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Craig JR, Saibene AM, Felisati EG, Felisati G. Collaboration between otolaryngologists and oral surgeons in maxillary sinus elevation planning. Clin Implant Dent Relat Res 2024. [PMID: 39187918 DOI: 10.1111/cid.13385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 07/16/2024] [Accepted: 08/10/2024] [Indexed: 08/28/2024]
Abstract
BACKGROUND The collaboration between otolaryngologists and dental providers is crucial for the planning and execution of maxillary sinus elevation (MSE) procedures, which are integral to successful dental implant placements. PURPOSE This article examines the essential role of otolaryngological assessments in identifying potential sinonasal risks that could impact the outcomes of MSE. MATERIALS AND METHODS A comprehensive narrative review of existing literature was conducted. DISCUSSION The review underscores the importance of thorough preoperative evaluations, including patient history, computed tomography (CT) or cone-beam CT (CBCT) scans, and nasal endoscopy, to mitigate sinonasal health risks. It details various clinical scenarios and patient assessments, emphasizing a systematic approach to diagnosing and managing sinonasal conditions proactively. The discussion reveals that while some sinus conditions may not significantly affect MSE success, conditions impacting mucociliary clearance and sinus drainage are critical risk factors requiring otolaryngological intervention. Additionally, the article introduces a grading system to assist clinicians in identifying patients who would benefit from otolaryngological evaluations prior to MSE. CONCLUSION This review highlights the value of interdisciplinary collaboration and standardized protocols in enhancing the predictability and safety of MSE procedures, ultimately improving patient outcomes.
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Affiliation(s)
- John R Craig
- Department of Otolaryngology-Head and Neck Surgery, Henry Ford Health, Detroit, Michigan, USA
| | - Alberto Maria Saibene
- Otolaryngology Unit, Santi Paolo e Carlo Hospital, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Elena Giulia Felisati
- Department of Otolaryngology and Head and Neck Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giovanni Felisati
- Otolaryngology Unit, Santi Paolo e Carlo Hospital, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
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Song Y, Rong M, Ye Y, Zhang H, Chu H, Yang Y, Wang Y, Gan Z. Pathogenic factors of maxillary sinus mucosal thickening observed by cone-beam computed tomography (CBCT). Appl Radiat Isot 2024; 208:111241. [PMID: 38503200 DOI: 10.1016/j.apradiso.2024.111241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 12/19/2023] [Accepted: 02/15/2024] [Indexed: 03/21/2024]
Abstract
OBJECTIVE To explore the pathogenic factors associated with maxillary sinus mucosal thickening with Cone-beam computed Tomography (CBCT). METHODS From 2016 through 2020, 93 patients with periapical periodontitis or periodontitis in the maxillary posterior dental region were selected. RESULTS The preoperative thickness of the periodontitis group was significantly higher than that of the periapical periodontitis group (P < 0.05). The difference achieves statistical significance for the comparison of the thickness change with various severity of inflammation (F = 54.824, P = 0.000), the change with time (F = 312.741, P = 0.000). and the change with the interaction severity of inflammation and time(F = 86.132, P = 0.000). CONCLUSIONS Patients with maxillary sinus mucosa thickening caused by periodontitis and periapical periodontitis should be extracted their infectious teeth and get thoroughly debridement. Maxillary sinus augmentation can perform favorable efforts 3-6 months after extracting teeth.
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Affiliation(s)
- Yingying Song
- Department of Pediatric Stomatology, Stomatological Hospital, Southern Medical University, Guangzhou, 510280, Guangdong, People's Republic of China
| | - Mingdeng Rong
- Department of Periodontics and Implantology, Stomatological Hospital, Southern Medical University, Guangzhou, 510280, Guangdong, People's Republic of China
| | - Yingxin Ye
- Department of Stomatology, Binhaiwan Central Hospital of Dongguan, Dongguan, 523000, Guangdong, People's Republic of China
| | - Hanfei Zhang
- Department of Stomatology, Binhaiwan Central Hospital of Dongguan, Dongguan, 523000, Guangdong, People's Republic of China
| | - Hongxing Chu
- Department of Periodontics and Implantology, Stomatological Hospital, Southern Medical University, Guangzhou, 510280, Guangdong, People's Republic of China
| | - Yong Yang
- Department of Periodontics and Implantology, Stomatological Hospital, Southern Medical University, Guangzhou, 510280, Guangdong, People's Republic of China
| | - Yarong Wang
- Department of Periodontics and Implantology, Stomatological Hospital, Southern Medical University, Guangzhou, 510280, Guangdong, People's Republic of China
| | - Zekun Gan
- Department of Periodontics and Implantology, Stomatological Hospital, Southern Medical University, Guangzhou, 510280, Guangdong, People's Republic of China.
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Nakajima Y, Apaza Alccayhuaman KA, Botticelli D, Lang NP, De Rossi EF, Xavier SP. Mucosal adhesion phenomenon after maxillary sinus floor elevation: A preclinical study. Clin Oral Implants Res 2023; 34:967-978. [PMID: 37403596 DOI: 10.1111/clr.14123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 06/04/2023] [Accepted: 06/21/2023] [Indexed: 07/06/2023]
Abstract
AIM To describe the histological events that occur after maxillary sinus floor elevation when the elevated and undetached sinus mucosa are in close proximity or in contact with each other. MATERIALS AND METHODS From 76 rabbits, 152 elevated maxillary sinuses were analyzed histologically. Sites without adhesions were classified as "No proximity," whereas the adhesion stages were divided into "Proximity," "Fusion," and "Synechia stages." The width of the pseudostratified columnar epithelium and the distance between the two layers of the elevated and undetached sinus mucosae were measured at various standardized positions. RESULTS Thirty-one sites presenting with adhesions were found. Twelve sites were in the proximity stage," presenting cilia of the two epithelial layers that were shortened and interlinked within the mucous context. Hyperactivity of the goblet cells was also observed. In the other cases, the hyperplastic epithelium showed attempts to reach the contralateral mucosa. The 15 "fusion stage" sites presented regions with epithelial cells of the two mucosal layers that penetrated each other. Four sites presented "synechiae stages," represented by bridges of connective tissue connecting the two lamina propria. CONCLUSIONS Close proximity or tight contact between the elevated and undetached mucosa adhering to the bone walls might occur after maxillary sinus floor elevation. This induced hyperplasia of the epithelial cells and adhesion of the two layers until synechiae formation.
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Affiliation(s)
- Yasushi Nakajima
- Department of Oral Implantology, Osaka Dental University, Osaka, Japan
- ARDEC Academy, Rimini, Italy
| | | | | | | | | | - Samuel Porfirio Xavier
- ARDEC Academy, Rimini, Italy
- Department of Oral and Maxillofacial Surgery and Periodontology, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
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Radmand F, Razi T, Baseri M, Gavgani LF, Salehnia F, Faramarzi M. Anatomic evaluation of the posterior superior alveolar artery using cone-beam computed tomography: A systematic review and meta-analysis. Imaging Sci Dent 2023; 53:177-191. [PMID: 37799745 PMCID: PMC10548151 DOI: 10.5624/isd.20230009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 03/25/2023] [Accepted: 03/31/2023] [Indexed: 10/07/2023] Open
Abstract
Purpose This systematic review examined the detection of the posterior superior alveolar artery, along with various anatomic characteristics, on cone-beam computed tomography images. Materials and Methods Studies were identified electronically through the Web of Science, MEDLINE, Scopus, and Embase databases. The quality of the included studies was evaluated using a 5-item binary scale. The detection rate, location, and classified diameter of the posterior superior alveolar artery were estimated as prevalence values. The diameter of this artery, as well as the distances from the artery to the alveolar crest and sinus floor, were estimated as means with associated 95% confidence intervals. Results Thirty-seven studies were enrolled, with 34 of these included in the meta-analysis. The mean detection rate was 79% (range: 72%-84%), and the mean diameter was 1.06±0.05 mm (range: 0.96-1.16 mm). The posterior superior alveolar artery was located intraosseously in 64% of cases. The mean distance of the artery from the alveolar crest was 16.71±0.49 mm (range: 15.75-17.68 mm), while the mean distance from the artery to the sinus floor was 8.85±0.4 mm (range: 8.05-9.64 mm). Conclusion According to the findings of this meta-analysis regarding various anatomic characteristics of the posterior superior alveolar artery, severe hemorrhage after damage to this artery during sinus augmentation procedures is not a substantial clinical problem.
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Affiliation(s)
- Faraz Radmand
- Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Tahmineh Razi
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Milad Baseri
- Dental and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Leili Faraji Gavgani
- Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
- Research Center for Evidence-Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fatemeh Salehnia
- Research Center for Evidence-Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Masoumeh Faramarzi
- Department of Periodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
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Nemati M, Khodaverdi N, Hosn Centenero SA, Tabrizi R. Which factors affect the risk of membrane perforation in lateral window maxillary sinus elevation? A prospective cohort study. J Craniomaxillofac Surg 2023; 51:427-432. [PMID: 37423790 DOI: 10.1016/j.jcms.2023.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 05/13/2023] [Accepted: 06/25/2023] [Indexed: 07/11/2023] Open
Abstract
It was the aim of this prospective cohort study to assess the various anatomical and other patient-related factors that increase membrane perforation risk. Patients underwent cone-beam computed tomography (CBCT) before surgery. The presence of septa, presence of mucous retention cyst, lateral wall thickness, membrane thickness, and residual bone height were predictive factors. Age, gender, and smoking were covariates for the study. The presence or absence of membrane perforation was the study outcome. In total, 140 subjects were studied. The hazard ratio (HR) for the presence of septa with membrane perforation was 8.07 (2.93-22.29) (p < 0.001). The HR for perforation with a single edentulous area relating to two or more teeth was 68.09 (9.52-49.16). The risk of membrane perforation in smokers was 25 times more than in non-smokers - HR 25 (7.58-82.51) (p < 0.001). The HR for membrane perforation in subjects with mucous retention cysts compared with subjects without retention cysts was 27.75 (8.73-88.23) (p < 0.001). Within the limitations of the study it seems that anatomical, habitual, and pathological factors may increase the risk of Schneiderian membrane perforation when a lateral window approach is used for sinus floor augmentation.
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Affiliation(s)
- Majid Nemati
- Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nazilla Khodaverdi
- Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Samir Aboul Hosn Centenero
- Oral and Maxillofacial Surgery Department, Hospital Clinic de Barcelona, International University of Catalunya, Barcelona, Spain
| | - Reza Tabrizi
- Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Jacob RGM, Ervolino da Silva AC, Chaushu L, Lang NP, Borges Duailibe de Deus C, Botticelli D, Rangel Garcia Júnior I. Evaluation of Two Configurations of Hydroxyapatite and Beta-Tricalcium Phosphate in Sinus Grafts with Simultaneous Implant Installation: An Experimental Study in Rabbits. Dent J (Basel) 2023; 11:121. [PMID: 37232771 PMCID: PMC10217008 DOI: 10.3390/dj11050121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/20/2023] [Accepted: 04/28/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND This study aimed to evaluate peri-implant bone formation in rabbits after sinus grafting mediated by hydroxyapatite and beta-tricalcium phosphate (HA + β-TCP) in granule or paste configurations, concomitant with immediate implant installation. MATERIAL & METHODS Thirty-four rabbit maxillary sinuses were grafted with HA + β-TCP, half of which were applied in a granule and half in a paste composition. Implant placement was performed simultaneously. At 7 and 40 days postoperatively, the animals were euthanized, and samples were prepared for tomographic, microtomographic, histological, histometric (hematoxylin and eosin staining, HE), and immunohistochemical (labeling of transcription factor Runx-2 [RUNX2], vascular endothelial growth factor [VEGF], osteocalcin [OCN], and tartrate-resistant acid phosphatase [TRAP]) analysis. Implant removal torque was also measured. RESULTS On tomography, maintenance of sinus membrane integrity was observed in both the groups. Higher values of morphometric parameters evaluated by micro-CT were found in the "paste group" after seven days. At 40 days, there were no significant differences between the groups in most of the microtomographic parameters evaluated. In histological sections stained with HE, a higher percentage of newly formed bone was observed in the "granule group" after 40 days. Similar positive immunolabeling was observed for both RUNX2 and OCN in both the experimental groups. TRAP immunolabeling was similar in both groups as well. VEGF labeling increased in the "granule group", indicating a higher osteoconductive potential in this biomaterial. Similar removal torque values were observed in both groups. Thus, the two HA + β-TCP configurations showed similar healing patterns of simultaneously installed implants adjacent to sinus floor elevation. However, significantly higher bone values were observed for the "granule configuration". CONCLUSIONS The HA + β-TCP granules and paste presentations showed favorable long-term healing results, with bone formation in similar quantities and quality adjacent to the implants.
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Affiliation(s)
- Ricardo Garcia Mureb Jacob
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Rua José Bonifácio 1193, Araçatuba 16015-050, SP, Brazil; (R.G.M.J.); (A.C.E.d.S.); (C.B.D.d.D.); (I.R.G.J.)
- Department of Basic Sciences, School of Dentistry, São Paulo State University (UNESP), Rua José Bonifácio 1193, Araçatuba 16015-050, SP, Brazil
| | - Ana Cláudia Ervolino da Silva
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Rua José Bonifácio 1193, Araçatuba 16015-050, SP, Brazil; (R.G.M.J.); (A.C.E.d.S.); (C.B.D.d.D.); (I.R.G.J.)
| | - Liat Chaushu
- Department of Periodontology and Implant Dentistry, The Maurice and Gabriela Goldschleger School of Dentistry, Tel Aviv University, Tel Aviv 69978, Israel;
| | - Niklaus Peter Lang
- School of Dental Medicine, University of Berne, CH-3010 Berne, Switzerland
| | - Ciro Borges Duailibe de Deus
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Rua José Bonifácio 1193, Araçatuba 16015-050, SP, Brazil; (R.G.M.J.); (A.C.E.d.S.); (C.B.D.d.D.); (I.R.G.J.)
- Department of Basic Sciences, School of Dentistry, São Paulo State University (UNESP), Rua José Bonifácio 1193, Araçatuba 16015-050, SP, Brazil
| | | | - Idelmo Rangel Garcia Júnior
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Rua José Bonifácio 1193, Araçatuba 16015-050, SP, Brazil; (R.G.M.J.); (A.C.E.d.S.); (C.B.D.d.D.); (I.R.G.J.)
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Xue H, Wen J, Liu C, Shuai X, Zhang X, Kang N. Modified transcrestal sinus floor elevation with concomitant implant placement in edentulous posterior maxillae with residual bone height of 5 mm or less: a non-controlled prospective study. Int J Oral Maxillofac Surg 2023; 52:495-502. [PMID: 36058822 DOI: 10.1016/j.ijom.2022.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 08/15/2022] [Accepted: 08/15/2022] [Indexed: 11/26/2022]
Abstract
The aim of this study was to describe a modified transcrestal sinus floor elevation (mTSFE) technique and to evaluate its clinical effectiveness and reliability when residual bone height is severely reduced. Forty-three maxillary edentulous patients who met the inclusion criteria were enrolled. All patients underwent the mTSFE technique; 66 dental implants were inserted simultaneously. Patient-reported outcomes were assessed 2 weeks after surgery. Prosthetic crowns were placed 6 months after surgery. Radiographic analyses and clinical analyses were conducted to assess the clinical effectiveness and feasibility of mTSFE during a follow-up period of 2-8 years. The mean vertical bone increase after surgery was 8.09 mm, and it decreased to 6.56 mm at 6 months after surgery. Two cases of membrane perforation occurred during surgery and one implant was lost in the third year after surgery; the survival rate at the implant level was 98.48%. No severe postoperative complication was reported and the subjective feeling of patients was acceptable. This mTSFE technique could simplify the operative procedure and might be helpful to reduce intraoperative trauma, as well as to alleviate postoperative discomfort.
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Affiliation(s)
- H Xue
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Prosthodontics, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University, School of Medicine; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai, China
| | - J Wen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - C Liu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - X Shuai
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - X Zhang
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu, China
| | - N Kang
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu, China; Department of Oral Implantology (National Key Clinical Department), West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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Comuzzi L, Tumedei M, Petrini M, Romasco T, Lorusso F, De Angelis F, Piattelli A, Tatullo M, Di Pietro N. Clinical and Radiological Evaluation of a Self-Condensing Bone Implant in One-Stage Sinus Augmentation: A 3-Year Follow-Up Retrospective Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2583. [PMID: 36767949 PMCID: PMC9915976 DOI: 10.3390/ijerph20032583] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 01/25/2023] [Accepted: 01/27/2023] [Indexed: 06/18/2023]
Abstract
Stabilization of dental implants in the sinus region with a bone height below 4 mm gen-erally requires a two-stage sinus floor elevation surgery. To improve this aspect, the aim of this retrospective study was to demonstrate the feasibility of performing a one-stage maxillary sinus augmentation using an innovative self-condensing implant design, even in case of a bone height close to 2 mm. Clinical and radiological outcomes from 54 patients (26 females; 28 males; 69 total implants positioned) were analyzed 3 years post-surgery. The three-dimensional grafts change was evaluated by Cone-Beam Computed Tomography (CBCT) before surgery (T0), immediately after surgery (T1), and 1-year post-surgery (T2). The sinus floor levels measured at the medial (M-W), middle (MD-W), and lateral (L-W) walls reported: M-W of 1.9 ± 2.4 mm (T1) and 1.7 ± 2.6 mm (T2); MD-W of -0.1 ± 2.7 mm (T1) and 0.7 ± 2.4 mm (T2); L-W of 3.1 ± 3.0 mm (T1) and 3.1 ± 3.0 mm (T2); besides a bone crest height (C-F) of 4.6 ± 2.0 mm (T1) and 12.1 ± 1.4 mm (T2). Moreover, after 3 years only 1 implant was lost, and so an implant survival rate of 98.55% was recorded. In conclusion, these results suggest the efficacy of using this implant design for a one-stage sinus lift approach, not only in terms of increased implant survival rate and decreased marginal bone loss, but also for its potential applicability in case of reduced bone height.
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Affiliation(s)
- Luca Comuzzi
- Independent Researcher, San Vendemiano-Conegliano, 31020 Treviso, Italy
| | - Margherita Tumedei
- Department of Medical, Surgical, and Dental Sciences, University of Milan, 20122 Milan, Italy
| | - Morena Petrini
- Department of Medical, Oral and Biotechnological Sciences, “G. d’Annunzio” University of Chieti-Pescara, 66013 Chieti, Italy
| | - Tea Romasco
- Department of Medical, Oral and Biotechnological Sciences, “G. d’Annunzio” University of Chieti-Pescara, 66013 Chieti, Italy
- Center for Advanced Studies and Technology-CAST, “G. d’Annunzio” University of Chieti-Pescara, 66013 Chieti, Italy
| | - Felice Lorusso
- Department of Medical, Oral and Biotechnological Sciences, “G. d’Annunzio” University of Chieti-Pescara, 66013 Chieti, Italy
| | - Francesco De Angelis
- Department of Medical, Oral and Biotechnological Sciences, “G. d’Annunzio” University of Chieti-Pescara, 66013 Chieti, Italy
| | - Adriano Piattelli
- School of Dentistry, Saint Camillus International University of Health and Medical Sciences, 00131 Rome, Italy
- Facultad de Medicina, UCAM Universidad Católica San Antonio de Murcia, 30107 Murcia, Spain
| | - Marco Tatullo
- Department of Translational Biomedicine and Neurosciences (DiBraiN), University of Bari Aldo Moro, 70124 Bari, Italy
| | - Natalia Di Pietro
- Department of Medical, Oral and Biotechnological Sciences, “G. d’Annunzio” University of Chieti-Pescara, 66013 Chieti, Italy
- Center for Advanced Studies and Technology-CAST, “G. d’Annunzio” University of Chieti-Pescara, 66013 Chieti, Italy
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Nakajima Y, Botticelli D, De Rossi EF, Ferreira Balan V, Pires Godoy E, Ricardo Silva E, Xavier SP. Schneiderian Membrane Collateral Damage Caused by Collagenated and Non-Collagenated Xenografts: A Histological Study in Rabbits. Dent J (Basel) 2023; 11:dj11020031. [PMID: 36826176 PMCID: PMC9955563 DOI: 10.3390/dj11020031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/12/2023] [Accepted: 01/16/2023] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND The Schneiderian membrane (SM) that is in contact with biomaterial granules may become thinner and eventually perforate. It has been shown that these events are related to the biomaterial used. Hence, the main aim of the present study was to compare the damaging effects of two xenografts with different resorbability rates on SM. The secondary aim was to evaluate the possible protection from damage offered by a collagen membrane placed adjacent to the SM and by inward displacement of the bone window with the SM during elevation. METHODS Thirty-six albino New Zealand rabbits underwent bilateral sinus elevation. One group of 18 animals received deproteinized bovine bone mineral (DBBM group) and the other received swine-collagenated corticocancellous bone (collagenated group). Moreover, in the DBBM group, the bone window was displaced inward during elevation in one sinus together with the SM. In the collagenated group, a collagen membrane was placed adjacent to the SM in one sinus. Six animals were assessed per period after 2, 4, and 8 weeks. RESULTS The mean pristine mucosa width ranged between 67 µm and 113 µm, and none had a width of <40 µm. In the 2-week group, the elevated mucosa of the DBBM group presented 59 thinned sites and five perforations, while in the collagenated group, 14 thinned sites and one perforation were observed. Damage to SM decreased in number in the 4-week treatment group. In the 8-week group, the number of thinned sites in the DBBM group increased to 124, and the perforations to 8. In the collagenated group, 7 thinned sites and 1 small perforation were observed. CONCLUSIONS More damage to the Schneiderian membrane was observed in the DBBM group than in the collagenated group. The presence of the inward bone window offered protection from damage to the Schneiderian membrane.
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Affiliation(s)
- Yasushi Nakajima
- Department of Oral Implantology, Osaka Dental University, 8-1 Kuzuhahanazonocho, Hirakata 573-1121, Osaka, Japan
- ARDEC Academy, 47923 Rimini, Italy
| | | | | | - Vitor Ferreira Balan
- Department of Oral and Maxillofacial Surgery and Periodontology, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-904, Brazil
| | - Eduardo Pires Godoy
- Department of Oral Biology, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo 05508-060, Brazil
| | - Erick Ricardo Silva
- ARDEC Academy, 47923 Rimini, Italy
- Department of Oral and Maxillofacial Surgery and Periodontology, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-904, Brazil
| | - Samuel Porfirio Xavier
- ARDEC Academy, 47923 Rimini, Italy
- Department of Oral and Maxillofacial Surgery and Periodontology, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-904, Brazil
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10
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Miyauchi Y, Izutani T, Teranishi Y, Iida T, Nakajima Y, Xavier SP, Baba S. Healing Patterns of Non-Collagenated Bovine and Collagenated Porcine Xenografts Used for Sinus Floor Elevation: A Histological Study in Rabbits. J Funct Biomater 2022; 13:jfb13040276. [PMID: 36547536 PMCID: PMC9787467 DOI: 10.3390/jfb13040276] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 11/30/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022] Open
Abstract
Objective: To compare healing of collagenated and non-collagenated xenografts used for maxillary sinus floor elevation. Materials and Methods: Two different xenografts were used: deproteinized bovine bone (DBBM group) and collagenated corticocancellous porcine bone (collagenated group). Healing was studied after 2, 4, and 8 weeks. The loss of dimensions of the elevated area and the percentages of new bone, xenograft remnants, osteoclastic zones, vessels, inflammatory infiltrates, and soft tissues were analyzed. Three regions were evaluated: close to the bone walls (bone wall region), subjacent the sinus mucosa (submucosa region), and the center of the elevated area (middle region). The primary variables were the percentage of new bone and xenograft remnants. Results: Between 2 and 8 weeks, the elevated areas showed a reduction of 16.3% and 52.2% in the DBBM and collagenated groups, respectively (p < 0.01 between the two areas after 8 weeks). After 8 weeks, the highest content of new bone was observed in the bone wall region, which was higher in the collagenated group than in the DBBM group (41.6% and 28.6%, respectively; p < 0.01). A similar quantity of new bone was found between the two groups in other regions. A higher percentage of vessels in all regions evaluated (p < 0.01) and soft tissue in the sub-mucosa region (p < 0.05) was found in the collagenated group than in the DBBM group. Conclusions: The present study showed that both xenografts allowed new bone formation. In comparison with the non-collagenated xenograft, the collagenated xenograft underwent higher resorption, resulting in greater shrinkage of the elevated space after sinus lifting and a higher content of new bone in the regions close to the bone walls. Clinical relevance: In this study, the region adjacent to the bone wall showed the highest new bone content. This region resembles the base of the sinus, closest to the sinus floor and walls, and is the most important region from a clinical point of view because it is where the implant will be installed. Residues of the biomaterial remained after 8 weeks of healing. Other reports have shown that these biomaterial residues may interfere with the integration of implants.
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Affiliation(s)
- Yuhei Miyauchi
- Department of Oral Implantology, Osaka Dental University, 8-1 Kuzuhahanazonocho, Hirakata, Osaka 573-1121, Japan
| | - Takayuki Izutani
- Department of Oral Implantology, Osaka Dental University, 8-1 Kuzuhahanazonocho, Hirakata, Osaka 573-1121, Japan
| | - Yuki Teranishi
- Department of Oral Implantology, Osaka Dental University, 8-1 Kuzuhahanazonocho, Hirakata, Osaka 573-1121, Japan
| | - Takahisa Iida
- Department of Oral Implantology, Osaka Dental University, 8-1 Kuzuhahanazonocho, Hirakata, Osaka 573-1121, Japan
| | - Yasushi Nakajima
- Department of Oral Implantology, Osaka Dental University, 8-1 Kuzuhahanazonocho, Hirakata, Osaka 573-1121, Japan
- ARDEC Academy, Viale Giovanni Pascoli 67, 47923 Rimini, Italy
| | - Samuel Porfirio Xavier
- ARDEC Academy, Viale Giovanni Pascoli 67, 47923 Rimini, Italy
- Department of Oral and Maxillofacial Surgery and Periodontology, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-904, São Paulo, Brazil
- Correspondence:
| | - Shunsuke Baba
- Department of Oral Implantology, Osaka Dental University, 8-1 Kuzuhahanazonocho, Hirakata, Osaka 573-1121, Japan
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la Encina ACD, Martínez-Rodríguez N, Ortega-Aranegui R, Cortes-Bretón Brinkmann J, Martínez-González JM, Barona-Dorado C. Anatomical variations and accessory structures in the maxilla in relation to implantological procedures: an observational retrospective study of 212 cases using cone-bean computed tomography. Int J Implant Dent 2022; 8:59. [PMID: 36441355 PMCID: PMC9705638 DOI: 10.1186/s40729-022-00459-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 11/12/2022] [Indexed: 11/29/2022] Open
Abstract
PURPOSE This study used cone-beam computed tomography (CBCT) to analyze the prevalence of several maxillary anatomical/accessory structures, as well as variations within each type, assessing how accurate diagnosis can minimize the risk of intraoperative complications during implantological procedures in the oral cavity. METHODS 212 CBCT scans of the maxilla were analyzed, captured over a period of 18 months for surgical planning purposes. The prevalence of posterior superior alveolar arteries (PSAA), maxillary sinus septa (MSS), and branches of the canalis sinuosus (CS) were evaluated, as were the diameter and location of each anatomical structure in horizontal and vertical planes. P < 0.05 was considered statistically significant. RESULTS PSAAs were observed in 99.1% of cases, the intrasinus type being the most frequent; MSS were noted in 15.6% of the sample, mainly in the posterior region with sagittal orientation; CS branches were observed in 50% of patients, mainly in relation to the incisors and significantly more prevalent among males. CONCLUSIONS The use of CBCT significantly increases the possibility of clearly identifying these anatomical structures. The differences found between patients highlight the importance of carrying out an exhaustive radiological study of the individual to prevent complications, such as Schneiderian membrane perforation, neurovascular damage or bleeding during surgery.
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Affiliation(s)
- Augusto Cimolai-de la Encina
- grid.4795.f0000 0001 2157 7667Department of Conservative Dentistry and Orofacial Prosthodontics, Faculty of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Natalia Martínez-Rodríguez
- grid.4795.f0000 0001 2157 7667Department of Dental Clinical Specialties, Faculty of Dentistry, Universidad Complutense de Madrid, Pza Ramon y Cajal S/N, 28040 Madrid, Spain ,grid.4795.f0000 0001 2157 7667Surgical and Implant Therapies in the Oral Cavity Research Group; University Complutense, Madrid, Spain
| | - Ricardo Ortega-Aranegui
- grid.4795.f0000 0001 2157 7667Department of Dental Clinical Specialties, Faculty of Dentistry, Universidad Complutense de Madrid, Pza Ramon y Cajal S/N, 28040 Madrid, Spain
| | - Jorge Cortes-Bretón Brinkmann
- grid.4795.f0000 0001 2157 7667Department of Dental Clinical Specialties, Faculty of Dentistry, Universidad Complutense de Madrid, Pza Ramon y Cajal S/N, 28040 Madrid, Spain ,grid.4795.f0000 0001 2157 7667Surgical and Implant Therapies in the Oral Cavity Research Group; University Complutense, Madrid, Spain
| | - José María Martínez-González
- grid.4795.f0000 0001 2157 7667Department of Dental Clinical Specialties, Faculty of Dentistry, Universidad Complutense de Madrid, Pza Ramon y Cajal S/N, 28040 Madrid, Spain ,grid.4795.f0000 0001 2157 7667Surgical and Implant Therapies in the Oral Cavity Research Group; University Complutense, Madrid, Spain
| | - Cristina Barona-Dorado
- grid.4795.f0000 0001 2157 7667Department of Dental Clinical Specialties, Faculty of Dentistry, Universidad Complutense de Madrid, Pza Ramon y Cajal S/N, 28040 Madrid, Spain ,grid.4795.f0000 0001 2157 7667Surgical and Implant Therapies in the Oral Cavity Research Group; University Complutense, Madrid, Spain
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Omori Y, Botticelli D, Migani S, Ferreira Balan V, Pires Godoy E, Xavier SP. Sinus Mucosal Damage Triggered by Synthetic or Xenogeneic Bone Substitutes: A Histological Analysis in Rabbits. J Funct Biomater 2022; 13:257. [PMID: 36412898 PMCID: PMC9680494 DOI: 10.3390/jfb13040257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 11/11/2022] [Accepted: 11/17/2022] [Indexed: 11/22/2022] Open
Abstract
Background: It has been shown in rabbit models that the sinus mucosa in contact with graft particles might experience a progressive thinning and perforations. The phenomenon depends on the graft used. Hence, the aim of the present study was to compare the damaging effects of a synthetic of a xenogeneic graft. Methods: Forty New Zealand rabbits received a bilateral sinus elevation. Both sinuses of twenty rabbits were grafted with a biphasic 60% hydroxyapatite and 40% β-tricalcium phosphate while the other twenty received a deproteinized bovine bone mineral graft. Thinned sites (<40 µm) and perforations on the mucosa in contact with graft particles were evaluated after 2 and 10 weeks (ten animals each period). The width of the pseudostratified epithelium was also measured as control. Results: After 2 weeks of healing, 61 thinned sites were detected in the Synthetic group and 49 in the Xenogeneic group. After 10 weeks, the number of thinned mucosae increased to 79 sites in the Synthetic group (p = 0.222 between periods), and to 114 sites in the Xenogeneic group (p = 0.030 between groups; p = 0.001 between periods). Perforations were few in the 2-week period, two in two sinuses out of 20 in the Synthetic group, and four in two sinuses out of 20 in the Xenogeneic group (p = 0.721). In the 10-week period, the perforations increased to eight in the Synthetic group, distributed in six sinuses out of 20, and to sixteen in the Xenogeneic group, distributed in 11 sinuses out of 20 (p = 0.082). The pseudostratified epithelium presented a reduced width at the thinned sites. Conclusions: The contact with synthetic or xenogeneic grafts will induce thinning and possible perforations of the sinus mucosa. This effect will increase over time, and it is stronger at the xenogeneic than the synthetic graft.
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Affiliation(s)
- Yuki Omori
- Department of Oral Implantology, Osaka Dental University, 8-1 Kuzuhahanazonocho, Osaka 573-1121, Japan
| | | | - Stefano Migani
- ARDEC Academy, Viale Giovanni Pascoli 67, 47923 Rimini, Italy
| | - Vitor Ferreira Balan
- Department of Oral and Maxillofacial Surgery and Periodontology, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café-Subsetor Oeste-11 (N-11), Ribeirão Preto 14040-904, Brazil
| | - Eduardo Pires Godoy
- Department of Oral Biology, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-904, Brazil
| | - Samuel Porfirio Xavier
- Department of Oral and Maxillofacial Surgery and Periodontology, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café-Subsetor Oeste-11 (N-11), Ribeirão Preto 14040-904, Brazil
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Lim ST, Kusano K, Taniyama T, Sakuma S, Nakajima Y, Xavier SP, Baba S. Contribution to Bone Formation of the Schneiderian Membrane after Sinus Augmentation: A Histological Study in Rabbits. MATERIALS (BASEL, SWITZERLAND) 2022; 15:8077. [PMID: 36431558 PMCID: PMC9692365 DOI: 10.3390/ma15228077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/07/2022] [Accepted: 11/10/2022] [Indexed: 06/16/2023]
Abstract
AIM to evaluate bone formation in close contact with the sinus mucosa after different periods from sinus augmentation and the influence on healing of the presence of an inward dis-placed bone window. MATERIAL AND METHODS Eighteen rabbits were included in the experiment. A trap-door technique was applied at the test sites, and the bony window was elevated inward (inward window; IW) together with the sinus mucosa. At the control sites, the bony window was removed before the elevation of the sinus mucosa. The elevated space was filled with deproteinized bovine bone mineral (DBBM) and both access windows were covered with a collagen membrane. Histometric measurements were performed subjacent the sinus mucosa after 2, 4, and 8 weeks of healing. RESULTS Very few sinuses presented small percentages of new bone in close contact with the sinus mucosa in the various period examined. The presence of bone in the neighbor areas might have influenced bone formation close to the sinus mucosa. The inward displaced bone window supported bone formation close to the sinus mucosa only in the earliest period of healing, while the bone walls increased their influence over time. The lack of increased new bone percentage over time in the most central regions of the elevated sinus mucosa do not support the hypothesis that the sinus mucosa may express its potential in bone formation. It can be speculated that the new bone found in the intermediate and middle regions of the control sites in the earliest period of healing might be due to residual of bone from the osteotomy. CONCLUSIONS Very small amounts of new bone were found subjacent to the sinus mucosa, mostly formed from the bone walls, the inward displaced bone window or from possible bone residues from the osteotomy procedures. The lack of increased new bone percentage over time in the most central regions of the elevated sinus mucosa indicates that the contribution to bone formation provided by the sinus mucosa is limited.
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Affiliation(s)
- Su Tien Lim
- Department of Oral Implantology, Osaka Dental University, Osaka 573-1121, Japan
| | - Kaoru Kusano
- Department of Oral Implantology, Osaka Dental University, Osaka 573-1121, Japan
| | - Tomohide Taniyama
- Department of Oral Implantology, Osaka Dental University, Osaka 573-1121, Japan
| | - Shigeru Sakuma
- Clinical Implant Society of Japan, Tokyo 170-0003, Japan
| | - Yasushi Nakajima
- Department of Oral Implantology, Osaka Dental University, Osaka 573-1121, Japan
- ARDEC Academy, Viale Giovanni Pascoli 67, 47923 Rimini, Italy
| | - Samuel Porfirio Xavier
- ARDEC Academy, Viale Giovanni Pascoli 67, 47923 Rimini, Italy
- Department of Oral and Maxillofacial Surgery and Periodontology, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-904, SP, Brazil
| | - Shunsuke Baba
- Department of Oral Implantology, Osaka Dental University, Osaka 573-1121, Japan
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Fu M, Jiang Z, Ren L, He J, Zhu D, Yang G. Maxillary sinus floor augmentation comparing removing versus retaining antral pseudocyst: A retrospective cohort study. Clin Oral Implants Res 2022; 33:1098-1113. [PMID: 36062937 DOI: 10.1111/clr.13993] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 08/15/2022] [Accepted: 08/18/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To retrospectively compare multilevel volumetric changes in both hard and soft tissues between antral pseudocyst (AP) removal and retainment before maxillary sinus floor augmentation (MSFA) and immediate implant placement. MATERIAL AND METHODS Twenty-six patients with thirty-eight implants placed from 2016 to 2021 were included and divided according to a cohort design as follows: 13 removing the cyst (RC group) and 13 "leaving alone" the cyst (LC group). 3D radiographic parameters (primary outcome), 2D parameters and clinical records (secondary outcome) involving both hard and soft tissues were evaluated for 4 periods (T1: immediate postoperative, T2: 6-month, T3: 12-month, and T4: 2- to 5- year follow-up). Possible confounding factors, including sinus anatomical features and implant distribution, were also analyzed to eliminate their disturbance. RESULTS The 3D volumetric change rate of bone grafts in the RC group (-9.32 ± 10.01%) from T2 to T3 was significantly lower than that in the LC group (-19.8 ± 10.59%) (p < .05). The change rate of apical bone height (ABH), endo-sinus bone gain (ESBG) and other 2D parameters were not significantly different between the two groups. 5.3% implants in RC group and 9.1% implants failed during follow-ups. 0% postoperative complications were observed in RC group. The Schneiderian membrane of RC group was significantly thinner than that of LC group at two measuring points in sinus. CONCLUSION The present study demonstrated that compared to AP retainment, AP removal before MSFA and immediate implant placement can obtain higher bone graft volumetric stability and favorable prognosis. The study protocol was approved by the Medical Ethics Committee of the Affiliated Hospital of Stomatology, School of medicine, Zhejiang University, China (Acceptance number: 2021-117(R)).
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Affiliation(s)
- Mengdie Fu
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Zhiwei Jiang
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Lingfei Ren
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Jin He
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Danji Zhu
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Guoli Yang
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, China
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15
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Wang Y, Sun J, Shi Y, Li X, Wang Z. Buccal bone thickness of posterior mandible for microscrews implantation in molar distalization. Ann Anat 2022; 244:151993. [PMID: 36041697 DOI: 10.1016/j.aanat.2022.151993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 06/04/2022] [Accepted: 08/16/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND This study explored the inter-radicular space and buccal bone thickness of the posterior mandibular region to provide an appropriate miniscrew insertion site for lower dentition distalization. METHODS The cone-beam computed tomographic (CBCT) records of 63 subjects were collected. Buccal bone thickness (BBT) was measured at four sections: (I) the root of the second premolar(P1); (II) the mesial root of the first molar(P2); (III) the distal root of the first molar(P3); (IV) the mesial root of the second molar(P4). The narrowest inter-radicular space of the four sections was also detected. Both BBT and inter-radicular space were measured at 4 height levels, 2, 4, 6 and 8mm from the alveolar ridge. RESULTS The largest BBT was observed at the mesial root of the second molar at 6 and 8mm, demonstrating a thickness of 6.77±2.50mm and 7.46±1.94mm, respectively. It provided sufficient coverage for mini-implants inserted 10°-30° oblique to the root. Therefore, during distalization of the mandibular dentition, roots have sufficient space to bypass the inclined mini-implants on the lingual side, avoiding miniscrew-root contact. The width between the mesiodistal roots of the first molar was the smallest, showing 1.53±0.69mm and 2.13±0.65mm at 4 and 6mm. Miniscrews implanted in this region had an increased risk of root proximity. CONCLUSIONS The most appropriate insertion site at the mandibular buccal shelf was the mesial point of the second molar at 6-8mm from the alveolar ridge, and an insertion angle of 10°-30° was recommended to avoid miniscrew-root contact. CBCT analysis is recommended before implantation due to individual differences.
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Affiliation(s)
- Yaqi Wang
- Department of Orthodontics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 324 Jingwu Road, Jinan, Shandong, China.
| | - Jing Sun
- Department of Stomatology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 324 Jingwu Road, Jinan, Shandong, China.
| | - Yanli Shi
- Department of Stomatology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 324 Jingwu Road, Jinan, Shandong, China.
| | - Xin Li
- Department of Stomatology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 324 Jingwu Road, Jinan, Shandong, China.
| | - Zhiqiang Wang
- Department of Orthodontics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 324 Jingwu Road, Jinan, Shandong, China; Department of Orthodontics,Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, 324 Jingwu Road, Jinan, Shandong, China.
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16
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THE PREVALENCE AND LOCATION OF THE POSTERIOR SUPERIOR ALVEOLAR ARTERY IN THE MAXILLARY SINUS WALL: A PRELIMINARY COMPUTED-CONE BEAM STUDY. Saudi Dent J 2022; 34:629-635. [PMID: 36267528 PMCID: PMC9577964 DOI: 10.1016/j.sdentj.2022.08.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 08/23/2022] [Accepted: 08/28/2022] [Indexed: 11/22/2022] Open
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Clinical and Histological Healing after Maxillary Sinus Floor Elevation. Dent J (Basel) 2022; 10:dj10070134. [PMID: 35877408 PMCID: PMC9324517 DOI: 10.3390/dj10070134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 07/13/2022] [Indexed: 02/01/2023] Open
Abstract
Sinus floor elevation is a surgical procedure that allows for the insertion of the implant in the posterior region of the maxilla in case of insufficient volume of native bone. Several studies have reported a high success rate, and this has helped to spread this surgical procedure around the world. The subject has been extensively studied and this could lead researchers to think that no new scientific evidence can be provided. However, new ideas and discoveries show that research never reaches a conclusion, and that new information can be added all the time. This collection aimed to provide new evidence that could be added to daily clinical work and to provide new ideas for future research.
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Wang Z, Zhang J, Ren L, Yang G. Repositioning of the bone window in lateral sinus floor elevation with simultaneous implant placement: A retrospective radiographic study. Clin Oral Implants Res 2022; 33:816-833. [PMID: 35713366 DOI: 10.1111/clr.13963] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/01/2022] [Accepted: 06/02/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To retrospectively evaluate whether repositioning the bone window leads to a better outcome of three-dimensional sinus augmentation in lateral sinus floor elevation (LSFE) with simultaneous implant placement. METHODS 34 patients with a total of 40 implants (14: test group, 26: control group) receiving LSFE with simultaneous implant placement were included in this retrospective research. CBCT images were taken before surgery, immediately and 6 months after surgery. The two-dimensional augmentation parameters, including apical bone height (ABH), endo-sinus bone gain (ESBG), and palatal/buccal bone height (PBH/BBH), and three-dimensional parameters, including augmentation volume (AV) and palatal/buccal augmentation volume (PAV/BAV), were measured. The lateral defect length (LDL) and lateral window length (LWL) were also measured to evaluate the lateral antrostomy recovery. RESULTS At the 6-month follow-up, the reduction rates at ABH, ESBG, and BBH of the test group (ABH: 10.41% ± 30.30%, ESBG: 2.55% ± 8.91%, BBH: 2.50% ± 8.65%) were significantly lower than those of the control group (ABH: 25.10% ± 22.02%, ESBG: 11.47% ± 9.79%, BBH: 7.10% ± 5.37%; p < .05). In addition, the test group showed better three-dimensional augmentation stability on the buccal side (BAV reduction: 15.51% ± 10.86% vs. 27.15% ± 12.61%; p < .05). Moreover, the LDL/LWL ratio of the test group was significantly lower than that of the control group (p < .05). CONCLUSION Within the limitations of this study, repositioning of the bone window in LSFE with simultaneous implant placement could contribute to endo-sinus augmentation stability on the buccal side at the 6-month follow-up. Moreover, it would also facilitate recovery of the lateral antrostomy defect.
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Affiliation(s)
- Zhikang Wang
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Jing Zhang
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Lingfei Ren
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Guoli Yang
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, China
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Comuzzi L, Tumedei M, Piattelli A, Tartaglia G, Del Fabbro M. Radiographic Analysis of Graft Dimensional Changes in Transcrestal Maxillary Sinus Augmentation: A Retrospective Study. MATERIALS 2022; 15:ma15092964. [PMID: 35591298 PMCID: PMC9102007 DOI: 10.3390/ma15092964] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/14/2022] [Accepted: 04/15/2022] [Indexed: 01/02/2023]
Abstract
Background. The maxillary sinus lift is a popular and predictable technique associated with implant-supported rehabilitation of the severely atrophic maxilla. The aim of the present retrospective study was to investigate the effectiveness of transcrestal maxillary sinus augmentation and the graft resorption pattern using different heterologous bone substitutes. Methods. A total of 75 sinus-grafting procedures were performed and 89 implants were placed in 66 patients, 24 males and 42 females, with mean age 67.9 ± 10.64 years (range 43−84 years). Nineteen subjects were smokers. The mean follow-up period was 93.33 ± 54.71 months (range 14−240 months). Clinical and radiographical evaluations were performed. Graft height and width were measured at baseline and at the latest follow-up. Results. Mesiodistal and vertical resorption averaged 9.3 ± 20.7% (standard deviation), and 5.04 ± 9.9% of the postoperative size, respectively, considering the graft as the unit. Linear regression analysis showed that graft resorption in both the vertical and the mesiodistal dimension is independent of the follow-up time. Conversely, there was a trend for greater resorption when increasing the postoperative graft size, in both vertical (p = 0.001) and horizontal (p = 0.007) dimensions. When grouping the dimensional changes by graft particle size (only small (<300 μm) particles, combination of small and medium (>500 μm)/large (>1000 μm) particles, and only medium/large particles), there was a trend for greater resorption associated with smaller particles, but it was not significant; neither in the mesiodistal nor in the vertical dimension (p = 0.17 and p = 0.25, respectively). No implant was lost during the observation period. In conclusion, the transcrestal technique for maxillary sinus augmentation documented a high level of predictability. The low clinical morbidity and the contextual dental implant positioning is clinically useful in relation to a significant reduction of the time required for implant restoration, a consistent decrease of the number of surgical phases, and a cost-effectiveness approach for the rehabilitation. The graft resorption pattern in all cases was compatible with persistent implant protection and support.
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Affiliation(s)
- Luca Comuzzi
- Independent Researcher, San Vendemmiano, 31020 Conegliano, Italy;
| | - Margherita Tumedei
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, 20122 Milan, Italy; (M.T.); (G.T.)
| | - Adriano Piattelli
- Dental School, Saint Camillus International University for Health Sciences (Unicamillus), 00131 Rome, Italy;
- Dental School, University of Belgrade, 11000 Belgrade, Serbia
- Casa di Cura Villa Serena, 65013 Città Sant’Angelo, Italy
- Fondazione Villaserena per la Ricerca, 65013 Città Sant’Angelo, Italy
| | - Gianluca Tartaglia
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, 20122 Milan, Italy; (M.T.); (G.T.)
- IRCCS Fondazione Ca’Granda IRCCS Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, 20122 Milan, Italy; (M.T.); (G.T.)
- IRCCS Orthopedic Institute Galeazzi, Via Riccardo Galeazzi 4, 20161 Milan, Italy
- Correspondence: ; Tel.: +39-02-50319950; Fax: +39-02-50319960
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20
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Perini A, Viña-Almunia J, Carda C, Martín de Llano JJ, Botticelli D, Peñarrocha-Diago M. Influence of the Use of a Collagen Membrane Placed on the Bone Window after Sinus Floor Augmentation-An Experimental Study in Rabbits. Dent J (Basel) 2021; 9:dj9110131. [PMID: 34821595 PMCID: PMC8623347 DOI: 10.3390/dj9110131] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 11/02/2021] [Accepted: 11/08/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND We studied the influence on healing of a resorbable membrane covering the osteotomy site after maxillary sinus grafting, evaluated in different regions of the augmented area. METHODS Maxillary sinus augmentation was performed in 24 New Zealand rabbits. Osteotomy, 4 × 6 mm, were performed bilaterally. A collagenated cortico-cancellous porcine bone was used to fill the elevated region. A collagen membrane was randomly placed over the osteotomy site on one side (MG), and the other side was left uncovered (NMG). The animals were euthanized after 2, 4, and 8 weeks; and histomorphometric analysis was performed in eight different regions. RESULTS New bone percentages were similar in both groups. There were no statistically significant differences. In MG, the overall percentages were 15.6 ± 7.3%, 22.9 ± 6.1%, and 24.9 ± 12.0% after 2, 4, and 8 weeks, respectively. In NMG, the percentages were 11.2 ± 4.5%, 24.1 ± 5.7%, and 24.5 ± 15.7%, respectively. The proportions of new bone in the various regions after 8 weeks were 31 ± 8.9% and 29.9 ± 9.1% in the bone walls region, 25 ± 10.1% and 32.8 ± 9.1% in the submucosa region, 22.6 ± 21.6% and 10.9 ± 11.5 in the middle region, 17.3 ± 14% and 13.4 ± 9.8% in the close-to-window region, and 21.8 ± 11.6%, 19.1 ± 6.4% in the osteotomy region-for MG and NMG, respectively. CONCLUSIONS In both groups the greatest amounts of bone formation occurred near to the pre-existing bone walls, followed by the sub-mucosa region. The smallest amounts were found in the close-to-window region, followed by the central region. The placement of a collagen membrane to cover the osteotomy site did not influence the amount of new bone formation after sinus grafting.
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Affiliation(s)
- Alessandro Perini
- Department of Neurosciences, Division of Dentistry, University of Padua, 35122 Padua, Italy;
- Correspondence:
| | - Jose Viña-Almunia
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain;
| | - Carmen Carda
- Department of Pathology and Health Research Institute of the Hospital Clínico (INCLIVA), Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain; (C.C.); (J.J.M.d.L.)
- Ciber-BBN, Instituto de Salud Carlos III, 46010 Valencia, Spain
| | - José Javier Martín de Llano
- Department of Pathology and Health Research Institute of the Hospital Clínico (INCLIVA), Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain; (C.C.); (J.J.M.d.L.)
| | | | - Miguel Peñarrocha-Diago
- Department of Neurosciences, Division of Dentistry, University of Padua, 35122 Padua, Italy;
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21
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Shao Q, Li J, Pu R, Feng Y, Jiang Z, Yang G. Risk factors for sinus membrane perforation during lateral window maxillary sinus floor elevation surgery: A retrospective study. Clin Implant Dent Relat Res 2021; 23:812-820. [PMID: 34750940 DOI: 10.1111/cid.13052] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 10/01/2021] [Accepted: 10/14/2021] [Indexed: 12/26/2022]
Abstract
PURPOSE To analyze the sinus membrane perforation (SMP) rate and its potential risk factors during lateral window maxillary sinus floor elevation (LSFE). MATERIALS AND METHODS For patients with LSFEs at Department of Implantology, Stomatology Hospital, School of Medicine, Zhejiang Universitiy during January 2014 to December 2020, patient-related risk factors (age/sex/smoking habit), surgery-related risk factors (operator experiment/number of tooth units/technique of osteotomy/surgical approach), and maxillary sinus-related risk factors (residual bone height/sinus membrane thickness/lateral wall thickness/maxillary sinus contours/presence of septa/blood vessels at the lateral maxillary sinus wall) were compared between perforated and nonperforated sites and were evaluated for their influence affecting SMP. RESULTS The study sample comprised 278 LSFE procedures in 278 patients; a total of 47 LSFE procedures (16.91%) presented SMP. Four significant factors were identified: smoking habit (p < 0.001), thin (≤1.5 mm) sinus membrane (p = 0.027), maxillary sinus contours (p < 0.001), and presence of septa (p = 0.001). The SMP rate of irregular, narrow tapered, and tapering sinus contours was significantly higher than that of ovoid and square one (p < 0.05). CONCLUSION In general, smoking habit, thin sinus membrane, irregular, narrow tapered, and tapering sinus contours, and presence of septa may increase the risk of SMP during LSFE.
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Affiliation(s)
- Qin Shao
- Department of Implantology, The Affiliated Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Key Laboratory of Oral Biomedical Research of Zhejiang Province, Zhejiang University School of Stomatology, Hangzhou, China
| | - Jialu Li
- Department of Implantology, The Affiliated Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Key Laboratory of Oral Biomedical Research of Zhejiang Province, Zhejiang University School of Stomatology, Hangzhou, China
| | - Rui Pu
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, Zhejiang University School of Stomatology, Hangzhou, China.,Department of Hospital-Acquired Infection Control, The Affiliated Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yuting Feng
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, Zhejiang University School of Stomatology, Hangzhou, China.,Department of Preventive Dentistry, The Affiliated Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zhiwei Jiang
- Department of Implantology, The Affiliated Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Key Laboratory of Oral Biomedical Research of Zhejiang Province, Zhejiang University School of Stomatology, Hangzhou, China
| | - Guoli Yang
- Department of Implantology, The Affiliated Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Key Laboratory of Oral Biomedical Research of Zhejiang Province, Zhejiang University School of Stomatology, Hangzhou, China
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22
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Henriques I, Caramês J, Francisco H, Caramês G, Hernández-Alfaro F, Marques D. Prevalence of maxillary sinus septa: systematic review and meta-analysis. Int J Oral Maxillofac Surg 2021; 51:823-831. [PMID: 34742634 DOI: 10.1016/j.ijom.2021.10.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 10/16/2021] [Accepted: 10/19/2021] [Indexed: 10/19/2022]
Abstract
The aim of this systematic review and meta-analysis was to determine the prevalence and characteristics of maxillary sinus septa using cone beam computed tomography and computed tomography data. Publications were searched until October 5, 2020 in three electronic databases. Additionally, article bibliographies were searched, and authors were contacted if required. This review has been registered in PROSPERO (CRD42019124933). Two independent evaluators assessed methodological quality using the Joanna Briggs Institute levels of evidence; inter-rater reliability tests were performed (Cohen's κ). The prevalence of maxillary sinus septa was expressed as a proportion; differences according to sex were reported in terms of the odds ratio (OR) and 95% confidence interval (95% CI). Heterogeneity and sources of heterogeneity were evaluated by meta-regression. Publication bias was assessed by visual analysis of the funnel plot. Statistical significance was set at P < 0.05. The 62 studies identified and included in the review involved 13,701 patients (22,460 sinuses). The meta-analysis of 35 studies (14,664 sinuses) revealed an overall mean sinus septa prevalence per sinus of 33.2% (95% CI 27.8-38.5%; I2 = 98.32%). The meta-analysis of 42 studies (9631 patients) found an overall mean sinus septa prevalence per patient of 41.0% (95% CI 36.0-46.0%, I2 = 96.45%). The OR for the difference in septa prevalence between sexes was 0.785 (95% CI 0.590-1.046; P = 0.098, I2 = 73.24%). Septa were most frequent in the middle area of the sinus and with a transverse orientation (86.0%). Within the limitations, the results suggest a high proportion of septa in the sinus, commonly in the middle area, which can interfere with the success of sinus floor elevation required for implant rehabilitation.
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Affiliation(s)
- I Henriques
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal
| | - J Caramês
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal; Instituto de Implantologia, Lisbon, Portugal; LIBPhys-FCT UID/FIS/04559/2013, Lisbon, Portugal
| | - H Francisco
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal; Instituto de Implantologia, Lisbon, Portugal
| | - G Caramês
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal; Instituto de Implantologia, Lisbon, Portugal
| | | | - D Marques
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal; Instituto de Implantologia, Lisbon, Portugal; LIBPhys-FCT UID/FIS/04559/2013, Lisbon, Portugal; Evidence Based Dentistry Research Centre, Cochrane Collaboration Portugal, Lisbon, Portugal.
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23
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Nosaka Y, Nosaka H, Nakajima Y, Tanioka T, Botticelli D, Baba S. A Reliable Surgical Procedure for Sinus Floor Augmentation with Antral Pseudocysts. Dent J (Basel) 2021; 9:dj9100122. [PMID: 34677184 PMCID: PMC8534752 DOI: 10.3390/dj9100122] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/11/2021] [Accepted: 10/14/2021] [Indexed: 01/08/2023] Open
Abstract
An antral pseudocyst (AP) is a common well-defined ‘dome-shaped’ faintly radiopaque lesion of the maxillary sinus, and usually does not require treatment in asymptomatic patients. However, when sinus floor augmentation is required to increase bone volume for implant installation, the elevation of the sinus mucosa might drive the AP against the ostium. This might cause its obstruction and, as possible consequence, sinusitis. The purpose of this study was to investigate the clinical and tomographic conditions of APs to identify a predictable cyst removal that might allow a safety sinus floor augmentation. A total of 52 maxillary sinuses in 46 patients (mean age 55.1 years) presenting AP were examined by cone beam computed tomographies (CBCTs). A two-stage approach was applied. At the first surgery, the cystic lesions were further inspected by an endoscope through the antrostomy, and histopathological diagnosis of the removed tissues was carried out. After the confirmation of decrease of the swelling of sinus membrane by CBCT, the sinus floor augmentation was performed, at least four months after cyst removal. The color and transparency of the 86 cystic lesions were classified into 4 types. The whitish transparent cysts were 34 (39.5%), the yellowish transparent cysts were 18 (20.9%), the dark purple transparent cysts were 8 (9.3%) and the milky-white opaque cysts were 26 (30.2%). The contents of the 60 (69.8%) transparent cysts were serous fluid, but those of milky-white cysts were composed of viscous or elastic soft tissues, and the aspiration of the contents was unsuccessful. The analysis of the preoperative CBCT did not provide certainty on the contents of the cystic lesions. All cystic lesions were diagnosed as AP, and an infection was identified in one AP, presenting marked infiltration of the inflammatory cells. Considering the difficulties of performing a correct diagnosis of the AP content by a CBCT analysis, the risk of failure of the surgery that creates severe afflictions to the patients, and the necessity of a histological evaluation of the cyst, a two-stage surgery appeared to be the most reliable procedure.
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Affiliation(s)
- Yasuhiro Nosaka
- Department of Oral Implantology, Osaka Dental University, Osaka 540-0008, Japan; (Y.N.); (T.T.); (S.B.)
- Nosaka Oral Surgery Clinic, Japan. 2F Chambre-Ashiya, 11-17, Nishiyama-cho, Ashiya 659-0083, Japan;
- Correspondence: ; Tel.: +81-797-25-0545; Fax: +81-797-25-0546
| | - Hitomi Nosaka
- Nosaka Oral Surgery Clinic, Japan. 2F Chambre-Ashiya, 11-17, Nishiyama-cho, Ashiya 659-0083, Japan;
| | - Yasushi Nakajima
- Department of Oral Implantology, Osaka Dental University, Osaka 540-0008, Japan; (Y.N.); (T.T.); (S.B.)
| | - Tadasuke Tanioka
- Department of Oral Implantology, Osaka Dental University, Osaka 540-0008, Japan; (Y.N.); (T.T.); (S.B.)
| | | | - Shunsuke Baba
- Department of Oral Implantology, Osaka Dental University, Osaka 540-0008, Japan; (Y.N.); (T.T.); (S.B.)
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24
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Ogino Y, Ayukawa Y, Tachikawa N, Shimogishi M, Miyamoto Y, Kudoh K, Fukuda N, Ishikawa K, Koyano K. Staged Sinus Floor Elevation Using Novel Low-Crystalline Carbonate Apatite Granules: Prospective Results after 3-Year Functional Loading. MATERIALS 2021; 14:ma14195760. [PMID: 34640156 PMCID: PMC8510057 DOI: 10.3390/ma14195760] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 09/27/2021] [Accepted: 09/27/2021] [Indexed: 01/22/2023]
Abstract
The aim of this study was to evaluate clinical outcomes of staged sinus floor elevation (SFE) using novel low-crystalline carbonate apatite (CO3Ap) granules. Patients who needed SFE for implant placement were recruited into this clinical trial. A staged procedure (lateral window technique using CO3Ap granules, followed by implant placement after 7 ± 2 months) was employed in 13 patients. Bone-height increase and insertion torque values (ITVs) were assessed along with histological evaluation. The survival and success rates of 3-year functioning implants were also evaluated. Mean of bone-height increase after SFE using CO3Ap granules was 7.2 ± 2.5 mm and this increase allowed implant placement in all cases (17 implants). Mean of ITV was 25.1 ± 13.2 Ncm and primary stability was achieved successfully in all cases. Histological analyses revealed mature new bone formation (36.8 ± 17.3%) and residual CO3Ap granules (16.2 ± 10.1%) in the compartment after SFE. The survival and success rates after 3-year functional loading were 100% and no complications were found. These results clearly indicate the clinical usefulness of CO3Ap granules for SFE.
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Affiliation(s)
- Yoichiro Ogino
- Section of Fixed Prosthodontics, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka 812-8582, Japan;
- Correspondence: ; Tel.: +81-92-642-6371
| | - Yasunori Ayukawa
- Section of Fixed Prosthodontics, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka 812-8582, Japan;
- Section of Implant and Rehabilitative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka 812-8582, Japan
| | - Noriko Tachikawa
- Department of Oral Implantology and Regenerative Dental Medicine, Tokyo Medical and Dental University, Tokyo 113-8510, Japan; (N.T.); (M.S.)
| | - Masahiro Shimogishi
- Department of Oral Implantology and Regenerative Dental Medicine, Tokyo Medical and Dental University, Tokyo 113-8510, Japan; (N.T.); (M.S.)
| | - Youji Miyamoto
- Department of Oral Surgery, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 770-8504, Japan; (Y.M.); (K.K.); (N.F.)
| | - Keiko Kudoh
- Department of Oral Surgery, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 770-8504, Japan; (Y.M.); (K.K.); (N.F.)
| | - Naoyuki Fukuda
- Department of Oral Surgery, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 770-8504, Japan; (Y.M.); (K.K.); (N.F.)
| | - Kunio Ishikawa
- Department of Biomaterials, Faculty of Dental Sciences, Kyushu University, Fukuoka 812-8582, Japan;
| | - Kiyoshi Koyano
- Division of Advanced Dental Devices and Therapeutics, Faculty of Dental Science, Kyushu University, Fukuoka 812-8582, Japan;
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25
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Omori Y, Botticelli D, Ferri M, Delgado-Ruiz R, Ferreira Balan V, Porfirio Xavier S. Argon Bioactivation of Implants Installed Simultaneously to Maxillary Sinus Lifting without Graft. An Experimental Study in Rabbits. Dent J (Basel) 2021; 9:dj9090105. [PMID: 34562979 PMCID: PMC8466067 DOI: 10.3390/dj9090105] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 08/25/2021] [Accepted: 09/01/2021] [Indexed: 11/16/2022] Open
Abstract
Background: The treatment of the surface of titanium implants with argon plasma improved its hydrophilicity and cell adhesion, resulting in higher bone apposition on implant and graft surfaces. The spontaneous perforation over time of the sinus mucosa after sinus augmentation has been documented in experimental studies at both implants and graft particles. The aim of the present study was to evaluate the influence of plasma argon treatment of the implant surface on bone apposition and on the rate of sinus mucosa perforations. Methods: A sinus lifting procedure was performed bilaterally in sixteen rabbits, and implants, either treated with argon plasma or left without treatment (control), were placed simultaneously without grafts. After 8 weeks, histological analyses were carried out. Results: A collapse of the sinus mucosa was observed at all implants. Twenty-four out of thirty-two implants presented sinus mucosa perforations at the apex. Several perforations were also found at the threads. Thinned mucosa sites (width < 40 µm) were found around almost all implants. About 2.6–2.9 mm of the apical regions of the implant did not present signs of osseointegration and about 1.3 mm were exposed to the sinus cavity. No statistically significant differences were found between plasma and control sites. Conclusions: In conclusion, the sinus mucosa was damaged and perforated by direct contact with treated and non-treated implant surfaces. The treatment of the implant surface with argon plasma did not affect the outcomes.
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Affiliation(s)
- Yuki Omori
- Department of Oral Implantology, Osaka Dental University, Osaka 565-0871, Japan;
- ARDEC Academy, 47923 Rimini, Italy;
| | | | - Mauro Ferri
- ARDEC Foundation, Cartagena de Indias 130001, Colombia;
| | - Rafael Delgado-Ruiz
- Department of Prosthodontics and Digital Technology, School of Dental Medicine, Stony Brook University, New York, NY 11794-8712, USA
- Correspondence:
| | - Vitor Ferreira Balan
- Department of Oral and Maxillofacial Surgery and Periodontology, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo 14040-904, Brazil; (V.F.B.); (S.P.X.)
| | - Samuel Porfirio Xavier
- Department of Oral and Maxillofacial Surgery and Periodontology, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo 14040-904, Brazil; (V.F.B.); (S.P.X.)
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26
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Sinus Mucosa Thickness Changes and Ostium Involvement after Maxillary Sinus Floor Elevation in Sinus with Septa. A Cone Beam Computed Tomography Study. Dent J (Basel) 2021; 9:dj9080082. [PMID: 34435994 PMCID: PMC8391700 DOI: 10.3390/dj9080082] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 07/13/2021] [Accepted: 07/19/2021] [Indexed: 01/15/2023] Open
Abstract
Background: A thickening of the sinus mucosa is observed after sinus floor augmentation. The objective of this retrospective study was to evaluate the influence of the presence of septa in the dimensional variation and ostium involvement over time of the Schneiderian mucosa after sinus floor augmentation. Materials and Methods: Fifteen sinuses with septa (septa group) and 15 without (control group) were selected. CBCTs taken before surgery, and were analyzed after 1 week and after 9 months. Schneiderian membrane thickness changes over time and involvement of the ostium were evaluated. Results: Four perforations occurred in the septa group and none in the control group. After 1 week of healing, the sinus mucosa thickness increased in height by 5.7 mm and 7.1 mm in the septa and control groups, respectively. In this period, the patency of the ostium decreased in both groups, and three infundibula were obstructed in the septa group, and five in the control group. The mucosa was thicker and the edema was closer to the ostium in the control compared to in the septa group. After 9 months of healing, the dimensions regressed to normal pattern and no obstruction of the infundibula were observed. No statistically significant differences were found between septa and control groups. Conclusions: after one week of healing, the sinus mucosa increased in dimensions in both septa and control groups. However, the sinus mucosa presented a tendency of being thicker and closer to the ostium, resulting in a higher number of infundibula obstructions, in the control group compared to in the septa group. After 9 months, the sinus mucosa regressed to normal dimensions and no obstructions of the infundibula were observed in any group.
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27
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Omori Y, Nakajima Y, Imai H, Yonezawa D, Ferri M, Apaza Alccayhuaman KA, Botticelli D. Influence of Anatomical Parameters on the Dimensions of the Subantral Space and Sinus Mucosa Thickening after Sinus Floor Elevation. A Retrospective Cone Beam Computed Tomography Study. Dent J (Basel) 2021; 9:dj9070076. [PMID: 34202457 PMCID: PMC8304157 DOI: 10.3390/dj9070076] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 06/08/2021] [Accepted: 06/23/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Various anatomical parameters might influence the surgical approach for maxillary sinus floor elevation. The objective of the present study was to retrospectively evaluate the influence of anatomical parameters on the dimensions of the subantral space and of the sinus mucosa thickening after sinus floor elevation. MATERIAL AND METHODS Seventy-eight maxillary sinuses in sixty-five patients were evaluated on cone beam computed tomographies taken before surgery and after one week (t1w) and nine months (t9m). Several parameters such as the distance XF between an axis parallel to the base of the nose (X-axes) and the sinus floor (F) were correlated with the height gain (IF) at t1w and t9m and the post-surgical edema. RESULTS A weak significant positive correlation was observed between height gain vs. sinus height of interest (XF), the balcony, and the sinus floor angle. The post-surgical edema was influenced by the initial mucosa thickness and the xenograft used. CONCLUSIONS Various parameters might affect height gain and sinus mucosa thickening after sinus floor elevation. The height of interest, the balcony, and the sinus floor angle showed significant correlations with height gain. The initial thickness of the mucosa and the biomaterial used influenced the post-surgical edema.
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Affiliation(s)
- Yuki Omori
- Department of Oral Implantology, Osaka Dental University, Osaka 573-1144, Japan; (Y.O.); (Y.N.); (H.I.)
| | - Yasushi Nakajima
- Department of Oral Implantology, Osaka Dental University, Osaka 573-1144, Japan; (Y.O.); (Y.N.); (H.I.)
| | - Hideki Imai
- Department of Oral Implantology, Osaka Dental University, Osaka 573-1144, Japan; (Y.O.); (Y.N.); (H.I.)
| | - Daichi Yonezawa
- Department of Applied Prosthodontics, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8102, Japan
- Correspondence:
| | - Mauro Ferri
- ARDEC Foundation, 130001 Cartagena de Indias, Colombia;
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Costa MM, Botticelli D, Moses O, Omori Y, Fujiwara S, Silva ER, Xavier SP. Maxillary Sinus Augmentation Using Ceramic Alloplastic Granules or Paste: An Experimental Study in Rabbits. Dent J (Basel) 2021; 9:65. [PMID: 34205201 PMCID: PMC8226577 DOI: 10.3390/dj9060065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 05/26/2021] [Accepted: 05/28/2021] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Due to the lack of data comparing the biological behavior of two formulations, granules and paste, of alloplastic graft from microtomographic and histomorphometric points of view, the aim of the present experiment was to compare the histomorphometric and microtomographic healing of two formulations, i.e., granules (MR sites) or paste (MR-inject sites) of an alloplastic graft composed of a combination of beta-tricalcium phosphate and hydroxyapatite used for maxillary sinus lifting. METHODS A sinus lifting procedure was carried out bilaterally in 20 rabbits, and the elevated space was filled with either paste or granules of an alloplastic material. A collagen membrane was placed on the antrostomy and the animals were euthanized after 2 or 10 weeks, 10 animals each group. Microtomographic and histological analyses were performed. RESULTS Higher proportions of new bone formation were found at the MR, compared to the MR-inject sites both after 2 weeks (2.65 ± 2.89% vs. 0.08 ± 0.12%; p < 0.01) and 10 weeks of healing (34.20 ± 13.86 vs. 23.28 ± 10.35%; p = 0.022). CONCLUSIONS It was concluded that new bone formation was faster in the MR sites, compared to the MR-inject. However, a longer time of healing should be allowed to make final conclusions about the efficiency in bone formation of the paste formulation of the biomaterial used in the present study.
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Affiliation(s)
- Michael Medeiros Costa
- Department of Oral and Maxillofacial Surgery and Periodontology, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo 14040-904, Brazil; (M.M.C.); (E.R.S.); (S.P.X.)
| | | | - Ofer Moses
- Department of Periodontology and Dental Implantology, School of Dental Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Yuki Omori
- ARDEC Academy, 47923 Rimini, Italy; (D.B.); (Y.O.); (S.F.)
- Department of Oral Implantology, Osaka Dental University, Osaka 573-1144, Japan
| | | | - Erick Ricardo Silva
- Department of Oral and Maxillofacial Surgery and Periodontology, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo 14040-904, Brazil; (M.M.C.); (E.R.S.); (S.P.X.)
| | - Samuel Porfirio Xavier
- Department of Oral and Maxillofacial Surgery and Periodontology, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo 14040-904, Brazil; (M.M.C.); (E.R.S.); (S.P.X.)
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29
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Lee JH, Han WJ, Park JT. Three-dimensional CBCT based evaluation of the inferior part of the maxillary sinus: Retrospective Study. Sci Rep 2020; 10:21012. [PMID: 33273597 PMCID: PMC7713429 DOI: 10.1038/s41598-020-78156-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 11/12/2020] [Indexed: 12/16/2022] Open
Abstract
The maxillary sinus is the largest of the four paranasal sinuses in humans, and its close proximity to the teeth means that caution is required during dental treatment. In particular, implant surgeries involving the maxillary posterior teeth should include evaluating the inferior part of the maxillary sinus. The purpose of this study is to evaluate the differences by comparing the inferior part of the maxillary sinus based on the nasal cavity floor (NCF) between patients (male 30, female 30) genders through the use of the three-dimensional (3-D) program that can facilitate 3-D visualizations. The present study results obtained from 3-D visualizations using cone beam computed tomography (CBCT) data showed that the inferior part of the maxillary sinus was mostly larger in males than in females. In addition, the utilization of 3-D visualization data was more likely to assure accuracy than when using data obtained by two-dimensional (2-D) imaging. Therefore, 3-D visualizations of the inferior part of the maxillary sinus will contribute to accurate analyses of its anatomical structure during implant surgery and other operations. Further studies utilizing 3-D visualization will yield useful fundamental data and guidelines for future research.
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Affiliation(s)
- Jeong-Hyun Lee
- Department of Oral Anatomy, Dental College Dankook Institute For Future Science and Emerging Convergence, Dan-Kook University, Cheonan, 330-714, South Korea
| | - Won-Jeong Han
- Department of Dentomaxillofacial Radiology, Dental College, Dan-Kook University, Cheonan, 330-714, South Korea
| | - Jong-Tae Park
- Department of Oral Anatomy, Dental College Dankook Institute For Future Science and Emerging Convergence, Dan-Kook University, Cheonan, 330-714, South Korea.
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Sakuma S, Ferri M, Imai H, Fortich Mesa N, Blanco Victorio DJ, Apaza Alccayhuaman KA, Botticelli D. Involvement of the maxillary sinus ostium (MSO) in the edematous processes after sinus floor augmentation: a cone-beam computed tomographic study. Int J Implant Dent 2020; 6:35. [PMID: 32743707 PMCID: PMC7396408 DOI: 10.1186/s40729-020-00233-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Accepted: 05/28/2020] [Indexed: 02/07/2023] Open
Abstract
Background After sinus floor augmentation, a thickening of the sinus mucosa has been described. The aim of the present study was to evaluate the involvement of the maxillary sinus ostium in the edematous processes after a sinus floor augmentation procedure. Methods Seventy-two cone-beam computerized tomographies (CBSTs) were taken before sinus floor augmentation and after 1 week and 9 months from surgery and analyses. Sinus mucosa thickness and area, ostium diameter and patency, and extension of the post-surgical transient mucosal thickening in relation to the ostium were evaluated on the CBCTs for all three periods. The term “virtual” when referring to sinus mucosa thickness and area was introduced because of the edema and bleeding that both contributed to a transient thickening and additional elevation of the sinus mucosa. Results The mean virtual thickness of the sinus mucosa was 2.7 ± 4.0 mm, 7.7 ± 7.1 mm, 1.7 ± 2.0 mm before surgery, and after 1 week and 9 months. The virtual mucosa area was 37.2 ± 52.5 mm2, 184.5 ± 153.8 mm2, and 34.0 ± 50.7 mm2. The ostium diameter at the three periods evaluated was 1.8 ± 0.5 mm, 1.1 ± 0.6 mm, 1.5 ± 0.8 mm, respectively. Three infundibula (4.2%) were found out of patency before surgery while this number increased to 14 (19.4%) after 1 week. Nine months after surgery, only one infundibulum (1.4%) was out of patency, however, without presenting signs of sinus pathologies. The extension of the mucosal edema on the palatal sinus was reduced after 9 months of healing. Conclusions One week after sinus floor augmentation, the maxillary sinus mucosa increased in dimensions and in several cases involved the ostium, reducing its diameter and producing a transient loss of patency. After 9 months of healing, the initial conditions were recovered.
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Affiliation(s)
- Shigeru Sakuma
- ARDEC Academy, Viale Giovanni Pascoli 67, 47923, Rimini, Italy
| | - Mauro Ferri
- ARDEC Foundation, Cartagena, de Indias, Colombia
| | - Hideki Imai
- ARDEC Academy, Viale Giovanni Pascoli 67, 47923, Rimini, Italy.,Department of Oral Implantology, Osaka Dental University, Osaka, Japan
| | | | | | - Karol Alí Apaza Alccayhuaman
- ARDEC Academy, Viale Giovanni Pascoli 67, 47923, Rimini, Italy.,Department of Oral Biology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
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