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Lahoud P, Nader N, Younes R. Sinus Augmentation Using Mineralized Bone Allografts: A 6-Month Histological and Histomorphometric Analysis. J Maxillofac Oral Surg 2022; 21:1180-1190. [PMID: 36896082 PMCID: PMC9989108 DOI: 10.1007/s12663-022-01728-z] [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: 09/13/2021] [Accepted: 04/22/2022] [Indexed: 11/24/2022] Open
Abstract
Purpose The aim of this study was to evaluate, after a six-month healing period, the histological and histomorphometric results of mineralized bone allograft used in lateral sinus augmentation procedures. Materials and Methods Twenty-one pneumatized maxillary sinuses with residual bone height ≤ 4 mm were grafted with a mixture of 1/1 cortical and cancellous mineralized bone allograft using lateral sinus floor elevation. Six months later, during implant placement, a core biopsy was retrieved for histological and histomorphometric evaluation. Results Biopsies showed mature cancellous bone with no signs of acute or chronic inflammatory reactions. Higher magnification revealed new lamellar bone, active osteocytes and normal lamellar arrangement around Haversian canals interspersed with osteocytes in lacunae. At grafted bone periphery, a high concentration of osteoblastic/osteoclastic couple was noted, indicating active bone remodeling. Histomorphometric evaluation revealed an average vital bone content of 30.32% (25.00-44.00%), and a percentage of residual non-vital bone of 18.06% (14.05-25.00%). Conclusions Histological and histomorphometric evaluation indicated that the mixture of 1 to 1 cortical and cancellous mineralized bone allograft promoted de-novo bone formation and can be predictably used for sinus augmentation procedures.
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Affiliation(s)
- Pierre Lahoud
- Department of Oral Surgery, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
- Cranio-Facial Research Laboratory, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Nabih Nader
- Department of Oral Surgery, Faculty of Dental Medicine, Lebanese University, Beirut, Lebanon
| | - Ronald Younes
- Department of Oral Surgery, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
- Cranio-Facial Research Laboratory, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
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2
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Albanese M, Zotti F, Lanaro L, Trojan D, Paolin A, Montagner G, Iannielli A, Rodella LF, Nocini PF. Fresh-frozen homologous bone in sinus lifting: histological and radiological analysis. ACTA ACUST UNITED AC 2019; 68:226-235. [PMID: 31822046 DOI: 10.23736/s0026-4970.19.04192-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND The aim of this study was to evaluate radiological and histological characteristics of fresh-frozen homologous bone as grafting material for maxillary sinus floor augmentation. Radiological, histological and clinical evaluations were made. METHODS Twenty-three patients with a 2 mm to 6 mm alveolar ridge height in the posterior maxilla have been enrolled. Unilateral or bilateral sinus floor augmentations were performed with fresh frozen morcelized homologous bone. Together with implant placement, 7 months after surgery, a bone core was harvested for histological analysis. Radiological measurements were obtained by superimposition of CT scans carried out at the surgery time and six months later. A total of 93 implants were positioned. RESULTS A mean (±SD) increase in mineralized tissue height of 10.74±2.82 mm was noticed by comparing the CT scans. Histological analysis revealed the presence of newly formed bone in the grafted sites. The follow up period after the prosthetic load ranged from 8 to 31 months. One implant failure occurred. CONCLUSIONS Fresh frozen homologous bone seems to have a good healing pattern and to be a successful and steady grafting material for the treatment of maxillary ridge atrophy. It might be considered a valid alternative to autologous bone in sinus floor augmentation procedures.
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Affiliation(s)
- Massimo Albanese
- Department of Surgery, Dentistry, Pediatrics and Gynecology, G. B. Rossi Polyclinic, University of Verona, Verona, Italy
| | - Francesca Zotti
- Department of Surgery, Dentistry, Pediatrics and Gynecology, G. B. Rossi Polyclinic, University of Verona, Verona, Italy -
| | - Luca Lanaro
- Department of Surgery, Dentistry, Pediatrics and Gynecology, G. B. Rossi Polyclinic, University of Verona, Verona, Italy
| | | | | | | | | | - Luigi F Rodella
- Section of Anatomy and Pathophysiology, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Pier F Nocini
- Department of Surgery, Dentistry, Pediatrics and Gynecology, G. B. Rossi Polyclinic, University of Verona, Verona, Italy
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Arora A, Khadtale D, Agarwal B, Yadav R, Bhutia O, Roychoudhury A. Radiographical and histological evaluation of bioactive synthetic bone graft putty in sinus floor augmentation: A pre- and post-intervention study. Natl J Maxillofac Surg 2019; 10:13-19. [PMID: 31205383 PMCID: PMC6563639 DOI: 10.4103/njms.njms_58_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objective: The main objective is to evaluate the quantity and quality of bone formed after use of bioactive synthetic bone graft putty in sinus augmentation and to radiographically and histologically evaluate increase in alveolar bone height in augmented sinus. Materials and Methods: It is a pre- and post-intervention study of 15 patients (present at both baseline and at 6 months) with 80% power and 95% confidence level. Results: The mean increase in alveolar bone height is 7.08 ± 1.42 mm ranging from 5.6 mm to 10.7 mm. It is evident from the data that there has been increase in alveolar bone height postbone graft augmentation. P < 0.001 shows that increase in alveolar bone height is highly significant as compared to preoperative bone height. The mean postoperative density is 525.43 ± 104.18 hounsfield unit ranging from 649 HU to 350 HU. This is also a D3 quality bone as per Misch classification. The mean difference in alveolar bone density is 104 ± 125.16 HU. P = 0.0053 shows that increase in alveolar bone density is significant as compared to preoperative bone density. Conclusion: Bioactive synthetic bone graft putty yields sufficient quantity of mineralized tissue for implant placement in patients with 2–6 mm of alveolar bone height before grafting. Histologically, it has shown that it has good osteoconductive properties and good quality of bone is formed within 6 months of its augmentation.
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Affiliation(s)
- Ankit Arora
- Department of Oral and Maxillofacial Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Dipankar Khadtale
- Department of Oral and Maxillofacial Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Bhaskar Agarwal
- Department of Oral and Maxillofacial Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Rahul Yadav
- Department of Oral and Maxillofacial Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Ongkila Bhutia
- Department of Oral and Maxillofacial Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Ajoy Roychoudhury
- Department of Oral and Maxillofacial Surgery, All India Institute of Medical Sciences, New Delhi, India
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Fresh Frozen Allogeneic Bone Block in Maxillary Sinus Floor Elevation: Histomorphometric Analysis of a Bone Specimen Retrieved 15 Years after Grafting Procedure. APPLIED SCIENCES-BASEL 2019. [DOI: 10.3390/app9061119] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Nowadays implant-prosthetic rehabilitations are one of the best solutions for rehabilitating our patients. These allow obtaining rehabilitations with optimal functional and aesthetic performances. Often patients, who undergo implant-prosthetic therapy, have the conditions of edentulias, single or multiple, that have been going on for some time. This, according to the literature, produces resorption of the alveolar bone, a process that is complicated in the posterior area of the upper arch by a pneumatization of the maxillary sinuses. The loss of vertical height, so that the implant fixtures can be inserted, requires a maneuver called maxillary sinus floor elevation. This procedure, now safely performed with piezoelectric instruments, allows increasing bone height through bone grafting. In this study, the tissue obtained from a patient, after 15 years from the intervention, was evaluated by histological and SEM analyses. The bone healing in the patient has led to a perfect integration between the patient’s bone and the fresh frozen allograft used, however still present and detectable after 15 years.
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5
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Maddalone M, Mirabelli L, Venino PM, Karanxha L, Porcaro G, Del Fabbro M. Long-term stability of autologous bone graft of intraoral origin after lateral sinus floor elevation with simultaneous implant placement. Clin Implant Dent Relat Res 2018; 20:713-721. [DOI: 10.1111/cid.12649] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 05/02/2018] [Accepted: 06/09/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Marcello Maddalone
- Department of Surgery and Medicine; University of Milano-Bicocca; Monza Italy
| | - Luca Mirabelli
- Department of Surgery and Medicine; University of Milano-Bicocca; Monza Italy
| | - Pier Matteo Venino
- Department of Surgery and Medicine; University of Milano-Bicocca; Monza Italy
| | - Lorena Karanxha
- Department of Biomedical, Surgical and Dental Sciences; Università degli Studi di Milano; Milan Italy
| | - Gianluca Porcaro
- Department of Surgery and Medicine; University of Milano-Bicocca; Monza Italy
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences; Università degli Studi di Milano; Milan Italy
- Dental Clinic; IRCCS Istituto Ortopedico Galeazzi; Milan Italy
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Correia F, Pozza DH, Gouveia S, Felino A, Faria E Almeida R. The applications of regenerative medicine in sinus lift procedures: A systematic review. Clin Implant Dent Relat Res 2018; 20:229-242. [PMID: 29205768 DOI: 10.1111/cid.12561] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 10/25/2017] [Accepted: 11/01/2017] [Indexed: 01/13/2023]
Abstract
BACKGROUND Findings in regenerative medicine applied to the sinus lift procedures. PURPOSE Evaluate the effectiveness of regenerative medicine in sinus lift. MATERIALS AND METHODS An extensive search for manuscripts were performed by using different combinations of keywords and MeSH terms (Pub-med; Embase; Scopus; Web of Science Core Collection; Medline; Current Contents Connect; Derwent Innovations Index; Scielo Citation Index; Cochrane library). The full text selected articles are written in English, Portuguese, Spanish, Italian, German, or French, and published until 28 of November 2016. Inclusion criteria were: implant osteointegration, radiographic, histologic, and/or histomorphometric analysis, clinical studies in humans using of regenerative medicine. This systematic review was performed by selecting only randomized controlled clinical trials and controlled clinical trials. RESULTS Eighteen published studies (11 CT and 7 RCT) were considered eligible for inclusion in the present systematic review. These studies demonstrated considerable variation of biomaterial and cell technics used, study design, sinus lift technic, outcomes, follow-up, and results. CONCLUSION Only few studies have demonstrated potential of regenerative medicine in sinus lift; further randomized clinical trials are needed to achieve more accurate results.
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Affiliation(s)
- Francisco Correia
- Department of Oral Surgery and Periodontology, Faculty of Dental Medicine, University of Porto, Porto, Portugal
| | - Daniel Humberto Pozza
- Departamento de Biomedicina da Faculdade de Medicina, and Faculdade de Ciências da Nutrição e Alimentação, and I3s, Universidade do Porto, Porto, Portugal and Universidad Europea de Madrid
| | - Sónia Gouveia
- Instituto de Engenharia Eletrónica e Informática de Aveiro (IEETA/UA) and Centro de I&D em Matemática e Aplicações (CIDMA/UA), Universidade de Aveiro (UA), Portugal
| | - António Felino
- Department of Oral Surgery and Periodontology, Faculty of Dental Medicine, University of Porto, Porto, Portugal
| | - Ricardo Faria E Almeida
- Department of Oral Surgery and Periodontology, Faculty of Dental Medicine, University of Porto, Porto, Portugal
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De Ponte FS, Cutroneo G, Falzea R, Rizzo G, Catalfamo L, Favaloro A, Vermiglio G, Runci M, Centofanti A, Anastasi G. Histochemical and morphological aspects of fresh frozen bone: a preliminary study. Eur J Histochem 2016; 60:2642. [PMID: 28076936 PMCID: PMC5178803 DOI: 10.4081/ejh.2016.2642] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 11/12/2016] [Accepted: 11/17/2016] [Indexed: 11/23/2022] Open
Abstract
Bone graft are used in dentistry for the reconstruction of severely atrophic jaws. Fresh frozen bone has no osteogenic property but it has osteoconductive and osteoinductive properties because its matrix contains growth factors such as vascular endothelial growth factor. The purpose of the present study was to evaluate morphological and protein expression characteristics of fresh frozen bone before graft and after six months of graft in patients who needed maxillary reconstruction. After 6 month of graft we observed the presence of viable bone as evidenced by full osteocyte lacunae and by the presence of RANKR, osteocalcin positive cells and vascular endothelial growth factor. In conclusion, our findings show that the fresh frozen bone after six month of graft is for the most part viable bone, encouraging its use as an alternative to autogenous bone for reconstructing maxillary bone defects prior to implant.
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8
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Danesh-Sani SA, Engebretson SP, Janal MN. Histomorphometric results of different grafting materials and effect of healing time on bone maturation after sinus floor augmentation: a systematic review and meta-analysis. J Periodontal Res 2016; 52:301-312. [PMID: 27534916 DOI: 10.1111/jre.12402] [Citation(s) in RCA: 93] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2016] [Indexed: 01/11/2023]
Abstract
The aim of this systematic review was to evaluate histomorphometric variables, the amount of new bone (NB), residual graft (RG) particles and soft tissue (ST), related to various grafting materials and assess the effect of graft healing time on different histomorphometric outcomes. Studies that were published before October 2015 were electronically and manually searched in three databases. We included human studies that reported the amount of NB, RG and ST in the biopsies taken from the grafted sinuses. Based on the applied grafting materials, extracted data were categorized into different groups. Furthermore, extracted data were classified into three groups based on healing time: (i) ≤ 4.5 mo; (ii) 4.5-9 mo; and (iii) ≥ 9-13.5 mo. The search provided 791 titles. Full text analysis was performed for 258 articles resulting in 136 studies that met the inclusion criteria. Autogenous bone (AB) resulted in the highest amount of NB and lowest amount of RG compared to other grafting materials. Based on this meta-analysis, a significant difference was noticed in the amount of NB formation in grafts with a healing time of > 4.5 mo when compared to the grafts with less healing time. However, when comparing biopsies taken at 4.5-9 mo of healing (average = 6.22 mo) to the ones taken at ≥ 9-13.5 mo (average = 10.36 mo), no significant difference was noticed in the amount of NB formation of various grafts except allografts that resulted in a significantly higher percentage of NB at 9.5 mo of healing. Based on histomorphometric analysis, AB results in the highest amount of NB formation in comparison to the other grafting materials. Bone substitute materials (allografts, alloplastic materials and xenografts) seem to be good alternatives to autogenous bone and can be considered as grafting materials to avoid disadvantages related to AB, including morbidity rate, limited availability and high volumetric change. Combining AB with alloplastic materials and xenografts brings no significant advantages regarding NB formation.
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Affiliation(s)
- S A Danesh-Sani
- Department of Periodontology and Implant Dentistry, New York University College of Dentistry, New York, NY, USA
| | - S P Engebretson
- Department of Periodontology and Implant Dentistry, New York University College of Dentistry, New York, NY, USA
| | - M N Janal
- Department of Epidemiology and Health Promotion, New York University College of Dentistry, New York, NY, USA
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9
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Maxillary sinus grafting with fresh frozen allograft versus bovine bone mineral: A tomographic and histological study. J Craniomaxillofac Surg 2016; 44:708-14. [PMID: 27107475 DOI: 10.1016/j.jcms.2016.03.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Revised: 02/22/2016] [Accepted: 03/14/2016] [Indexed: 01/10/2023] Open
Abstract
We evaluated histologically and tomographically the effects of fresh frozen bone allograft (FFB) or bovine bone mineral (BBM) in maxillary sinus floor augmentations. In total, 30 maxillary sinuses from 30 patients (mean age = 51.17 ± 10.86 years) underwent sinus augmentation. Patients were divided in two test groups (15 sinuses each). The first group was grafted with allograft bone, and the second group received bovine bone mineral. After 6 months, bone samples from each group were collected for histological examination. Implant survival rates were 97.78% (FFB group) and 100% (BBM group) 6 months after functional loading. Median volumetric reductions of 31.2% (11.33-40.56) and 12.22% (9.91-20.59) were observed in the FFB and BBM groups, respectively. Comparisons between the groups for differences in initial and final volumes of bone (p = 0.015) and the rate of resorption (p = 0.009) showed statistically significant differences. The FFB group showed osteoblastic cells in close contact with osteoid matrix, connected through bridges between allograft bone particles and new bone formation. The BBM group showed BBM particles in close contact with new bone, with visible osteoid matrix bridges and osteoblastic cells surrounding it. None showed signs of acute or chronic inflammatory infiltrate. Despite better results with BBM, both FFB and BBM in maxillary sinus augmentation resulted in high percentages of new bone formation, and allowed implant placement with a low rate of failure of osseointegration at a 6-month follow-up.
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10
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Rodella LF, Cocchi MA, Rezzani R, Procacci P, Hirtler L, Nocini P, Albanese M. Fresh frozen bone in oral and maxillofacial surgery. J Dent Sci 2015. [DOI: 10.1016/j.jds.2014.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
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11
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Maxillary sinus augmentation with bovine hydroxyapatite alone: A safe technique with predictable outcomes in patients with severe maxillary atrophy. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.maxilo.2014.07.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Pereira E, Messias A, Dias R, Judas F, Salvoni A, Guerra F. Horizontal Resorption of Fresh-Frozen Corticocancellous Bone Blocks in the Reconstruction of the Atrophic Maxilla at 5 Months. Clin Implant Dent Relat Res 2014; 17 Suppl 2:e444-58. [PMID: 25346211 PMCID: PMC4616242 DOI: 10.1111/cid.12268] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Background Reliable implant-supported rehabilitation of an alveolar ridge needs sufficient volume of bone. In order to achieve a prosthetic-driven positioning, bone graft techniques may be required. Purpose This prospective cohort study aims to clinically evaluate the amount of resorption of corticocancellous fresh-frozen allografts bone blocks used in the reconstruction of the severe atrophic maxilla. Materials and Methods Twenty-two partial and totally edentulous patients underwent bone augmentation procedures with fresh-frozen allogenous blocks from the iliac crest under local anesthesia. Implants were inserted into the grafted sites after a healing period of 5 months. Final fixed prosthesis was delivered ± 4 months later. Ridge width analysis and measurements were performed with a caliper before and after grafting and at implant insertion. Bone biopsies were performed in 16 patients. Results A total of 98 onlay block allografts were used in 22 patients with an initial mean alveolar ridge width of 3.41 ± 1.36 mm. Early exposure of blocks was observed in four situations and one of these completely resorbed. Mean horizontal bone gain was 3.63 ± 1.28 mm (p < .01). Mean buccal bone resorption between allograph placement and the reopening stage was 0.49 ± 0.54 mm, meaning approximately 7.1% (95% confidence interval: [5.6%, 8.6%]) of total ridge width loss during the integration period. One hundred thirty dental implants were placed with good primary stability (≥ 30 Ncm). Four implants presented early failure before the prosthetic delivery (96.7% implant survival). All patients were successfully rehabilitated. Histomorphometric analysis revealed 20.9 ± 5.8% of vital bone in close contact to the remaining grafted bone. A positive strong correlation (adjusted R2 = 0.44, p = .003) was found between healing time and vital bone percentage. Conclusions Augmentation procedures performed using fresh-frozen allografts from the iliac crest are a suitable alternative in the reconstruction of the atrophic maxilla with low resorption rate at 5 months, allowing proper stability of dental implants followed by fixed prosthetic rehabilitation.
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Affiliation(s)
- Eugénio Pereira
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Ana Messias
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Ricardo Dias
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Fernando Judas
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Alexander Salvoni
- Faculty of Odontology and Medicine, São Leopoldo Mandic, Campinas, Brazil
| | - Fernando Guerra
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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13
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Sehn FP, Dias RR, de Santana Santos T, Silva ER, Salata LA, Chaushu G, Xavier SP. Fresh-frozen allografts combined with bovine bone mineral enhance bone formation in sinus augmentation. J Biomater Appl 2014; 29:1003-13. [PMID: 25245781 DOI: 10.1177/0885328214552709] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We evaluated histologically, histomorphometrically, and tomographically the effects of the association of fresh-frozen bone allograft (FFB) with bovine bone mineral (BBM) in maxillary sinus floor augmentation. In total, 34 maxillary sinuses from 29 patients, with a mean age of 51.32 (±6.44) years, underwent sinus augmentation. Patients were divided into control and test groups (17 sinuses each). The controls were grafted with allograft bone, and the test group received a combination of FFB and BBM at a 2:1 ratio. After 6 months, bone samples were collected for histological and histomorphometric examinations. The implant survival rates were 93.02% (control group) and 100% (test group) at 6 months after functional loading. Median volumetric reductions of 28.32% (17.05-44.05) and 12.62% (5.65-16.87) were observed for the control and test groups, respectively. Statistically significant histomorphometric differences were found between the control and test groups regarding newly formed bone 12.54% (10.50-13.33) vs. 24.42% (17.62-35.92), p < 0.001, total bone 48.34% (39.03-54.42) vs. 61.32% (50.61-64.96), p = 0.007, and connective tissue 51.66% (45.57-60.97) vs. 39.30% (35.03-49.37), p = 0.007. The addition of BBM to allograft bone in maxillary sinus augmentation resulted in higher percentages of new bone formation and total bone, and permitted implant placement with a low rate of osseointegration failure at the 6-month follow-up.
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Affiliation(s)
- Felipe Perraro Sehn
- Department of Oral and Maxillofacial Surgery and Periodontology. Ribeirão Preto Dental School, University of São Paulo, São Paulo, Brazil
| | - Rafael Rodrigues Dias
- Department of Oral and Maxillofacial Surgery and Periodontology. Ribeirão Preto Dental School, University of São Paulo, São Paulo, Brazil
| | - Thiago de Santana Santos
- Department of Oral and Maxillofacial Surgery and Periodontology. Ribeirão Preto Dental School, University of São Paulo, São Paulo, Brazil
| | - Erick Ricardo Silva
- Department of Oral and Maxillofacial Surgery and Periodontology. Ribeirão Preto Dental School, University of São Paulo, São Paulo, Brazil
| | - Luiz Antonio Salata
- Department of Oral and Maxillofacial Surgery and Periodontology. Ribeirão Preto Dental School, University of São Paulo, São Paulo, Brazil
| | - Gavriel Chaushu
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Tel Aviv University, Israel
| | - Samuel Porfírio Xavier
- Department of Oral and Maxillofacial Surgery and Periodontology. Ribeirão Preto Dental School, University of São Paulo, São Paulo, Brazil
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14
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Kher U, Ioannou AL, Kumar T, Siormpas K, Mitsias ME, Mazor Z, Kotsakis GA. A clinical and radiographic case series of implants placed with the simplified minimally invasive antral membrane elevation technique in the posterior maxilla. J Craniomaxillofac Surg 2014; 42:1942-7. [PMID: 25316651 DOI: 10.1016/j.jcms.2014.08.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2014] [Revised: 07/28/2014] [Accepted: 08/15/2014] [Indexed: 11/28/2022] Open
Abstract
The aim of the present case series was to evaluate a simplified minimally invasive transalveolar sinus elevation technique utilizing calcium phosphosilicate (CPS) putty for hydraulic sinus membrane elevation. The simplified minimally invasive antral membrane elevation technique is based on the application of hydraulic pressure via a viscous bone graft that acts as an incompressible fluid. In this retrospective study, 21 patients (mean age: 48.5 ± 12 years) consecutively treated with the simplified minimally invasive transalveolar sinus elevation technique were evaluated. 28 tapered implants were placed in posterior maxillary sites with less than 6 mm of residual bone height as determined radiographically on cone beam volumetric tomographs. No sinus membrane perforations were noted and none of the patients complained of symptoms of sinusitis post-operatively (0%). The mean gain in bone height post-operatively was 10.31 ± 2.46 mm (p < 0.001). All implants successfully integrated (100% success rate) and were loaded with cement-retained prostheses. The proposed technique is a simple, efficacious, minimally invasive approach for sinus elevation that can be recommended for sites with at least 3 mm of residual height.
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Affiliation(s)
| | - Andreas L Ioannou
- Advanced Education Program in Periodontology, University of Minnesota, United States.
| | - Tarun Kumar
- Division of Periodontology, Bapuji Dental College & Hospital, Davangere, India
| | | | - Miltiades E Mitsias
- Department of Periodontology & Implant Dentistry, New University College of Dentistry, NY, United States
| | | | - Georgios A Kotsakis
- Advanced Education Program in Periodontology, University of Minnesota, United States
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15
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de Castilho TRRN, Tortamano P, Marotti J, de Andrade JCS, Chilvarquer I, Ximenez MEL, Alves MTDS. Clinical and Histomorphometric Evaluation of Fresh Frozen Bone Allograft in Sinus Lift Surgery. Clin Implant Dent Relat Res 2014; 18:40-50. [DOI: 10.1111/cid.12234] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | - Pedro Tortamano
- Department of Prosthodontics; School of Dentistry; University of São Paulo; São Paulo Brazil
| | - Juliana Marotti
- Department of Prosthodontics and Biomaterials; Faculty of Medicine; RWTH Aachen University; Aachen Germany
| | - José Carlos Silva de Andrade
- Implantology Specialization Course, Fundação da Faculdade de Odontologia; School of Dentistry; University of São Paulo; São Paulo Brazil
| | - Israel Chilvarquer
- Department of Stomatology; School of Dentistry; University of São Paulo; São Paulo Brazil
| | - Michel Eli Lipiec Ximenez
- Radiology Specialization Course; Associação Paulista dos Cirurgiões Dentistas-Jardim Paulista; São Paulo Brazil
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16
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Jeong SM, Lee CU, Son JS, Oh JH, Fang Y, Choi BH. Simultaneous sinus lift and implantation using platelet-rich fibrin as sole grafting material. J Craniomaxillofac Surg 2014; 42:990-4. [PMID: 24503388 DOI: 10.1016/j.jcms.2014.01.021] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2013] [Revised: 09/28/2013] [Accepted: 01/03/2014] [Indexed: 11/28/2022] Open
Abstract
Recently, several authors have shown that simultaneous sinus lift and implantation using autologous platelet-rich fibrin as the sole filling material is a reliable procedure promoting bone augmentation in the maxillary sinus. The aim of this study was to examine the effect of simultaneous sinus lift and implantation using platelet-rich fibrin as the sole grafting material on bone formation in a canine sinus model. An implant was placed after sinus membrane elevation in the maxillary sinus of six adult female mongrel dogs. The resulting space between the membrane and sinus floor was filled with autologous platelet-rich fibrin retrieved from each dog. The implants were left in place for six months. Bone tissue was seen at the lower part of the implants introduced into the sinus cavity. The height of the newly formed bone around the implants ranged from 0 mm to 4.9 mm (mean; 2.6 ± 2.0 mm) on the buccal side and from 0 mm to 4.2 mm (mean; 1.3 ± 1.8 mm) on the palatal side. The findings from this study suggest that simultaneous sinus lift and implantation using platelet-rich fibrin as sole grafting material is not a predictable and reproducible procedure, especially with respect to the bone formation around the implants in the sinus cavity.
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Affiliation(s)
- Seung-Mi Jeong
- Department of Dentistry, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - Chun-Ui Lee
- Department of Dentistry, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - Jeong-Seog Son
- Department of Dentistry, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - Ji-Hyeon Oh
- Department of Dentistry, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - Yiqin Fang
- Department of Dentistry, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - Byung-Ho Choi
- Department of Dentistry, Yonsei University Wonju College of Medicine, Wonju, South Korea.
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V. Jammal M, R. Missana L, Takabatake K, Takagi S, Nagatsuka H. Freeze Dried Bone Matrix on Rat Critical Size Defect Regeneration. J HARD TISSUE BIOL 2014. [DOI: 10.2485/jhtb.23.233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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18
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The Use of Computer-Guided Flapless Dental Implant Surgery (NobelGuide) and Immediate Function to Support a Fixed Full-ArchProsthesis inFresh-Frozen Homologous Patients with Bone Grafts. J Craniofac Surg 2013; 24:e551-8. [DOI: 10.1097/scs.0b013e31829ac8e2] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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19
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Sbordone C, Toti P, Ramaglia L, Guidetti F, Sbordone L, Martuscelli R. A 5-year clinical and computerized tomographic implant follow-up in sinus-lifted maxillae and native bone. Clin Oral Implants Res 2013; 25:1056-64. [PMID: 23822163 DOI: 10.1111/clr.12222] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The present study analysed apical and marginal bone remodelling around dental implants placed in both maxillary (sinus elevated with particulated autogenous osseous graft) and corresponding native bone areas, with a follow-up of 5 years. The clinical survival of implants was also observed. MATERIALS AND METHODS In this retrospective chart review, 27 patients were enrolled, with 55 dental implants inserted from 2000 to 2006, 26 of which were followed (one implant per patient); if required, patients were treated via sinus lift with autogenous bone and particulate technique. The internal controls were implants positioned in native areas beneath the sinus. Radiologic survey was assessed via computerized tomographic analysis measuring apical bone level (ABL) and marginal bone level (MBL), at 1- (T1 ), 3- (T2 ) and 5 years (T3 ), around implants (buccal, b; palatal, p; mesial, m; and distal sides, d). Clinical probing depth (CPD) and clinical attachment level (CAL) for all the four peri-implant aspects were measured. Cumulative survival rate (CSR) and survival rate (SR) of implants were calculated. Significances for paired and unpaired comparisons were searched for. RESULTS A significant degree of apical resorption was recorded between T1 and T3 for the mesial particulate group; again, a significant difference was discovered between the native and particulate procedures for mABL. A further feature was discovered for the particulate procedure, for which ABLs resulted negative at least for three of the aspects. Regarding MBL measurements, similar behaviours were revealed using time-comparison analysis for the two procedures at the buccal aspect. Comparisons among diameters, irrespective of the procedure, showed that resorption times for the bMBL were shorter as the diameter of the implant became wider. The implant CSR was 92% in native areas (two failures/25 implants) and 93.3% in sinuses lifted with particulate bone (two failures/30 implants). CONCLUSIONS The results suggest that a protrusion of the implant apices into augmented sinus lift occurred, whereas the bone remodelling of the coronal areas was not influenced by the events in the maxillary sinus. A diameter ranging from 4 to 5 mm might better guarantee a conservation of marginal peri-implant bone level compared with implants with smaller diameters.
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Affiliation(s)
- Carolina Sbordone
- Maxillo-Facial Surgery, School of Medicine, University of Naples "Federico II", Napoli, Italy
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20
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Sbordone C, Toti P, Guidetti F, Califano L, Bufo P, Sbordone L. Volume changes of autogenous bone after sinus lifting and grafting procedures: A 6-year computerized tomographic follow-up. J Craniomaxillofac Surg 2013; 41:235-41. [DOI: 10.1016/j.jcms.2012.09.007] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2012] [Revised: 09/08/2012] [Accepted: 09/10/2012] [Indexed: 10/27/2022] Open
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21
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Zhou HJ, Zhan RY, Zheng XJ, Li G, Cao F, Chen MT. Use of medical aural and encephalic glue-soaked gelfoam for frontal sinus repair: a single-centre experience. J Craniomaxillofac Surg 2013; 41:665-9. [PMID: 23453132 DOI: 10.1016/j.jcms.2013.01.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2012] [Revised: 01/03/2013] [Accepted: 01/04/2013] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Frontal sinus (FS) perforation is a common complication in frontal craniotomy. The primary goal of treatment is to seal the FS without destroying physiological function. OBJECTIVE This article describes a new FS cavity reconstruction technique using medical aural and encephalic glue (EC glue)-soaked gelfoam. METHODS Between 2007 and 2012, 118 patients underwent FS reconstruction using EC glue-soaked gelfoam. The FS cavity was reconstructed in all patients and no patient experienced intracranial infection, frontal sinusitis, or cerebrospinal fluid (CSF) leakage. RESULTS Restoring physiological function is the primary goal of FS reconstruction. Difficulty often arises in sealing the sinus opening, especially when the mucosa is damaged. Mucosal border dissection and electric coagulation of the mucosal laceration can help to reconstruct the mucosal cavity. Sealing the sinus with autogenous or exogenous material, such as fascia, bone flap or gelfoam carries increased risks of intracranial infection, frontal sinusitis, and CSF leakage in the short term, and increased the occurrence of a FS mucocoele in the long term. Gelfoam saturated with EC glue obtained good results. CONCLUSION We describe the application of gelfoam saturated with EC glue to treat an open FS with or without mucosal violation during frontal craniotomy. Gelfoam saturated with EC glue is a quick, effective, low-cost and reliable means of sealing the FS while preserving its physiological function.
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Affiliation(s)
- Heng-Jun Zhou
- Department of Neurosurgery, First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou 310003, China
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22
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Abstract
PURPOSE The aim of this study is to demonstrate the clinical applicability and efficacy of an allograft for maxillary sinus augmentations in patients requiring placement of dental implants. PATIENTS AND METHODS Sixty consecutive patients underwent a total of 90 sinus augmentations. Twenty-nine were women and 31 men, with a mean age of 54 years. Twenty-six patients received a bilateral procedure and 34 unilateral. All cases were treated with the lateral wall technique. Allograft consisted of demineralized freeze-dried blocks in 6 cases, particulate in 82 cases, and a combination of both in 2 cases. In 30 patients, it was combined with platelet-rich plasma. A total of 84 implants were inserted. Bone samples of grafted areas were obtained in two patients for histological examination. RESULTS Seventy-three implants were clinically successful at the reentry time. Eleven implants in seven patients were removed between 15 days and 6 months after their placement. Seven of these implants were replaced and received prostheses as well, for an overall postloading success rate of 95.2%. Follow-up for all patients after final restoration was between 12 and 96 months. Specimen's histological evaluation revealed bone formation and evidence of inflammatory infiltrate. CONCLUSIONS Based on the findings of this study, it can be suggested that the use of the demineralized freeze-dried bone allograft from the Banco de Huesos y Tejidos Fundación Cosme y Damian for sinus augmentation is effective and constitutes a feasible therapeutic alternative for implant placement.
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Acocella A, Bertolai R, Ellis E, Nissan J, Sacco R. Maxillary alveolar ridge reconstruction with monocortical fresh-frozen bone blocks: A clinical, histological and histomorphometric study. J Craniomaxillofac Surg 2012; 40:525-33. [DOI: 10.1016/j.jcms.2011.09.004] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2010] [Revised: 09/18/2011] [Accepted: 09/27/2011] [Indexed: 01/17/2023] Open
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Fraguas E, Ribeiro M, Croci A, Santos L, Pallos D, Sendyk W. Stability of implants placed simultaneously or in a delayed manner on fresh frozen onlay allografts in rabbits. Clin Oral Implants Res 2012; 24:1295-9. [PMID: 22905701 DOI: 10.1111/j.1600-0501.2012.02572.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2012] [Indexed: 12/01/2022]
Affiliation(s)
| | - Marna Ribeiro
- Department of Peridontics and Implantology; UNISA; São Paulo Brazil
| | - Alberto Croci
- Hospital das Clínicas of the School of Medicine of the University of São Paulo; Tissue Bank Medical Director; São Paulo Brazil
| | - Luiz Santos
- Institute of Orthopedics and Traumatology; Hospital das Clínicas of the School of Medicine; University of São Paulo; São Paulo Brazil
| | - Débora Pallos
- Department of Peridontics and Implantology; UNISA; São Paulo Brazil
| | - Wilson Sendyk
- Department of Peridontics and Implantology; UNISA; São Paulo Brazil
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25
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Fresh-Frozen Bone Blocks for Horizontal Ridge Augmentation in the Upper Maxilla: 6-Month Outcomes of a Randomized Controlled Trial. Clin Implant Dent Relat Res 2012; 16:116-23. [DOI: 10.1111/j.1708-8208.2012.00458.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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26
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Human Maxillary Sinuses Augmented With Mineralized, Solvent-Dehydrated Bone Allograft: A Longitudinal Case Series. IMPLANT DENT 2011; 20:445-54. [DOI: 10.1097/id.0b013e31823420a4] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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27
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Sato I, Imura K, Miwa Y, Yoshida S, Sunohara M. Distributions of calcitonin gene-related peptide and substance P in the human maxillary sinus of Japanese cadavers. J Craniomaxillofac Surg 2011; 40:e249-52. [PMID: 22079125 DOI: 10.1016/j.jcms.2011.10.027] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2010] [Revised: 10/17/2011] [Accepted: 10/17/2011] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Substance P (SP) and calcitonin gene-related peptide (CGRP) are released by the nociceptive sensory nerve and are involved in blood flow, pain and inflammation in the nasal mucosa. The purpose of this study was to assess the distribution of the SP and CGRP nerve fibres related to blood supply within human Schneiderian membrane of the maxillary sinus (MS). MATERIAL AND METHODS In this study, the MS from Japanese cadavers was examined by whole-mount immunohistochemistry. Human male cadavers (ranging in age from 80 to 90 years) were used in this study. RESULTS SP- and CGRP-positive fibres were found around large vessels of the medialis superior alveolar branches and also within the floor region of the MS. The floor region of the MS was composed of complex branches of these fibres. CONCLUSION Our results give useful information for surgical sinus floor elevation in this region of the MS. These anatomical features may assist in the execution of a successful surgical procedure.
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Affiliation(s)
- Iwao Sato
- Department of Anatomy, School of Life Dentistry at Tokyo, The Nippon Dental University, 1-9-20 Fujimi, Chiyoda-ku, Tokyo 102-8159, Japan.
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28
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Fresh-frozen human bone graft to repair defect after mandibular giant follicular cyst removal: a case report. Cell Tissue Bank 2011; 13:305-13. [DOI: 10.1007/s10561-011-9257-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2011] [Accepted: 04/16/2011] [Indexed: 12/29/2022]
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