Digitally Guided Aspiration Technique for Maxillary Sinus Floor Elevation in the Presence of Cysts: A Case Series

IF 3.7 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical Implant Dentistry and Related Research Pub Date : 2025-02-24 DOI:10.1111/cid.70009

Yuhuan Jiang, Yujia Yang, Liya Chen, Weikai Zhou, Yi Man, Jing Wang

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引用次数: 0

Abstract

Objectives

Sinus floor elevation (SFE) is a widely established surgical procedure for dental implant placement in the atrophic posterior maxilla. However, the presence of maxillary sinus cysts (MSCs) can significantly complicate this intervention. This study presents and evaluates the efficacy and safety of the Digitally Guided Aspiration Technique (DGAT), a novel approach for managing MSCs during SFE procedures.

Materials and Methods

Implant survival and success rates were evaluated according to established criteria, and all complications were systematically documented. Three-dimensional measurements, including MSC volume, residual bone height (BH) surrounding the implants, and apical bone coverage, were obtained using cone beam computed tomography (CBCT). Marginal bone loss (MBL) was assessed through standardized periapical radiographs following prosthetic loading. The accuracy of implant positioning was evaluated by measuring the three-dimensional deviations between virtually planned and actually placed implants. Comprehensive cytological and histological analyses were conducted on aspirated cystic fluid and harvested bone specimens, respectively. Patient-reported outcomes were assessed using questionnaires at the 6-month post-restoration follow-up.

Results

The study comprised seven patients with seven cysts receiving a total of 10 implants. At the 6-month follow-up, the implant survival rate was 100% with no biological or technical complications observed. Volumetric analysis revealed a significant mean reduction in MSC volume of 45.34% ± 33.08% (p = 0.012). Postoperative measurements demonstrated a statistically significant increase in BH compared to baseline values (p < 0.001). This gain remained largely stable throughout the 6-month observation period, with minimal resorption noted in the buccal aspect (p = 0.03) and mean value (p = 0.05). Prior to second-stage surgery, radiographic evaluation confirmed complete bone coverage of all implants, with 60% exhibiting > 2 mm of apical bone coverage. MBL remained within physiological limits. Analysis of implant positioning accuracy showed that coronal global and vertical deviations fell within acceptable clinical parameters, while apical global deviation and angular deviation marginally exceeded recommended thresholds. Cytological analysis of the aspirated cystic fluid revealed no evidence of infection, while histological examination of the regenerated tissue demonstrated mature bone formation with abundant vascularization. Patient-reported outcomes indicated high satisfaction levels.

Conclusions

DGAT can reduce the volume of MSCs, achieve favorable bone grafting and dental implant outcomes with a low incidence of complications. The safety and effectiveness of this procedure need to be compared to the traditional aspiration technique in future randomized controlled trials.

Trial Registration: Chinese Clinical Trial Registry: ChiCTR2400083235. This clinical trial was not registered prior to participant recruitment and randomization

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数字引导下上颌窦底抬高囊肿的抽吸技术：一个病例系列

目的窦底提升（SFE）是一种广泛建立的用于萎缩后上颌种植体植入的手术方法。然而，上颌窦囊肿（MSCs）的存在会显著地使这种干预复杂化。本研究介绍并评估了数字引导抽吸技术（DGAT）的有效性和安全性，这是一种在SFE过程中管理MSCs的新方法。材料和方法根据所建立的标准评估种植体的存活率和成功率，并系统记录所有并发症。三维测量，包括间充质干细胞体积，种植体周围残余骨高度（BH）和根尖骨覆盖，使用锥形束计算机断层扫描（CBCT）获得。通过假体加载后标准化根尖周x线片评估边缘骨丢失（MBL）。通过测量虚拟计划种植体与实际放置种植体之间的三维偏差来评估种植体定位的准确性。对抽取的囊液和采集的骨标本分别进行了全面的细胞学和组织学分析。在修复后6个月的随访中使用问卷评估患者报告的结果。结果7例患者共7个囊肿，共植入10个。在6个月的随访中，种植体成活率为100%，未观察到任何生物或技术并发症。体积分析显示骨髓间充质干细胞体积平均减少45.34%±33.08% （p = 0.012）。术后测量显示，与基线值相比，BH在统计学上显著增加（p < 0.001）。在整个6个月的观察期间，这种增加基本保持稳定，口腔方面的吸收最小（p = 0.03），平均值（p = 0.05）。在第二阶段手术之前，放射学评估证实所有种植体的骨覆盖完全，60%的种植体显示2毫米的根尖骨覆盖。MBL保持在生理限度内。种植体定位精度分析显示，冠状面整体偏差和垂直偏差均在可接受的临床参数范围内，而根尖整体偏差和角度偏差略高于推荐阈值。吸出的囊液的细胞学分析显示没有感染的证据，而再生组织的组织学检查显示成熟的骨形成和丰富的血管化。患者报告的结果表明满意度很高。结论DGAT可以减少MSCs的体积，获得良好的植骨和种植牙效果，并发症发生率低。在未来的随机对照试验中，需要将该方法的安全性和有效性与传统的抽吸技术进行比较。试验注册：中国临床试验注册中心：ChiCTR2400083235。在参与者招募和随机化之前，该临床试验未注册

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来源期刊

Clinical Implant Dentistry and Related Research 医学-牙科与口腔外科

CiteScore

6.00

自引率

13.90%

发文量

103

审稿时长

4-8 weeks

期刊介绍： The goal of Clinical Implant Dentistry and Related Research is to advance the scientific and technical aspects relating to dental implants and related scientific subjects. Dissemination of new and evolving information related to dental implants and the related science is the primary goal of our journal. The range of topics covered by the journals will include but be not limited to: New scientific developments relating to bone Implant surfaces and their relationship to the surrounding tissues Computer aided implant designs Computer aided prosthetic designs Immediate implant loading Immediate implant placement Materials relating to bone induction and conduction New surgical methods relating to implant placement New materials and methods relating to implant restorations Methods for determining implant stability A primary focus of the journal is publication of evidenced based articles evaluating to new dental implants, techniques and multicenter studies evaluating these treatments. In addition basic science research relating to wound healing and osseointegration will be an important focus for the journal.