schneiderian membrane which attached to the floor of the maxillary sinus acted as the anatomical basis of the maxillary sinus floor augmentation. Its loose attachment to the cortical bone of the sinus floor and the good tensile strength are the key factors for the operation. Abnormal Schneiderian membrane status, including membrane thickening, cysts and polyps formation can often be observed when patients are examined by cone-beam computed tomography, CBCT before operation. How the abnormal status of Schneiderian membrane affects the outcome of operation and whether it is a contraindication for maxillary sinus floor augmentation is still controversial. This article will introduce the structure and function of Schneiderian membrane and the reference factors for judging membrane thickness, and review the research progress on the effect of increased membrane thickness on surgery, in order to provide reference for clinicians′ clinical decision-making.

Key words: Schneiderian membrane, maxillary sinus floor augmentation, dental implantation

中图分类号:

R782.05

杨阳, 张歆缘, 满毅, 屈依丽. 施耐德膜增厚对上颌窦底提升术影响的研究进展[J]. 《口腔颌面外科杂志》, 2021, 31(2): 114-119.

YANG Yang, ZHANG Xinyuan, MAN Yi, QU Yili. Recent advances of Schneiderian membrane thickening and the effect of maxillary sinus floor augmentation[J]. 《Journal of Oral and Maxillofacial Surgery》, 2021, 31(2): 114-119.

https://journal06.magtech.org.cn/Jweb_joms/CN/Y2021/V31/I2/114

图/表 6

图1 直接进行上颌窦底提升的CBCT图像 A. 术前CBCT; B. 术后即刻CBCT。

Figure 1 CBCT images showing direct maxillary sinus floor lifting

图2 摘除囊肿后进行窦底提升 A. 术前CBCT；B. 导板下侧壁开窗摘除囊肿；C. 术后即刻CBCT。

Figure 2 Sinus floor lifting performed after removal of the cyst

图3 根尖囊肿治疗后进行窦底提升 A. 根尖囊肿；B. 拔除病原牙后，囊肿消失；C. 术后即刻CBCT。

Figure 3 Sinus floor lifting after treatment of apical cyst

图4 施耐德膜重度增厚时进行窦底提升 A. 术前CBCT；B. 术后即刻CBCT示黏膜变薄。

Figure 4 Sinus floor lifting during severe thickening of Schneiderian membrane

图5 术后施耐德膜暂时变薄 A. 术前CBCT；B. 术后即刻CBCT示黏膜变薄; C. 术后6个月CBCT示黏膜恢复正常。

Figure 5 Temporary thinning of Schneiderian membrane after operation

图6 术后施耐德膜暂时增厚 A. 术前CBCT；B. 术后即刻CBCT示黏膜增厚； C. 术后6个月CBCT示黏膜恢复正常。

Figure 6 Temporary thickening of Schneiderian membrane after operation

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