Cat Scan 분석에 의한 Schneiderian membrane 두께와 membrane perforation 간의 관계

Lack of sufficient crestal bone height and/or pneumatized sinus cavities are often a major obstacle to the placement of dental implants in the posterior maxilla. Sinus elevation surgery is one solution to this problem. Perforation of the Schneiderian membrane is the most common complication of this surgical technique. The purpose of this study is to evaluate the relationship between the thickness of the Schneiderian membrane and the incidence of membrane perforation. Sixty-three CAT-scans from an available 625 patients undergoing sinus augmentation procedures by residents at the New York University Ashman Department of Implant Dentistry were chosen at random for evaluation. Membrane thickness was measured using Sim/PlantTM software at the midpoint of the lateral wall osteotomy and on the same vertical plane at the widest portion of sinus cavity. 62% percent of the cases examined were in the thin membrane group (<1.5 mm) and 38 % of case belonged to thick membrane group (>=L5 mm). The overall observed perforation rate for the 63 cases was 31.7% (20/63). The perforation rate in the thicker membrane group was 16.6% (4/24) while the perforation rate in the thinner membrane group was 41.0% (16/39). The observed perforation rates indicate that a moderately thickened sinus membrane is more conducive to a perforation-free elevation than a thin sinus membrane when performed by residents under faculty supervision. Further research is indicated to determine if this is also true for more experienced clinicians.