{"id":269,"date":"2019-12-19T16:46:25","date_gmt":"2019-12-19T15:46:25","guid":{"rendered":"https:\/\/www.implantologie-orl.fr\/?page_id=269"},"modified":"2020-05-10T14:44:57","modified_gmt":"2020-05-10T12:44:57","slug":"de-la-membrane-sinusienne-a-l-ostium-maxillaire","status":"publish","type":"page","link":"https:\/\/www.concedo.fr\/implantologie-orl\/de-la-membrane-sinusienne-a-l-ostium-maxillaire\/","title":{"rendered":"De la membrane sinusienne \u00e0 l&rsquo;ostium maxillaire&#8230;"},"content":{"rendered":"\n<p>Lors d&rsquo;une pose d&rsquo;implant ou d&rsquo;un sinus lift LA LIMITE ANATOMIQUE SUPERIEURE est constitu\u00e9e par la MEMBRANE SINUSIENNE (membrane schneiderienne).<\/p>\n\n\n\n<p>La membrane sinusienne est en fait la muqueuse de rev\u00eatement du sinus maxillaire au niveau du plancher du sinus.<\/p>\n\n\n\n<p>MEMBRANE DE SCHNEIDER = MUQUEUSE DU SINUS MAXILLAIRE<\/p>\n\n\n\n<p>Cette <em>\u00ab\u00a0sacro sainte limite \u00e0 ne pas d\u00e9passer\u00a0\u00bb<\/em> focalise l&rsquo;attention de l&rsquo;implantologue \u00e0 juste titre car sa d\u00e9chirure expose le malade :<\/p>\n\n\n\n<ol><li>\u00e0 des complications infectieuses : SINUSITE AIGUE,<\/li><li>\u00e0 un ECHEC de l&rsquo;implantation.<\/li><\/ol>\n\n\n\n<p>La muqueuse d&rsquo;un sinus sain est radio transparente comme ci dessous : <\/p>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large\"><img decoding=\"async\" loading=\"lazy\" width=\"540\" height=\"332\" src=\"https:\/\/www.implantologie-orl.fr\/wp-content\/uploads\/2019\/12\/Capture-d\u2019e\u0301cran-2019-12-06-a\u0300-21.01.45.png\" alt=\"\" class=\"wp-image-81\" srcset=\"https:\/\/www.concedo.fr\/implantologie-orl\/wp-content\/uploads\/2019\/12\/Capture-d\u2019e\u0301cran-2019-12-06-a\u0300-21.01.45.png 540w, https:\/\/www.concedo.fr\/implantologie-orl\/wp-content\/uploads\/2019\/12\/Capture-d\u2019e\u0301cran-2019-12-06-a\u0300-21.01.45-300x184.png 300w, https:\/\/www.concedo.fr\/implantologie-orl\/wp-content\/uploads\/2019\/12\/Capture-d\u2019e\u0301cran-2019-12-06-a\u0300-21.01.45-439x270.png 439w\" sizes=\"(max-width: 540px) 100vw, 540px\" \/><\/figure><\/div>\n\n\n\n<p>Cependant un \u00e9paississement de la muqueuse sinusienne est fr\u00e9quemment retrouv\u00e9.<\/p>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large is-resized\"><img decoding=\"async\" loading=\"lazy\" src=\"https:\/\/www.implantologie-orl.fr\/wp-content\/uploads\/2019\/12\/Capture-d\u2019e\u0301cran-2019-12-19-a\u0300-14.15.49.png\" alt=\"\" class=\"wp-image-259\" width=\"272\" height=\"349\"\/><figcaption>Epaississement muqueux (fl\u00e8che blanche)<\/figcaption><\/figure><\/div>\n\n\n\n<p>Certains auteurs ont consid\u00e9r\u00e9 de mani\u00e8re arbitraire que le seuil d&rsquo;\u00e9paississement pathologique \u00e9tait \u00e9tabli \u00e0 2 ou 3 mm :<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" loading=\"lazy\" width=\"900\" height=\"582\" src=\"https:\/\/www.implantologie-orl.fr\/wp-content\/uploads\/2019\/12\/Capture-d\u2019e\u0301cran-2019-12-19-a\u0300-15.00.23-e1576764133523.png\" alt=\"\" class=\"wp-image-273\" srcset=\"https:\/\/www.concedo.fr\/implantologie-orl\/wp-content\/uploads\/2019\/12\/Capture-d\u2019e\u0301cran-2019-12-19-a\u0300-15.00.23-e1576764133523.png 900w, https:\/\/www.concedo.fr\/implantologie-orl\/wp-content\/uploads\/2019\/12\/Capture-d\u2019e\u0301cran-2019-12-19-a\u0300-15.00.23-e1576764133523-300x194.png 300w, https:\/\/www.concedo.fr\/implantologie-orl\/wp-content\/uploads\/2019\/12\/Capture-d\u2019e\u0301cran-2019-12-19-a\u0300-15.00.23-e1576764133523-768x497.png 768w, https:\/\/www.concedo.fr\/implantologie-orl\/wp-content\/uploads\/2019\/12\/Capture-d\u2019e\u0301cran-2019-12-19-a\u0300-15.00.23-e1576764133523-418x270.png 418w\" sizes=\"(max-width: 900px) 100vw, 900px\" \/><figcaption><a href=\"https:\/\/www.orlfrance.org\/recommandations-de-bonne-pratique\/\">Recommandation de bonne pratique sur la prise en charge ORL associ\u00e9e \u00e0 la chirurgie implantaire.<\/a><\/figcaption><\/figure>\n\n\n\n<p>Le plus important dans l&rsquo;analyse ORL d&rsquo;un sinus n&rsquo;est pas l&rsquo;\u00e9paisseur de la muqueuse mais la <strong>PERMEABILITE de l&rsquo;OSTIUM<\/strong> qui d\u00e9termine si oui ou non le fonctionnement d&rsquo;un sinus maxillaire est physiologique. Cette analyse ne se situe pas au niveau de sa membrane sinusienne mais au NIVEAU DE L&rsquo;OSTIUM DU SINUS MAXILLAIRE.<\/p>\n\n\n\n<p><strong>Un SINUS MAXILLAIRE SAIN est un SINUS MAXILLAIRE AVEC UN OSTIUM PERMEABLE<\/strong> : on dit alors que le sinus est bien \u00ab\u00a0ventil\u00e9\u00a0\u00bb :<\/p>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large\"><img decoding=\"async\" loading=\"lazy\" width=\"428\" height=\"278\" src=\"https:\/\/www.implantologie-orl.fr\/wp-content\/uploads\/2019\/12\/Capture-d\u2019e\u0301cran-2019-12-19-a\u0300-14.14.59.png\" alt=\"\" class=\"wp-image-263\" srcset=\"https:\/\/www.concedo.fr\/implantologie-orl\/wp-content\/uploads\/2019\/12\/Capture-d\u2019e\u0301cran-2019-12-19-a\u0300-14.14.59.png 428w, https:\/\/www.concedo.fr\/implantologie-orl\/wp-content\/uploads\/2019\/12\/Capture-d\u2019e\u0301cran-2019-12-19-a\u0300-14.14.59-300x195.png 300w, https:\/\/www.concedo.fr\/implantologie-orl\/wp-content\/uploads\/2019\/12\/Capture-d\u2019e\u0301cran-2019-12-19-a\u0300-14.14.59-416x270.png 416w\" sizes=\"(max-width: 428px) 100vw, 428px\" \/><figcaption>Fl\u00e8che orange : Bonne ventilation par l&rsquo;ostium d&rsquo;un sinus maxillaire gauche.<\/figcaption><\/figure><\/div>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large is-resized\"><img decoding=\"async\" loading=\"lazy\" src=\"https:\/\/www.implantologie-orl.fr\/wp-content\/uploads\/2019\/12\/Capture-d\u2019e\u0301cran-2019-12-19-a\u0300-14.14.34.png\" alt=\"\" class=\"wp-image-267\" width=\"295\" height=\"250\"\/><figcaption>Vue endoscopique d&rsquo;un ostium (fl\u00e8che blanche) perm\u00e9able et donc sain du sinus maxillaire droit.<\/figcaption><\/figure><\/div>\n\n\n\n<p>Le bilan pr\u00e9-implantaire au maxillaire doit <strong>INCLURE L&rsquo;OSTIUM DU SINUS MAXILLAIRE<\/strong> afin de contr\u00f4ler la bonne perm\u00e9abilit\u00e9 des sinus. (Importance m\u00e9dico l\u00e9gale) <a href=\"https:\/\/www.orlfrance.org\/recommandations-de-bonne-pratique\/\">Recommandation de bonne pratique 2019<\/a>.<\/p>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large is-resized\"><img decoding=\"async\" loading=\"lazy\" src=\"https:\/\/www.implantologie-orl.fr\/wp-content\/uploads\/2019\/12\/Capture-d\u2019e\u0301cran-2019-12-19-a\u0300-16.08.05.png\" alt=\"\" class=\"wp-image-287\" width=\"255\" height=\"345\" srcset=\"https:\/\/www.concedo.fr\/implantologie-orl\/wp-content\/uploads\/2019\/12\/Capture-d\u2019e\u0301cran-2019-12-19-a\u0300-16.08.05.png 226w, https:\/\/www.concedo.fr\/implantologie-orl\/wp-content\/uploads\/2019\/12\/Capture-d\u2019e\u0301cran-2019-12-19-a\u0300-16.08.05-222x300.png 222w, https:\/\/www.concedo.fr\/implantologie-orl\/wp-content\/uploads\/2019\/12\/Capture-d\u2019e\u0301cran-2019-12-19-a\u0300-16.08.05-199x270.png 199w\" sizes=\"(max-width: 255px) 100vw, 255px\" \/><figcaption>Cone Beam incluant l&rsquo;ostium du sinus (cercle vert) = IMAGE ADAPTEE au BILAN ORL PRE IMPLANTAIRE <\/figcaption><\/figure><\/div>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large\"><img decoding=\"async\" loading=\"lazy\" width=\"320\" height=\"320\" src=\"https:\/\/www.implantologie-orl.fr\/wp-content\/uploads\/2019\/12\/Capture-d\u2019e\u0301cran-2019-12-19-a\u0300-16.43.43-1.png\" alt=\"\" class=\"wp-image-291\" srcset=\"https:\/\/www.concedo.fr\/implantologie-orl\/wp-content\/uploads\/2019\/12\/Capture-d\u2019e\u0301cran-2019-12-19-a\u0300-16.43.43-1.png 320w, https:\/\/www.concedo.fr\/implantologie-orl\/wp-content\/uploads\/2019\/12\/Capture-d\u2019e\u0301cran-2019-12-19-a\u0300-16.43.43-1-300x300.png 300w, https:\/\/www.concedo.fr\/implantologie-orl\/wp-content\/uploads\/2019\/12\/Capture-d\u2019e\u0301cran-2019-12-19-a\u0300-16.43.43-1-150x150.png 150w, https:\/\/www.concedo.fr\/implantologie-orl\/wp-content\/uploads\/2019\/12\/Capture-d\u2019e\u0301cran-2019-12-19-a\u0300-16.43.43-1-270x270.png 270w\" sizes=\"(max-width: 320px) 100vw, 320px\" \/><figcaption>Cone Beam n&rsquo;incluant pas l&rsquo;ostium du sinus = IMAGE INADAPTEE au BILAN ORL PRE IMPLANTAIRE<\/figcaption><\/figure><\/div>\n\n\n\n<p>Un service comme <a href=\"http:\/\/www.concedo.fr\/?pk_campaign=blog2019&amp;pk_source=implantologie-orl.fr&amp;pk_medium=blog\">Concedo<\/a> permet de certifier l&rsquo;absence de contre indication ORL en respectant les recommandations d&rsquo;experts.<\/p>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large is-resized\"><a href=\"https:\/\/www.concedo.fr\/\"><img decoding=\"async\" loading=\"lazy\" src=\"https:\/\/www.implantologie-orl.fr\/wp-content\/uploads\/2019\/12\/Capture-d\u2019e\u0301cran-2019-12-06-a\u0300-22.12.27-7.png\" alt=\"\" class=\"wp-image-198\" width=\"421\" height=\"138\"\/><\/a><\/figure><\/div>\n","protected":false},"excerpt":{"rendered":"<p>Lors d&rsquo;une pose d&rsquo;implant ou d&rsquo;un sinus lift LA LIMITE ANATOMIQUE SUPERIEURE est constitu\u00e9e par la MEMBRANE SINUSIENNE (membrane schneiderienne). La membrane sinusienne est en fait la muqueuse de rev\u00eatement du sinus maxillaire au niveau du plancher du sinus. MEMBRANE DE SCHNEIDER = MUQUEUSE DU SINUS MAXILLAIRE Cette \u00ab\u00a0sacro sainte limite \u00e0 ne pas d\u00e9passer\u00a0\u00bb focalise l&rsquo;attention de l&rsquo;implantologue \u00e0 juste titre car sa d\u00e9chirure expose le malade : \u00e0 des complications infectieuses : SINUSITE AIGUE, \u00e0 un ECHEC de&#8230;<\/p>\n<p class=\"read-more\"><a class=\"btn btn-default\" href=\"https:\/\/www.concedo.fr\/implantologie-orl\/de-la-membrane-sinusienne-a-l-ostium-maxillaire\/\">Lire la suite<span class=\"screen-reader-text\"> Lire la suite<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"_links":{"self":[{"href":"https:\/\/www.concedo.fr\/implantologie-orl\/wp-json\/wp\/v2\/pages\/269"}],"collection":[{"href":"https:\/\/www.concedo.fr\/implantologie-orl\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.concedo.fr\/implantologie-orl\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.concedo.fr\/implantologie-orl\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.concedo.fr\/implantologie-orl\/wp-json\/wp\/v2\/comments?post=269"}],"version-history":[{"count":17,"href":"https:\/\/www.concedo.fr\/implantologie-orl\/wp-json\/wp\/v2\/pages\/269\/revisions"}],"predecessor-version":[{"id":370,"href":"https:\/\/www.concedo.fr\/implantologie-orl\/wp-json\/wp\/v2\/pages\/269\/revisions\/370"}],"wp:attachment":[{"href":"https:\/\/www.concedo.fr\/implantologie-orl\/wp-json\/wp\/v2\/media?parent=269"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}