Effects Of Different Changes In Maxillary Sinus On Maxillary Sinus Floor Elevation With Implantation

Objective:To analyze the images of patients with maxillary sinus floor elevation(MSFE)and implantation existing pre-operative changes in maxillary sinus by CBCT,and discuss the image recognition of different changes in maxillary sinus and the impact on the surgery complications and the curative effect about implantation.Methods:The CBCT imaging data concerning 95 MSFE implanting cases about 141 implants with maxillary sinus changes was selected from 2011 to 2019.According to the preoperative changes,the whole was divided into these groups: mucosal thickening group,effusion group,retention cyst group and calcification group.Preoperative residual alveolar bone height(RBH),MSFE’s maxillary sinus elevation height(MSEH),MSFE’s method choice,planting time,incidence of mucosal perforation,incidence of postoperative maxillary sinusitis,incidence of peri-implantitis and implant survival rate(ISR)during imaging follow-up were compared between the groups.Results:In 95 cases of maxillary sinus augmentation(total 141 implants),there are 60 cases of maxillary sinus mucosal thickening group(86 implants),20 cases of effusion group(32 implants),17 cases of retention cyst group(25 implants),12 cases of calcification group(19 implants).The mean RBH was 4.15±2.03 mm,the mean MSEH was6.45±3.77 mm,86.32%(82/95)chose transcrestal sinus floor elevation,93.62%(132/141)chose MSFE synchronous implantation,the mucosal perforation rate was 11.58%,and the incidence of postoperative maxillary sinusitis was 6.32%.There were not any statistically significant differences in RBH、MESH、MSFE’s method choice,planting time,the rate of mucosal perforation and the incidence of postoperative maxillary sinusitis between different groups(P>0.05).The mean time for postoperative imaging follow-up of 141 implants was 22.38±10.81 months,and the longest was 69 months.The incidence of peri-implantitis was 4.96%,ISR was 97.16%.There was no significant differences in the incidence of peri-implantitis and ISR between different groups(P>0.05).4 cases of implant failure were all related to postoperative maxillary sinusitis,with preoperative mucosal thickening and/or calcification.Conclusion:Due to insufficient RBH considering MSFE implantation for restoration patients,and without clinical symptoms,the maxillary sinus mucosal thickening(2-10mm)、effusion、retention cyst(<25mm)and calcification may not be contraindications.The different changes effect on RBH,MESH,MSFE’s method choice,planting time,surgery complications are no different,and the influence on planting curative effect can be expected in short-term(5 years),but the postoperative maxillary sinusitis is a high risk for implants,regular follow-up about CBCT imaging can help effectively diagnose postoperative maxillary sinusitis and observe surrounding situation of implants,therefore,can make proper treatment in time.