Abstract:

Objective　To analyze the incidence of mucosal perforation and bleeding in maxillary sinus floor elevation and related factors，and provide a reference for clinical prevention and standard treatment. Methods　In the Department of Stomatology of Central Hospital of Jiading District of Shanghai，all patients treated with dental implants from January 2011 to June 2017 were identified. A total of 366 patients and 468 implants were included by excluding unqualified medical records. Results　In all cases，totally 25 patients had maxillary sinus perforation，the incidence being 6.83%. Totally 23 patients were with intraoperative bleeding，the incidence being 6.28%. The 2D Logistic regression analysis showed that mode of maxillary sinus floor elevation，smoking and maxillary sinus mucosal thickness ≥ 0.3 mm were associated with maxillary sinus perforation（P < 0.05）. Mode of maxillary sinus floor elevation，maxillary sinus mucosal thickness ≥ 0.3 mm and vascular bone holes in the anterior maxillary sinus were associated with intraoperative bleeding（P < 0.05）. Conclusion　Through the preoperative oral and imaging examination，analysis of maxillary sinus anatomy can provide guidance for cultivation of indications，reduce the occurrence of complications such as maxillary sinus perforation and intraoperative bleeding.

Key words: dental implants, maxillary sinus floor elevation, complications

摘要：

目的　分析上颌窦底提升术中上颌窦黏膜穿孔及出血等术中并发症的发生情况及其影响因素，从而为临床医生预防相关并发症的发生及进行口腔种植规范化治疗提供参考。方法　选取2011年1月至2017年6月于上海市嘉定区中心医院口腔科就诊并接受上颌窦底提升术及种植手术的患者366例（共植入468颗种植体），统计术中上颌窦黏膜穿孔及出血的发生情况及相关影响因素，并进行二元Logistic回归分析。结果　本研究中，发生术中上颌窦黏膜穿孔的患者25例，发生率为6.83%；发生术中出血的患者23例，发生率为6.28%。二元Logistic回归分析结果显示，上颌窦底外提升术式、上颌窦黏膜厚度≥ 0.3 mm和吸烟是患者术中发生上颌窦黏膜穿孔的危险因素（均P < 0.05）。上颌窦底外提升术式、上颌窦黏膜厚度≥ 0.3 mm及上颌窦前壁有血管是术中发生出血的危险因素（均P < 0.05）。结论　通过术前口腔检查结合CBCT等影像学检查，分析上颌窦相关解剖结构及对患者吸烟量的控制可为临床医生对种植适应证的把握及上颌窦底提升术的操作提供帮助，减少术中上颌窦黏膜穿孔和出血等并发症的发生。

关键词: 牙种植, 上颌窦底提升术, 并发症