Rinosinusitis kao komplikacija podizanja dna maksilarnog sinusa

master's thesis

• Title (english): Rhinosinusitis as a complication of sinus lift surgery
• Author: Marjana Stipić
• Mentor: Goran Geber (mentor)
• Committee member: Goran Geber (predsjednik povjerenstva)
• Committee member: Robert Trotić (član povjerenstva)
• Committee member: Davor Vagić (član povjerenstva)
• Granter: University of Zagreb; School of Dental Medicine; (Chair of Otorhynolaringology); Zagreb
• Defense date and country: 2020-09-11, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Dental Medicine

Abstract

Implantološka je terapija danas izbor kod djelomično ili potpuno bezubih pacijenata. Međutim,
resorpcija alveolarnog grebena posteriorne regije gornje čeljusti i pneumatizacija maksilarnog
sinusa dovode do smanjenog volumena kosti što ograničava primjenu implantološke terapije. Kod
takvih je pacijenata nužno podizanje dna maksilarnog sinusa. Radi se o operativnom zahvatu kojeg
karakterizira premještanje dna maksilarnog sinusa prema kranijalnoj bazi uz istodobno
nadomještanje kosti. Na CBCT-u potrebno je utvrditi anatomske odnose i volumen kosti na mjestu
planirane implantacije, a nakon radiološke procjene, anamneze i kliničkog pregleda pristupa se
planiranju zahvata. Odluka između klasičnih i modernih operativnih tehnika ovisi o anatomiji
rezidualnog grebena i individualnim sklonostima operatera. Nakon podizanja Schneiderove
membrane apikalno u smjeru sinusa nastali defekt ispunjava se materijalima za nadomještanje
kosti. Implantati se mogu postaviti imedijatno ili odgođeno ovisno o tehnici i korištenom koštanom
transplantatu. Oštećenje cilijarne funkcije prilikom zahvata, obliteracija maksilarnog ušća,
potisnuće stranog tijela u sinus i postojeća upala sinusa mogu dovesti do razvoja rinosinusitisa.
Tako nastali rinosinusitis može biti akutnog i kroničnog tijeka. Simptomi u toj situaciji gotovo su
uvijek unilateralni. Prisutna bakterijska flora slična je onoj u usnoj šupljini. Akutnu upalu
karakterizira miješana bakterijska flora, dok u kroničnoj upali prevladava anaerobna. Dijagnoza
se temelji na liječničkom pregledu i radiološkom nalazu, dok su komplikacije vrlo rijeke. Liječenje
zahtjeva primjenu lijekova i neku od kirurških metoda. Rano prepoznavanje simptoma i liječenje
sprječava gubitak implantata.

Abstract (english)

Today, implant therapy is the treatment of choice for patients who are partially or completely
edentulous. However, the resorption of the alveolar ridge of the posterior region of maxilla and
pneumatization of the maxillary sinus lead to reduced bone volume, which limits the potential for
implant therapy. In such patients, sinus floor elevation is necessary. Sinus floor elevation is a
surgical procedure through which the floor of the maxillary sinus is transferred towards the cranial
base, with simultaneous augmentation of the bone defect. CBCT is necessary to determine the
anatomical position and bone volume of the implantation site determined earlier. Following the
radiological assessment, anamnesis and clinical examination, the surgeon may plan the procedure.
The decision between classical and modern operative techniques depends on the anatomy of the
residual ridge and the individual preferences of the surgeon. After lifting the Schneiderian
membrane apically in the direction of maxillary sinus, the defect created during this procedure is
filled with bone graft materials. Implants can be placed immediately, or their placement may be
delayed, depending on the technique used and the type of bone graft material. Impairment of ciliary
function during the procedure, obliteration of the maxillary ostium, displacement of a foreign body
into the sinus and previously existing sinusitis can all lead to the development of rhinosinusitis.
Rhinosinusitis caused by these factors can be acute or chronic. Symptoms are almost always
unilateral in this situation. The bacterial flora present in the maxillary sinus is similar to the
bacterial flora in the oral cavity. Acute inflammation is characterized by a mixed bacterial flora,
while anaerobic bacterial flora dominates in cases of chronic inflammation. The diagnosis of
rhinosinusitis is based on medical examination and radiological evaluation. The treatment requires
the use of medicaments and some surgical methods. Early recognition of symptoms and treatment
prevent the loss of the placed implant. Complications of rhinosinusitis are very rare.

• Keywords: maksilarni sinus; zubni implantati; podizanje dna sinusa
• Keywords (english): Maxillary Sinus; Sinus floor elevation; Dental Implants
• Language: croatian
• URN:NBN: urn:nbn:hr:127:572183
• Study programme: Title: dental medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica dentalne medicine (doktor/doktorica dentalne medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2021-01-21 12:02:57