1
|
Carmagnola D, Pispero A, Pellegrini G, Sutera S, Henin D, Lodi G, Achilli A, Dellavia C. Maxillary sinus lift augmentation: A randomized clinical trial with histological data comparing deproteinized bovine bone grafting vs graftless procedure with a 5-12-year follow-up. Clin Implant Dent Relat Res 2024. [PMID: 38979855 DOI: 10.1111/cid.13359] [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: 01/29/2024] [Revised: 04/30/2024] [Accepted: 06/18/2024] [Indexed: 07/10/2024]
Abstract
INTRODUCTION Different protocols and procedures for sinus lift and implant placement are available, generally involving the use of grafts to increase the tissue volume and/or prevent the Schneiderian membrane from collapsing. Among xenografts, deproteinised bovine bone graft (DBBP) is frequently used in sinus lift procedures. Leaving an ungrafted space following membrane elevation has proven to have a bony regenerative potential as well. This study aimed to compare the clinical and histological features of sinus lift surgery performed with or without biomaterials. METHODS Patients with severe maxillary posterior atrophy (residual bone height 2-6 mm and residual crest thickness ≥4 mm), and in need of sinus lift surgery to allow the placement of three implants were enrolled and randomly divided into two groups. They underwent sinus lifts with DBBP (control) or with a graftless technique (test) and immediate placement of two implants (a mesial and distal one). After 6 months, a bone sample was retrieved from the area between the previously inserted fixtures, and a third, central implant was placed. The collected bone samples were analyzed morphologically and histomorphometrically. The patients were provided with prosthetic restorations after 6 months and followed up for 5-12 years. RESULTS Ten patients were enrolled in the test and nine in the control group. The 6-month follow-up showed in the control group an average augmentation of 10.31 mm (±2.12), while in the test group it was 8.5 mm (±1.41) and a success rate of 96.3% in the control and 86.7% in the test group (p > 0.05). The histological analysis evidenced the presence of new bone tissue surrounded by immature osteoid matrix in the test group, and a variable number of DBBP particles surrounded by an immature woven bone matrix in the control group. CONCLUSION The results of the present trial indicate that, with residual bone height of 2-6 mm and residual crest thickness ≥4 mm, sinus lift surgery with or without biomaterials followed by implant restoration, produces similar clinical and histological outcomes.
Collapse
Affiliation(s)
- Daniela Carmagnola
- Department of Biomedical, Surgical and Dental Science, Università degli Studi di Milano, Milan, Italy
| | - Alberto Pispero
- Department of Biomedical, Surgical and Dental Science, Università degli Studi di Milano, Milan, Italy
| | - Gaia Pellegrini
- Department of Biomedical, Surgical and Dental Science, Università degli Studi di Milano, Milan, Italy
| | - Samuele Sutera
- Oral Medicine and Oral Oncology Unit, Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Italy
| | - Dolaji Henin
- Department of Biomedical, Surgical and Dental Science, Università degli Studi di Milano, Milan, Italy
| | - Giovanni Lodi
- Department of Biomedical, Surgical and Dental Science, Università degli Studi di Milano, Milan, Italy
| | | | - Claudia Dellavia
- Department of Biomedical, Surgical and Dental Science, Università degli Studi di Milano, Milan, Italy
| |
Collapse
|
2
|
Zhang W, Chen H, Zhao K, Gu X. Three-dimensional changes and influencing factors of tent space following osteotome sinus floor elevation without grafting: A 48-month retrospective radiographic study. Clin Oral Implants Res 2024. [PMID: 38873850 DOI: 10.1111/clr.14312] [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: 11/05/2023] [Revised: 05/15/2024] [Accepted: 05/23/2024] [Indexed: 06/15/2024]
Abstract
OBJECTIVES To analyze the three-dimensional stability and morphologic changes of tent space after the osteotome sinus floor elevation (OSFE) procedures without bone grafts. MATERIALS AND METHODS Forty-six implants placed using the OSFE technique with simultaneous implant placement without bone grafts were included in this retrospective study. Cone-beam computed tomography (CBCT) scans of the augmented sinuses were obtained pre- and postoperatively up to 48 months of follow-up. The maxillary sinus cavity profiles were outlined using three-dimensional virtual reconstruction and superimposition of CBCT scans. The three-dimensional changes in the tent space were measured. A generalized estimating equation (GEE) was used to explore potential factors. RESULTS The implant survival rate was 97.8%. The mean volume of remaining tent space immediately after surgery was 96.8 ± 70.5 mm3, shrinking to 31.0 ± 24.9 mm3 after 48 months, while the mean percentage of remaining tent space volume decreased to 29.1 ± 20.7%. The tent space volume and the percentage of residual tent space volume only decreased significantly within 12 months after surgery (p = .008, .013). GEE results indicated positive correlations between the percentage of remaining tent space volume and implant protrusion length (p = .000) and apical height (p = .000), with a negative correlation between the sinus floor area immediately after surgery (p = .002) and the healing time (p = .022). CONCLUSIONS The volume of the tent space rapidly shrank after OSFE without bone grafts. Several factors might influence the tent space stability. Long-term clinical trials with larger sample sizes are necessary to further validate the results.
Collapse
Affiliation(s)
- Wen Zhang
- Department of Stomatology, Quzhou Hospital of Traditional Chinese Medicine, Quzhou, Zhejiang Province, China
| | - Haida Chen
- Department of Stomatology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Ke Zhao
- Department of Stomatology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Xinhua Gu
- Department of Stomatology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| |
Collapse
|
3
|
Saglanmak A, Cinar IC, Zboun M, Arisan V, Mijiritsky E. Maxillary Sinus Floor Elevation and Simultaneous Implant Installation via Osseodensification Drills: A Retrospective Analysis of Bone Gain in 72 Patients Followed for 6 Months. J Clin Med 2024; 13:2225. [PMID: 38673498 PMCID: PMC11050904 DOI: 10.3390/jcm13082225] [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: 03/13/2024] [Revised: 04/03/2024] [Accepted: 04/05/2024] [Indexed: 04/28/2024] Open
Abstract
Background/Objectives: The aim of this retrospective study was to radiographically evaluate the endo-sinus bone gain (ESBG) following osseodensification procedures using CBCT and compare the results to more conventional sinus lifting techniques. Methods: A total of 72 patients underwent crestal sinus floor elevation procedures and were provided with 102 implants with a sand-blasted and acid-etched surface with microthreads (Medentika® Microcone Implants, Hugelsheim, Germany). Patients were divided into two groups; the osseodensification group (OD; n = 36) and the osseodensified augmentation group (ODA; n = 36). Results: The mean residual bone height (RBH) was 5.71 (1.77) and 4.30 (0.94) mm in the OD and ODA groups, respectively. An ESBG of 3.45 (1.18) and 5.74 (1.31) mm was observed in the OD and ODA groups, respectively, and as compared to the baseline RBH, the ESBG was statistically significant in both groups after 6 months (p < 0.001). Conclusions: Within the limits of this retrospective study, crestal sinus lifting with the osseodensification technique seems to be a fast, effective, and safe method. Longer follow-up studies with full intrasinus bone topography and structure analyses are needed to prove the success rate of endo-sinus bone gain.
Collapse
Affiliation(s)
- Alper Saglanmak
- Department of Oral Implantology, Faculty of Dentistry, Istanbul University, Fatih, Istanbul 34093, Türkiye; (I.C.C.); (V.A.)
| | - Ihsan Caglar Cinar
- Department of Oral Implantology, Faculty of Dentistry, Istanbul University, Fatih, Istanbul 34093, Türkiye; (I.C.C.); (V.A.)
| | - Mohammed Zboun
- Department of Oral & Maxillofacial Surgery and Periodontology, Faculty of Dentistry, Arab American University, 13 Zababdeh, Jenin 240, Palestine;
| | - Volkan Arisan
- Department of Oral Implantology, Faculty of Dentistry, Istanbul University, Fatih, Istanbul 34093, Türkiye; (I.C.C.); (V.A.)
| | - Eitan Mijiritsky
- Department of Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, School of Medicine, Tel Aviv University, Tel Aviv 64239, Israel;
- Goldschleger School of Dental Medicine, Faculty of Medicine, Tel Aviv University, Tel Aviv 39040, Israel
| |
Collapse
|
4
|
Guillou E, Lerhe B, Gemmi T, Khenissa N, Latrèche S, Loridon G. Simultaneous sinus elevation and immediate implant placement without biomaterial: A technical note. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024; 125:101677. [PMID: 37926189 DOI: 10.1016/j.jormas.2023.101677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 10/21/2023] [Accepted: 11/02/2023] [Indexed: 11/07/2023]
Abstract
Sinus floor elevation is widely considered as one of the most reliable and predictable procedures for augmenting posterior maxillary bone volume before implant placement. The lateral window technique is often described as the gold standard, especially when dealing with limited residual bone height. Traditionally, severe vertical defects in the posterior maxilla required a two-stage approach: first elevating the sinus membrane with biomaterial, followed by a second surgery for implant placement. This article introduces an innovative approach to the lateral sinus lift procedure, enabling simultaneous implant placement in sites with less than 5 mm of remaining bone height. This original one-stage surgical approach is interesting because it does not involve grafting of any biomaterial into the sinus. Its main objectives are to enhance safety and predictability while reducing the risk of post-operative infections. However, it's essential to emphasize that achieving an ideal implant position with adequate primary stability is crucial for its viability.
Collapse
Affiliation(s)
- Estelle Guillou
- Department of Oral Surgery, Oral and Dental Medicine Institute, 28 Boulevard de Riquier, Nice 06300, France.
| | - Barbara Lerhe
- Department of Oral and Maxillo-Facial Surgery, Head and Neck Institute, Nice 06100, France
| | - Thomas Gemmi
- Department of Oral Surgery, Oral and Dental Medicine Institute, 28 Boulevard de Riquier, Nice 06300, France; Private Practice, Saint-Raphaël 83700, France
| | - Nouha Khenissa
- Department of Oral Surgery, Oral and Dental Medicine Institute, 28 Boulevard de Riquier, Nice 06300, France
| | - Sarah Latrèche
- Department of Oral Surgery, Oral and Dental Medicine Institute, 28 Boulevard de Riquier, Nice 06300, France
| | - Guillaume Loridon
- Department of Oral Surgery, Oral and Dental Medicine Institute, 28 Boulevard de Riquier, Nice 06300, France
| |
Collapse
|
5
|
Starch-Jensen T, Bruun NH, Spin-Neto R. Endo-sinus bone gain following sinus membrane elevation without graft compared with sinus floor augmentation and a composite graft: a one-year single-blind randomized controlled trial. Int J Oral Maxillofac Surg 2024; 53:319-332. [PMID: 37891069 DOI: 10.1016/j.ijom.2023.10.007] [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: 06/06/2023] [Revised: 10/06/2023] [Accepted: 10/11/2023] [Indexed: 10/29/2023]
Abstract
The objective of this study was to assess endo-sinus bone gain (ESBG) and bone density (BD) following maxillary sinus membrane elevation without graft (test) compared with maxillary sinus floor augmentation and 1:1 ratio of autogenous bone from the buccal antrostomy and deproteinized porcine bone mineral (control) using two- and three-dimensional radiographic methods. Forty healthy patients were randomly allocated to the test and control groups. Cone beam computed tomography scans were obtained at enrolment (T0), immediately after surgery (T1), at delivery of the prosthetic rehabilitation (T2), and 1 year after functional implant loading (T3). Mean differences were expressed with the 95% confidence interval. Significance was set at ≤ 0.05. ESBG and BD were significantly higher in the control group than test group at T1, T2, and T3 (P < 0.001). A significant decrease in ESBG and increase in BD was observed from T1 to T3 with both treatments (P < 0.001). There was a non-significant positive correlation of ESBG with implant protrusion length and non-significant negative correlation with residual bone height. In conclusion, test was associated with significantly lower ESBG and BD compared with control. However, the lower ESBG and BD did not appear to negatively affect the implant stability quotient or implant treatment outcome after 1 year of functional implant loading.
Collapse
Affiliation(s)
- T Starch-Jensen
- Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, and Department of Clinical Medicine, The Faculty of Medicine, Aalborg University, Aalborg, Denmark.
| | - N H Bruun
- Unit of Clinical Biostatistics, Aalborg University Hospital, Aalborg, Denmark
| | - R Spin-Neto
- Department of Dentistry and Oral Health, Section for Oral Radiology, Faculty of Health, Aarhus University, Aarhus, Denmark
| |
Collapse
|
6
|
Wang M, Li B, Feng H, Ye Q, Sun Y, Duan X, He J. Assessment of the osteogenic effect after maxillary sinus floor elevation and simultaneous implantation with or without bone grafts by analyzing trabecular bone parameters: a retrospective study. J Appl Oral Sci 2024; 32:e20230406. [PMID: 38359269 PMCID: PMC10984575 DOI: 10.1590/1678-7757-2023-0406] [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: 11/07/2023] [Revised: 12/14/2023] [Accepted: 12/18/2023] [Indexed: 02/17/2024] Open
Abstract
OBJECTIVE The aim of this population-based retrospective study was to compare the osteogenic effect of newly formed bone after maxillary sinus floor elevation (MSFE) and simultaneous implantation with or without bone grafts by quantitatively analyzing trabecular bone parameters. METHODOLOGY A total of 100 patients with missing posterior maxillary teeth who required MSFE and implantation were included in this study. Patients were divided into two groups: the non-graft group (n=50) and the graft group (n=50). Radiographic parameters were measured using cone beam computed tomography (CBCT), and the quality of newly formed bone was analyzed by assessing trabecular bone parameters using CTAn (CTAnalyzer, SkyScan, Antwerp, Belgium) software. RESULTS In the selected regions of interest, the non-graft group showed greater bone volume/total volume (BV/TV), bone surface/total volume (BS/TV), trabecular number (Tb. N), and trabecular thickness (Tb. Th) than the graft group (p<0.001). The non-graft group showed lower trabecular separation (Tb. Sp) than the graft group (p<0.001). The incidence of perforation and bleeding was higher in the graft group than in the non-graft group (p<0.001), but infection did not significantly differ between groups (p>0.05). Compared to the graft group, the non-graft group showed lower postoperative bone height, gained bone height and apical bone height (p<0.001). CONCLUSION MSFE with and without bone grafts can significantly improve bone formation. In MSFE, the use of bone grafts hinders the formation of good quality bone, whereas the absence of bone grafts can generate good bone quality and limited bone mass.
Collapse
Affiliation(s)
- Mohan Wang
- Anhui Medical UniversityStomatologic Hospital & CollegeKey Laboratory of Oral Diseases Research of Anhui ProvinceHefeiChinaAnhui Medical University, Stomatologic Hospital & College, Key Laboratory of Oral Diseases Research of Anhui Province, Hefei, China.
- Shanghai Jiao Tong University School of MedicineNinth People's HospitalCollege of StomatologyShanghaiChinaShanghai Jiao Tong University School of Medicine, Ninth People's Hospital, College of Stomatology, Department of Oral and Maxillofacial Surgery, Shanghai, China.
| | - Beibei Li
- Anhui Medical UniversityStomatologic Hospital & CollegeKey Laboratory of Oral Diseases Research of Anhui ProvinceHefeiChinaAnhui Medical University, Stomatologic Hospital & College, Key Laboratory of Oral Diseases Research of Anhui Province, Hefei, China.
| | - Hailiang Feng
- Zhejiang University School of MedicineThe Second Affiliated HospitalDepartment of StomatologyHangzhouChinaZhejiang University School of Medicine, The Second Affiliated Hospital, Linping Campus, Department of Stomatology, Hangzhou, China.
| | - Qingsong Ye
- Anhui Medical UniversityStomatologic Hospital & CollegeKey Laboratory of Oral Diseases Research of Anhui ProvinceHefeiChinaAnhui Medical University, Stomatologic Hospital & College, Key Laboratory of Oral Diseases Research of Anhui Province, Hefei, China.
| | - Yahui Sun
- Anhui Medical UniversityStomatologic Hospital & CollegeKey Laboratory of Oral Diseases Research of Anhui ProvinceHefeiChinaAnhui Medical University, Stomatologic Hospital & College, Key Laboratory of Oral Diseases Research of Anhui Province, Hefei, China.
| | - Xinxiu Duan
- Anhui Medical UniversityStomatologic Hospital & CollegeKey Laboratory of Oral Diseases Research of Anhui ProvinceHefeiChinaAnhui Medical University, Stomatologic Hospital & College, Key Laboratory of Oral Diseases Research of Anhui Province, Hefei, China.
| | - Jiacai He
- Anhui Medical UniversityStomatologic Hospital & CollegeKey Laboratory of Oral Diseases Research of Anhui ProvinceHefeiChinaAnhui Medical University, Stomatologic Hospital & College, Key Laboratory of Oral Diseases Research of Anhui Province, Hefei, China.
| |
Collapse
|
7
|
Li N, Jiang Z, Pu R, Zhu D, Yang G. Implant failure and associated risk factors of transcrestal sinus floor elevation: A retrospective study. Clin Oral Implants Res 2023; 34:66-77. [PMID: 36346662 DOI: 10.1111/clr.14020] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 10/20/2022] [Accepted: 11/03/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVES This retrospective study aimed to evaluate early and late implant loss rates after transcrestal sinus floor elevation (TSFE) and to identify the risk factors related to these failures. MATERIAL AND METHODS All patients treated with TSFE and simultaneous implant placement during October 2015 to March 2019 were evaluated for inclusion. A total of 802 patients with 976 implants met the inclusion criteria. Clinical and radiographic information was collected from medical records and image software. Univariate and multivariate Cox proportional hazards frailty regression models were performed to identify potential risk factors associated with early and late implant loss after TSFE. RESULTS The 3-year cumulative implant survival rate was 96.9% (95% CI 95.8%-98.0%). Twelve implants in 12 patients were lost before or at the abutment connection, while 24 implants in 24 patients were lost after functional loading. The Cox frailty regression analyses indicated that two factors were correlated with early implant loss: TSFE with grafting materials, and operators with less clinical experience. As for late implant loss, RBH ≤6 mm, male sex, and certain implant brands were associated with a significantly increased failure rate. CONCLUSIONS Transcrestal sinus floor elevation with simultaneous implant placement is a predictable treatment option in the atrophic maxilla. The presence of grafting materials and the lack of clinical experience of the surgeon were possibly associated with early implant loss, while low RBH, male sex, and certain implant brands tended to increase late implant loss.
Collapse
Affiliation(s)
- Na Li
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang, China.,Zhejiang Provincial Clinical Research Center for Oral Diseases, Zhejiang, China.,Key Laboratory of Oral Biomedical Research of Zhejiang Province, Zhejiang, China.,Cancer Center of Zhejiang University, Hangzhou, China
| | - Zhiwei Jiang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang, China.,Zhejiang Provincial Clinical Research Center for Oral Diseases, Zhejiang, China.,Key Laboratory of Oral Biomedical Research of Zhejiang Province, Zhejiang, China.,Cancer Center of Zhejiang University, Hangzhou, China
| | - Rui Pu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang, China
| | - Danji Zhu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang, China.,Zhejiang Provincial Clinical Research Center for Oral Diseases, Zhejiang, China.,Key Laboratory of Oral Biomedical Research of Zhejiang Province, Zhejiang, China.,Cancer Center of Zhejiang University, Hangzhou, China
| | - Guoli Yang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang, China.,Zhejiang Provincial Clinical Research Center for Oral Diseases, Zhejiang, China.,Key Laboratory of Oral Biomedical Research of Zhejiang Province, Zhejiang, China.,Cancer Center of Zhejiang University, Hangzhou, China
| |
Collapse
|
8
|
Wang X, Sun L, Wang L, Shi S, Zhang S, Song Y. Predictors of peri-implant bone remodeling outcomes after the osteotome sinus floor elevation: a retrospective study. BMC Oral Health 2022; 22:622. [PMID: 36539789 PMCID: PMC9764540 DOI: 10.1186/s12903-022-02592-6] [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: 09/01/2022] [Accepted: 11/14/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND This study aimed to evaluate the radiographic outcomes of implants after osteotome sinus floor elevation (OSFE), and further identify the separate predictors for these radiographic outcomes. METHODS In this retrospective cohort study, a total of 187 implants were inserted into 138 patients using the OSFE technique. Seventy-four patients in the grafted group, and 64 patients in the non-grafted group completed this study. The vertical bone gain (VBG) and marginal bone loss (MBL) at 3 years following surgery were assessed as outcome variables. Based on extensive literature results, variables considered potential predictors of outcome variables included sex, age, tooth position, implant length, implant diameter, with or without grafting materials, residual bone height, sinus width, bone density, and sinus membrane thickness. Subsequently, the binary logistic regression analysis was applied with VBG and MBL as dependent variables, respectively. The receiver operating characteristic curve (ROC) with its area under the curve (AUC) was performed to further determine the predictive value of these predictors. RESULTS One hundred and six implants in grafted group and 81 implants in the non-grafted group were analyzed. The average VBG was 2.12 ± 1.94 mm for the grafted group and 0.44 ± 1.01 mm for the non-grafted group at 3 years (P < 0.05). The mean MBL was 1.54 ± 1.42 mm for the grafted group and 1.13 ± 1.69 mm for the non-grafted group at 3 years (P > 0.05). After the adjustment for confounders, logistic regression analysis demonstrated that implant length, grafting, residual bone height, and sinus membrane thickness were predictors of VBG. The odds ratio for VBG was 3.90, 4.04, 4.13 and 2.62, respectively. Furthermore, grafting exhibited the largest AUC at 0.80. While tooth position and implant length were predictors of MBL, the odds ratio for MBL was 3.27 and 7.85, respectively. Meanwhile, implant length exhibited the largest AUC at 0.72. CONCLUSIONS OSFE with or without simultaneous grafting materials both showed predictable clinical outcomes. Additionally, the present study is the first quantitative and significant verification that VBG has a significant association with sinus membrane thickness, as well as residual bone height, implant length and grafting. Whereas tooth position and implant length are markedly associated with MBL.
Collapse
Affiliation(s)
- Xingxing Wang
- grid.233520.50000 0004 1761 4404State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Oral Implants, School of Stomatology, The Fourth Military Medical University, Xi’an, 710032 Shaanxi People’s Republic of China
| | - Lijuan Sun
- grid.233520.50000 0004 1761 4404State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Periodontology, School of Stomatology, The Fourth Military Medical University, Xi’an, 710032 Shaanxi People’s Republic of China
| | - Lei Wang
- grid.43169.390000 0001 0599 1243Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi’an Jiaotong University, Xi’an, 710004 Shaanxi People’s Republic of China
| | - Shaojie Shi
- 920th Hospital of Joint Logistics Support Force, Kunming, People’s Republic of China
| | - Sijia Zhang
- grid.233520.50000 0004 1761 4404State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Oral Implants, School of Stomatology, The Fourth Military Medical University, Xi’an, 710032 Shaanxi People’s Republic of China
| | - Yingliang Song
- grid.233520.50000 0004 1761 4404State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Oral Implants, School of Stomatology, The Fourth Military Medical University, Xi’an, 710032 Shaanxi People’s Republic of China
| |
Collapse
|
9
|
Deng X, Shi R, Zhan J, Yang F. Application Effect of External and Internal Elevation of Maxillary Sinus in Implant Restoration of Posterior Maxilla. Emerg Med Int 2022; 2022:7879633. [PMID: 36090544 PMCID: PMC9458401 DOI: 10.1155/2022/7879633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 08/05/2022] [Indexed: 11/17/2022] Open
Abstract
Objective To explore and analyze the application effect of external and internal elevation of the maxillary sinus in implant restoration of the posterior maxilla. Methods A total of 84 patients undergoing implant restoration of the posterior maxilla in the hospital were enrolled between January 2019 and March 2021. According to the random number table method, they were divided into the observation group (n = 42) and the control group (n = 42). The control group underwent external elevation of the maxillary sinus, while the observation group underwent internal elevation of the maxillary sinus. At 6 h, 12 h, and 24 h after surgery, the pain degree between the two groups was compared. All were followed up at 6 months after surgery. The osseointegration (bone resorption around implants, elevation height of maxillary sinus floor, average healing time) and soft tissues (bleeding index, plaque index, probing depth) in both groups were observed. The occurrence of postoperative complications was recorded. Results At 6 h, 12 h, and 24 h after surgery, VAS scores in the observation group were significantly lower than those in the control group (P < 0.05). At 6 months after surgery, bone resorption and elevation height of the maxillary sinus floor in the observation group were significantly higher than those i.0.0n the control group, and the average healing time was significantly shorter than that in the control group (P < 0.05). The bleeding index, plaque index, and probing depth in the observation group were significantly lower than those in the control group (P < 0.05). There was no significant difference in the incidence of postoperative complications between the observation group and the control group (9.52% vs. 19.05%) (P > 0.05). Conclusion The application effect of internal elevation of the maxillary sinus is good in implant restoration of the posterior maxilla, which can relieve pain and swelling and improve implant effect.
Collapse
Affiliation(s)
- Xuan Deng
- The Second Affiliated Hospital, Department of Stomatology, Hengyang Medical School, University of South China, Hengyang, Hunan 421001, China
| | - Rujie Shi
- The Second Affiliated Hospital, Department of Stomatology, Hengyang Medical School, University of South China, Hengyang, Hunan 421001, China
| | - Jia Zhan
- The Second Affiliated Hospital, Department of Stomatology, Hengyang Medical School, University of South China, Hengyang, Hunan 421001, China
| | - Fang Yang
- The Second Affiliated Hospital, Department of Neurosurgery, Hengyang Medical School, University of South China, Hengyang, Hunan 421001, China
| |
Collapse
|
10
|
Simultaneous Implant Placement and Sinus Lift Using Leukocyte-Platelet Rich Fibrin: A Retrospective 40-Month Study. J Craniofac Surg 2022; 33:e706-e708. [PMID: 35240666 DOI: 10.1097/scs.0000000000008610] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 02/09/2022] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT The aim of this study was to report the 40-month clinical radiographical outcomes of maxillary sinus floor augmentation using leukocyte-platelet rich fibrin (L-PRF) as a single graft in combination with immediately placed implants. Twenty partially edentulous individuals with missing teeth in the region associated to maxillary sinus were included in this retrospective study. A lateral sinus floor elevation was performed considering a complete wear of the bone wall of the maxillary sinus and immediately placing the implant and filled the maxillary sinus with L-PRF clots as a single graft. After 5 months, all the implants received single screwed implant-supported prostheses. Subsequent evaluation was every 4 months assessing the success rate and biological complications. Two maxillary sinus membrane were perforated and covered with L-PRF clots. The mean bone height gain was 62.6%, observing a 100% of success and that in all the cases achieved at least the implant height. In conclusion, the use of platelet-rich fibrin clot as a single graft biomaterial during the maxillary sinus lift procedure combined with immediate implant placement may be a reliable clinical alternative, even to repair the sinus membrane.
Collapse
|
11
|
Wang Z, Jia Q, Jiang HB, Han J, Zou L, Niu G. The Relation between Morphology of Maxillary Sinus after Augmentation in Three Classification Methods and Residual Bone Height: A Retrospective Study. Int J Clin Pract 2022; 2022:1850012. [PMID: 36249910 PMCID: PMC9536978 DOI: 10.1155/2022/1850012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 09/13/2022] [Accepted: 09/16/2022] [Indexed: 11/18/2022] Open
Abstract
Maxillary sinus augmentation is critical to oral implantology, particularly in some cases. The morphology of the sinus floor reflects the lifting effect to a certain extent; however, there has been limited research on the morphology after sinus augmentation. The present study aims to investigate the relationship between residual bone height (RBH) and the morphology of the sinus floor and determine whether a correlation exists between the different evaluation classifications. Maxillary sinus floor augmentation procedures were performed in 56 patients and 68 teeth using the sinus crest approach (SCA). Imaging results obtained after one year of sinus augmentation were analyzed and simultaneously classified along the coronal plane, the sagittal plane, and the biplane (coronal-sagittal). The higher the RBH, the closer the result tends to be to A, A', or type 1 (more satisfactory). There was a significant correlation between the three different evaluation classifications (p < 0.05). The morphology of perforation cases was involved in types C, D, C', and D'. A more satisfactory post-lifting morphology (tent type and flat type) is probably related to an optimal preoperative bone height, and an unsatisfactory post-lifting morphology is related to a low preoperative sinus floor height. The sagittal plane evaluation correlates with the coronal plane and biplane evaluation and is thus more recommended.
Collapse
Affiliation(s)
- Zhi Wang
- Second Clinical Division, School and Hospital of Stomatology, Peking University, Beijing 100101, China
| | - Qi Jia
- Department of Dental Materials, Peking University School and Hospital of Stomatology, Beijing 100081, China
- The Conversationalist Club, School of Stomatology, Shandong First Medical University, Jinan, Shandong 250117, China
| | - Heng Bo Jiang
- Department of Dental Materials, Peking University School and Hospital of Stomatology, Beijing 100081, China
- The Conversationalist Club, School of Stomatology, Shandong First Medical University, Jinan, Shandong 250117, China
| | - Jianmin Han
- Department of Dental Materials, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Lidong Zou
- Second Clinical Division, School and Hospital of Stomatology, Peking University, Beijing 100101, China
| | - Guangliang Niu
- Department of Oral Prosthodontics, The First Affiliated Hospital of Nanchang University, Nanchang 330006, China
| |
Collapse
|
12
|
Alkhasawnah Q, Elmas S, Sohrabi K, Attia S, Heinemann S, El Khassawna T, Heiss C. Confirmation of Calcium Phosphate Cement Biodegradation after Jawbone Augmentation around Dental Implants Using Three-Dimensional Visualization and Segmentation Software. MATERIALS 2021; 14:ma14227084. [PMID: 34832488 PMCID: PMC8618138 DOI: 10.3390/ma14227084] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 11/10/2021] [Accepted: 11/16/2021] [Indexed: 01/01/2023]
Abstract
The use of autologous bone graft for oral rehabilitation of bone atrophy is considered the gold standard. However, the available grafts do not allow a fast loading of dental implants, as they require a long healing time before full functionality. Innovative bioactive materials provide an easy-to-use solution to this problem. The current study shows the feasibility of calcium phosphate cement paste (Paste-CPC) in the sinus. Long implants were placed simultaneously with the cement paste, and provisional prosthetics were also mounted in the same sessions. Final prosthetics and the full loading took place within the same week. Furthermore, the study shows for the first time the possibility to monitor not only healing progression using Cone Beam Computer tomography (CBCT) but also material retention, over two years, on a case study example. The segmented images showed a 30% reduction of the cement size and an increased mineralized tissue in the sinus. Mechanical testing was performed qualitatively using reverse torque after insertion and cement solidification to indicate clinical feasibility. Both functional and esthetic satisfaction remain unchanged after one year. This flowable paste encourages the augmentation procedure with less invasive measure through socket of removed implants. However, this limitation can be addressed in future studies.
Collapse
Affiliation(s)
- Qusai Alkhasawnah
- Experimental Trauma Surgery, Faculty of Medicine, Justus-Liebig-University, Aulweg 128, 35392 Giessen, Germany; (Q.A.); (S.E.); (C.H.)
- Center of Dental Implants, Jordan German Dental Institute, Mamdouh Al Saraireh Street 5, Amman 11821, Jordan
| | - Sera Elmas
- Experimental Trauma Surgery, Faculty of Medicine, Justus-Liebig-University, Aulweg 128, 35392 Giessen, Germany; (Q.A.); (S.E.); (C.H.)
| | - Keywan Sohrabi
- Faculty of Health Sciences, University of Applied Sciences, Wiesenstrasse 14, 35390 Giessen, Germany;
| | - Sameh Attia
- Department of Oral and Maxillofacial Surgery, Justus-Liebig University of Giessen, Klinikstr. 33, 35392 Giessen, Germany;
| | | | - Thaqif El Khassawna
- Experimental Trauma Surgery, Faculty of Medicine, Justus-Liebig-University, Aulweg 128, 35392 Giessen, Germany; (Q.A.); (S.E.); (C.H.)
- Faculty of Health Sciences, University of Applied Sciences, Wiesenstrasse 14, 35390 Giessen, Germany;
- Correspondence: ; Tel.: +49-641-993-0581
| | - Christian Heiss
- Experimental Trauma Surgery, Faculty of Medicine, Justus-Liebig-University, Aulweg 128, 35392 Giessen, Germany; (Q.A.); (S.E.); (C.H.)
- Department of Trauma, Hand and Reconstructive Surgery, Justus-Liebig University Giessen, Rudolf-Buchheim-Street 7, 35392 Giessen, Germany
| |
Collapse
|
13
|
Filipov I, Bolognesi F, Chirila L, Cristache CM, Corinaldesi G, Park KB. Preliminary Study with the Use of a Titanium Mesh as Space Maker and Implant Primary Stabilization for One-Stage Sinus Lift in Cases with Less Than 1.5 mm Residual Bone. J Clin Med 2021; 10:jcm10214853. [PMID: 34768375 PMCID: PMC8584652 DOI: 10.3390/jcm10214853] [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: 09/13/2021] [Revised: 10/08/2021] [Accepted: 10/19/2021] [Indexed: 11/23/2022] Open
Abstract
(1) Background: In the lateral area of the maxilla, the alveolar bone can lose significant volume due to maxillary sinus pneumatization following teeth extractions. This preliminary study evaluated the effectiveness of a novel technique for one-stage sinus lifting and simultaneous implant placement in cases with less than 1.5 mm residual alveolar bone. The subsequent survival rate at 1-year post-occlusal loading was assessed. (2) Methods: 15 patients were selected, the main inclusion criteria were the partially edentulous area in the posterior maxilla with alveolar bone height of less than 1.5 mm below the sinus. All of the patients underwent one-stage sinus lifting, along with simultaneous implant placement using a “butterfly” anchorage device to optimize the primary stability and xenograft bone as graft material. At 6 to 9 months after surgery, the anchorage device was removed and implants were loaded. Panoramic x-ray images were used to assess the new bone formation, while the biological stability was measured using resonance frequency analysis. (3) Results: 15 implants were inserted. The mean implant stability quotient (ISQ) value was 71.3 (SD = ±2.51) and the mean healing period was 7.3 (SD = ±1.23) months. The mean bone height after the healing period was 14.4 (SD = ±2.05). A statistically significant correlation was found between the healing period and the ISQ value (Spearman rho = 0.684, sig. = 0.005). No statistically significant correlation was found between the ISQ value and the new regenerated bone height (Person r = 0.389, sig. = 0.152). Smoking was identified as a risk factor involved in postoperative complications. (4) Conclusions: The results of the present preliminary study demonstrated that the proposed “butterfly” technique was effective when performing one-stage sinus lifting and simultaneous implant placement in cases with less than 1.5 mm of residual alveolar bone. The survival rate was 100% at 1-year post occlusal loading.
Collapse
Affiliation(s)
- Iulian Filipov
- Department of Oral and Maxillofacial Surgery, “Queen Maria” Military Emergency Hospital, 9 Pietii Str., 500007 Brasov, Romania
- Department of Dental Techniques, Faculty of Midwifery and Medical Assisting (FMAM), “Carol Davila” University of Medicine and Pharmacy, 8, Eroilor Sanitari Blvd, 050474 Bucharest, Romania
- Correspondence: (I.F.); (C.M.C.)
| | - Federico Bolognesi
- Oral and Maxillo-Facial Surgery Unit, IRCCS Policlinico di Sant’Orsola, Via Giuseppe Massarenti, 9, 40138 Bologna, Italy;
- Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, 59 Via S. Vitale, 40100 Bologna, Italy;
| | - Lucian Chirila
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, “Carol Davila” University of Medicine and Pharmacy, 19 Plevnei Ave., 010221 Bucharest, Romania;
| | - Corina Marilena Cristache
- Department of Dental Techniques, Faculty of Midwifery and Medical Assisting (FMAM), “Carol Davila” University of Medicine and Pharmacy, 8, Eroilor Sanitari Blvd, 050474 Bucharest, Romania
- Correspondence: (I.F.); (C.M.C.)
| | - Giuseppe Corinaldesi
- Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, 59 Via S. Vitale, 40100 Bologna, Italy;
| | - Kwang Bum Park
- Department of Implantology and Periodontology, Daegu Mir Dental Hospital, Jung-gu, Daegu 41934, Korea;
| |
Collapse
|