The Influence Of Two Kinds Of Maxillary Sinus Lifting Through Alveolar Ridge On The Thickness Of Sinus Floor Mucosa

Objective:By observing the response of sinus floor mucosa in two different operation methods,the volume change of sinus floor mucosa was analyzed,and then the security of two operation methods was evaluated,which can provide reference for clinical work.Methods:From September 2019 to November 2020,65 implant cases with single missing maxillary posterior teeth and insufficient bone height were selected.According to the inclusion criteria and exclusion criteria,the patients were selected.The inclusion criteria were as follows:no maxillary sinusitis,good general health,can tolerate the surgery,and the single missing maxillary posterior teeth need maxillary sinus lifting,the height of residual bone in the implant area≥4mm,the time of missing teeth≥3 months;the preoperative thickness of maxillary sinus mucosa(MT):MT≤4mm;the floor of maxillary sinus is flat without separation.Exclusion criteria:smokers;patients with maxillary sinus lesions;patients with severe periodontitis without treatment;patients with history of maxillary sinus surgery;patients with poor compliance;patients with intraoperative mucosal perforation or postoperative maxillary sinusitis.The patients were divided into four groups according to different lifting height and operation methods:A1:lifting height≤3mm,osteotome sinus floor elevation;A2:lifting height>3mm,osteotome sinus floor elevation;B1:lifting height≤3mm,CAS-KIT technique;B2:lifting height>3mm,CAS-KIT technique.The CBCT of the patients before operation,one week after operation and one month after operation were used in mimics research to measure the volume of the maxillary sinus floor mucosa(MV).The changes of the sinus floor mucosa volume in each group one week after operation,ΔW,ΔM1 andΔM2,one month after operation,were analyzed.The effects of the two methods were evaluated.Results:The volume of sinus floor mucosa in each group before operation was:group A1:2118.11±400.63mm~3,group A2:2184.35±455.34mm~3,group B1:2181.12±340.43mm~3,group B2:2238.83±428.36mm~3(no significant differences among the groups,P=0.959).The mean volume of sinus floor mucosa in each group was(A1)9025.81±637.44mm~3,(A2)11785.07±767.64mm~3,(B1)6008.28±808.37mm~3,(B2)7319.86±836.66mm~3one week after operation(significant differences among the groups,P<0.05).The average swelling degree after a week(ΔW)was 6841.46±841.95mm~3,9666.96±941.54mm~3,3869.44±720.25mm~3,5138.73±816.16mm~3(significant differences among the groups,P<0.05).The average volume of sinus floor mucosa in each group was(A1)2214.31±514.54mm~3,(A2)2139.47±452.71mm~3,(B1)2162.88±484.04mm~3,(B2)2181.60±454.08mm~3one month after operation(no significant differences among the groups,P=0.959),the volume of sinus floor mucosa changes in each group compared with that before operation(ΔM1)was(A1)29.96±59.19mm~3,(A2)21.35±52.08mm~3,(B1)24.05±55.68mm~3,(B2)29.55±44.26mm~3(no significant differences among the groups,P=0.959),and the volume changes compared with that one week after operation(ΔM2)was(A1)6811.49±882.42mm~3,(A2)9645.61±974.02mm~3,(B1)3845.39±726.78mm~3,(B2)5109.19±823.85mm~3(significant differences among the groups,P<0.05).The increase of lifting height and osteotome sinus floor elevation(OSFE)will aggravate the swelling reaction of the sinus floor mucosa,but it will not affect the thickness of the sinus floor mucosa one month after the operation.Conclusion:In this study,the swelling of sinus floor mucosa occurred one week after operation in all patients,and the sinus floor mucosa returned to the preoperative level one month after operation.If the lifting height is the same,the swelling of the mucosa after OSFE is more significant than that after CAS-KIT technique one week after the operation;in the same surgical method,if the lifting height is increased,the swelling is more significant one week after the operation.Therefore,the stimulation of OSFE on sinus floor mucosa may be greater than CAS-KIT technique,but on the premise of no perforation,the sinus floor mucosa can return to the preoperative level one month after the operation of the two methods,and the two methods have no significant effect on the thickness of sinus floor mucosa.