窦膜破损对种植体长期稳定性影响的meta分析

doi:10.19438/j.cjoms.2026.02.012

中国口腔颌面外科杂志 ›› 2026, Vol. 24 ›› Issue (2): 166-175.doi: 10.19438/j.cjoms.2026.02.012

窦膜破损对种植体长期稳定性影响的meta分析

夏亮^1,2#, 许宗和^3#, 邹多宏²

1.上海交通大学医学院附属第九人民医院口腔颅颌面科,上海 200011;
2.上海交通大学医学院附属第九人民医院口腔外科,上海交通大学口腔医学院, 国家口腔医学中心,国家口腔疾病临床医学研究中心,上海市口腔医学重点实验室, 中国医学科学院口腔颌面再生医学创新单元,上海 200011;
3.福建医科大学附属口腔医院种植科,福建福州 350002

收稿日期:2025-05-12 修回日期:2025-06-21 出版日期:2026-03-20 发布日期:2026-04-02
通讯作者: 邹多宏,E-mail: zdhyy@ahmu.edu.cn
作者简介:夏亮（1990—）,男,博士,主治医师,E-mail: anglexialiang@126.com;许宗和（1998—）,男,博士研究生,E-mail: 342653833@qq.com。^#并列第一作者
基金资助:
国家自然科学基金（32171347,92368111,81800992）;2022年度上海市卫生健康委员会卫生健康领军人才（2022XD038）;上海交通大学医学院附属第九人民医院临床研究助推计划（JYLJ202102）;中央高校基本科研业务费专项资金资助（YG2024LC05）;上海交通大学医学院附属第九人民医院医学研究培育基金（JYZZ114）

Meta-analysis of the impact of sinus membrane perforation on long-term stability of dental implants

Xia Liang^1,2, Xu Zonghe³, Zou Duohong²

1. Department of Oral and Craniomaxillofacial Surgery, Shanghai 200011;
2. Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Innovation Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences. Shanghai 200011;
3. Department of Oral Implantology, School and Hospital of Stomatology, Fujian Medical University. Fuzhou 350002, Fujian Province, China

Received:2025-05-12 Revised:2025-06-21 Online:2026-03-20 Published:2026-04-02

摘要/Abstract

摘要： 目的: 通过meta分析,系统评价上颌窦提升术（maxillary sinus floor elevation,MSFE）中窦膜破损对种植体长期稳定性的影响。方法: 系统检索PubMed、Embase、The Cochrane Library、CNKI、维普数据库中自建库至2023年12月公开发表的关于MSFE中窦膜破损对种植结果影响的相关文献。对纳入文献进行严格筛选与质量评估,最终选取符合纳入标准的高质量研究进行meta分析。结果: 共纳入10项研究,包括2 758例患者及6 695颗种植体。文献整体质量较高,报告的窦膜破损发生率为26.86%。Meta分析结果显示,窦膜破损与否在总体种植体成功率方面无显著差异[RR=0.99,95%CI (0.97, 1.01)],与随访时间也无明显相关性。分层分析发现,当窦膜破损程度为“小”或“中等”时,种植成功率与未破损组差异不显著;而当破损程度为“大”时,种植体成功率下降,但差异仍无统计学意义[RR=0.85,95%CI (0.58, 1.26)]。在并发症方面,相比窦膜未破损组,破损组术后出血风险[RR=18.79,95%CI (1.09, 325.16)]和感染率[RR=13.05,95%CI (2.13, 79.9)]显著升高,而骨移植失败率两组间差异无统计学意义[RR=0.86,95%CI (0.34, 5.36)]。结论: 窦膜破损是MSFE最常见的术中并发症之一。虽然窦膜破损并不显著影响种植成功率,但较大面积的破损可能降低其长期稳定性;且窦膜破损会显著增加术后感染及出血等并发症的发生风险。临床上应重视窦膜破损的识别与分级管理,合理选择修复策略。

关键词: 上颌窦提升术, 窦膜破损, 种植体成功率, Meta分析, 并发症

Abstract: PURPOSE: To systematically evaluate the effect of sinus membrane perforation during maxillary sinus floor elevation(MSFE) on the long-term stability of implants by meta-analysis. METHODS: A comprehensive search was conducted in PubMed, Embase, The Cochrane Library, CNKI and VIP databases for relevant studies published from database inception to December 2023. Clinical studies investigating the effect of sinus membrane perforation during MSFE on implant outcomes were screened. Eligible studies underwent rigorous quality assessment, and those meeting the inclusion criteria were included in the meta-analysis. RESULTS: A total of 10 studies were included, comprising 2 758 patients and 6 695 implants. The overall quality of the included studies was high, and the incidence of membrane perforation was 26.86%. Meta-analysis revealed no significant difference in implant success rates between perforated and non-perforated cases [RR=0.99, 95%CI (0.97, 1.01)], and no correlation with follow-up duration. Subgroup analysis showed that when the perforation size was classified as small or moderate, implant success rates were comparable to those in non-perforated cases. However, large perforations were associated with a trend toward decreased success rates, though not statistically significant [RR=0.85, 95%CI (0.58, 1.26)]. Regarding complications, the incidence of postoperative bleeding was significantly higher in the perforation group [RR=18.79, 95%CI (1.09, 325.16)], as was the incidence of postoperative infection [RR= 13.05, 95%CI(2.13, 79.9)]. No significant difference was found in graft failure rates between the two groups[RR=0.86, 95%CI(0.34, 5.36)]. CONCLUSIONS: Sinus membrane perforation is the most common intraoperative complication during MSFE. While membrane perforation does not significantly impact overall implant success rates, larger perforations may compromise long-term stability. Moreover, membrane perforation is significantly associated with increased risks of postoperative infection and bleeding. Clinicians should pay close attention to the identification and classification of membrane perforations and adopt appropriate repair strategies accordingly.

Key words: Maxillary sinus floor elevation, Sinus membrane perforation, Implant success rate, Meta-analysis, Complications

中图分类号:

R782.1

夏亮, 许宗和, 邹多宏. 窦膜破损对种植体长期稳定性影响的meta分析[J]. 中国口腔颌面外科杂志, 2026, 24(2): 166-175.

Xia Liang, Xu Zonghe, Zou Duohong. Meta-analysis of the impact of sinus membrane perforation on long-term stability of dental implants[J]. China J Oral Maxillofac Surg, 2026, 24(2): 166-175.

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窦膜破损对种植体长期稳定性影响的meta分析

Meta-analysis of the impact of sinus membrane perforation on long-term stability of dental implants

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