1
|
Pérez-Pevida E. The One Trephine-One Osteotome (OTOO) Protocol: A Modified Minimally Invasive Approach for Transcrestal Sinus Floor Elevation. J ORAL IMPLANTOL 2024; 50:195-199. [PMID: 38597165 DOI: 10.1563/aaid-joi-d-24-00050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Affiliation(s)
- Esteban Pérez-Pevida
- Department of Surgery, Faculty of Medicine, University of Salamanca, Salamanca, Spain
- Faculty of Health Sciences, Miguel de Cervantes European University, Valladolid, Spain
| |
Collapse
|
2
|
Deng C, Xiong C, Man Y, Qu Y. Combination of a surgical template and a collagen strip for guiding sinus floor elevation in the oblique sinus floor: A technical note. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101495. [PMID: 37169339 DOI: 10.1016/j.jormas.2023.101495] [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: 04/05/2023] [Accepted: 05/08/2023] [Indexed: 05/13/2023]
Abstract
Sinus floor elevation (SFE) by transcrestal approach has been proven to be a predictable and minimally invasive treatment that augments posterior maxilla with insufficient bone height, allowing the prosthetic rehabilitation of this area with dental implants. However, precise and sufficient elevation of the Schneiderian membrane without perforation is challenging through this blind technique especially in the presence of anatomical restrictions. This note describes a novel technique combining a surgical template and an absorbable collagen sponge (ACS) strip for transcrestal SFE in the oblique sinus floor. A surgical template was used to locate the oblique sinus floor and a collagen strip was placed to orient membrane elevation, meanwhile, protect the sinus membrane. Within the limits of present observation, this technique may increase the manipuility while reducing the risk of complications.
Collapse
Affiliation(s)
- Chen Deng
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China; Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Chenyi Xiong
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Yi Man
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China; Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Yili Qu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China; Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.
| |
Collapse
|
3
|
Zhang Y, Zhang C. Crestal sinus augmentation in a head back position: Retrospective case series. J Indian Soc Periodontol 2023; 27:428-433. [PMID: 37593563 PMCID: PMC10431223 DOI: 10.4103/jisp.jisp_229_22] [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: 05/07/2022] [Revised: 01/11/2023] [Accepted: 01/15/2023] [Indexed: 08/19/2023] Open
Abstract
Objectives To evaluate the clinical efficacy of Crestal Sinus Augmentation (CSA) in a head back position (CSA-HBP) for maxillary sinus mucosa elevation. Materials and Methods We enrolled 209 patients, 246 maxillary sinuses, 348 sites in this study. Complications, maxillary sinus mucosal perforation rate and cumulative survival rate (CSR) data were collected to evaluate the clinical efficacy of CSA-HBP. Maxillary sinus mucosal elevation height (EH) and new bone height (NH) were measured by cone-beam computerized tomography and standard periapical radiographs. The implantation sites of residual bone height (RBH) ≤5 mm and RBH >5 mm were marked as Groups A (n = 81) and B (n = 267), respectively. The implantation sites of the second and third molar sites were marked as Group C (n = 134), and the remaining sites were marked as Group D (n = 214). Results The RBH before implant placement was 6.63 ± 2.10 mm (95% confidence interval [CI] 6.41- 6.85 mm). The mucosal EH was 4.04 ± 1.86 mm (95% CI 3.85 - 4.24 mm). The NH was 2.36 ± 1.20 mm (95% CI 3.85-4.24 mm). No other complications were found except three cases of postoperative swelling and one case of nasal blood secretions. The overall mucosal perforation rate was 1.44% (5/348, 95% CI 0.2%-2.7%) and the rate of RBH ≤ 5 mm (Group A) was 1.49% (2/134, 95% CI 0%-3.50%). The 8-year CSR was 99.71% (347/348, 95% CI 99.2%-100.0%). Mucosal EH and NH were higher in RBH ≤5 mm (Group A) than in RBH >5 mm (Group B) (P = 0.001 and P = 0.001, Mann-Whitney U-test). There were no significant differences in mucosal EH and perforation rate between second and third molar sites (Group C) and other sites (Group D) (P = 0.77, Mann-Whitney U-test, and P = 0.16, Yates' Chi-square independence test). Conclusions CSA-HBP is a minimally invasive and reliable technique.
Collapse
Affiliation(s)
- Yuhang Zhang
- Department of Stomatology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Chunyuan Zhang
- Department of Stomatology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| |
Collapse
|
4
|
Tang C, Du Q, Luo J, Peng L. Simultaneous placement of short implants (≤ 8 mm) versus standard length implants (≥ 10 mm) after sinus floor elevation in atrophic posterior maxillae: a systematic review and meta-analysis. Int J Implant Dent 2022; 8:45. [PMID: 36197540 PMCID: PMC9535054 DOI: 10.1186/s40729-022-00443-1] [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: 07/29/2022] [Accepted: 09/24/2022] [Indexed: 11/18/2022] Open
Abstract
Purpose The objective of this meta-analysis was to compare the clinical outcomes of using short implants (≤ 8 mm) inserted with osteotome sinus floor elevation (OSFE) and standard implants (≥ 10 mm) inserted with sinus floor elevation (SFE) in atrophic posterior maxillae with insufficient residual bone height (RBH). Methods An electronic search was performed on PubMed, EMBASE, and the Cochrane Library from 1994 to July 2022, in combination with a manual search of references in relevant articles. Randomized controlled trials (RCTs) that compared the clinical results between short and standard implant placement with SFE were included. The primary outcomes were implant survival rate and marginal bone loss (MBL); the secondary outcome was complication rate. Results Three RCTs were included, totaling 138 short and 156 standard implants. The results of the meta-analysis showed no significant differences between the short and standard implant groups in survival rate (RR = 1.02, 95% CI 0.96–1.08, p = 0.570), MBL (MD = − 0.13, 95% CI − 0.32 to 0.07, p = 0.190) and complication rate (intra-surgical complication: RR = 1.14, 95% CI 0.46–2.83, p = 0.770; post-operative complication: RR = 1.34, 95% CI 0.71–2.55, p = 0.370). Conclusions Using short implants (≤ 8 mm) combined with OSFE might be an alternative to standard implants (≥ 10 mm) with SFE when the RBH of the posterior maxilla is insufficient. Based on a short-term clinical observation, short implants with OSFE show good results in terms of survival rate, MBL, and complication incidence. Graphical Abstract ![]()
Collapse
Affiliation(s)
- Chenxi Tang
- State Key Laboratory of Oral Diseases, Department of Implantology, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, China
| | - Qianhui Du
- State Key Laboratory of Oral Diseases, Department of Implantology, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, China
| | - Jiaying Luo
- State Key Laboratory of Oral Diseases, Department of Implantology, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, China
| | - Lin Peng
- State Key Laboratory of Oral Diseases, Department of Implantology, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, China.
| |
Collapse
|
5
|
Kang N, Liu C. Modified Osteotome Sinus Floor Elevation Technique for Multiple Edentulous Spaces: A Non-Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138019. [PMID: 35805687 PMCID: PMC9265290 DOI: 10.3390/ijerph19138019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 06/20/2022] [Accepted: 06/22/2022] [Indexed: 11/16/2022]
Abstract
Objectives: We aimed to demonstrate our modified osteotome sinus floor elevation (OSFE) technique for placing two implants in multiple maxillary posterior edentulous spaces with residual bone height (RBH) < 5 mm, to evaluate the clinical effect and explore the prognosis. Methods: We identified 18 appropriate patients with RBH < 5 mm and 12 patients with RBH ≥ 5 mm. After drill preparation, variously shaped curettes were applied to adequately release the tension of the membrane around the cavity and between two implants by blunt dissection. Then, an osteotome was used to elevate the membrane to the desired height. After filling bone graft into the elevated space, dental implants were inserted. Cone-Beam Computed Tomography (CBCT) was performed after surgery and 6 months later. Results: The implant survival rate was 100%, and after the 6-month resorption, the height of the graft apically between the two implants gradually stabilized at 8.92 mm. Compared with 12 patients with RBH ≥ 5 mm, their graft bone resorption demonstrated no significant difference. Conclusions: It can be suggested that the modified OSFE technique could yield predictable clinical results for placing adjacent implants in patients with RBH less than 5 mm after six months of follow-up. Clinical Significance: Our modified OSFE technique could be applied to place adjacent implants in patients with RBH less than 5 mm, especially for elderly patients or patients with bone crests and vessels on the lateral wall, owing to its advantages including less trauma and fewer complications, minimizing the risk of membrane perforation, shortening the treatment period, avoiding another surgery area or second-stage surgery, improving not only the bone around the implant apex but also between implants, etc.
Collapse
Affiliation(s)
- Ning Kang
- Department of Dental Implant, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- College of Biomedical Engineering, Sichuan University, Chengdu 610041, China
- Correspondence:
| | - Caojie Liu
- Department of Dental Implant, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| |
Collapse
|
6
|
Zheng X, Huang L, Huang S, Mo A, Zhu J. Influence of anatomical factors related to maxillary sinus on outcomes of transcrestal sinus floor elevation. J Dent Sci 2022; 17:438-443. [PMID: 35028068 PMCID: PMC8740080 DOI: 10.1016/j.jds.2021.07.023] [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: 06/11/2021] [Revised: 07/12/2021] [Indexed: 02/08/2023] Open
Abstract
Background/purpose Graft bone maturation and remodeling in the maxillary sinus require adequate angiogenesis and osteoprogenitor cells migration from the surrounding bony walls and Schneiderian membrane. This study aimed to evaluate the influence of anatomical factors related to maxillary sinus on the outcomes of transcrestal sinus floor elevation using cone-beam computed tomography (CBCT). Materials and methods Forty-five patients (63 elevated sites) were included in this study. CBCT were obtained preoperatively, immediately and 6 months after surgery. The anatomical features of residual bone height, maxillary sinus width, maxillary sinus angle and Schneiderian membrane thickness were measured on preoperative CBCT. Descriptive statistics and correlation analysis were conducted to evaluate the influence of anatomical factors on outcome parameters, including sinus lift height, graft bone resorption and marginal bone loss. Results The results showed that there was a positive correlation between sinus width and graft bone resorption. A significantly positive correlation between sinus angle and graft bone resorption was also found. Conclusion Our findings indicate that the anatomical factors of maxillary sinus (sinus width and sinus angle) have influence on the linear change of bone grafts after transcrestal sinus floor elevation.
Collapse
Affiliation(s)
- Xiaofei Zheng
- Stomatology Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Lirong Huang
- State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, China.,Dental Implant Center, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Si Huang
- State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, China.,Dental Implant Center, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Anchun Mo
- State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, China.,Dental Implant Center, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Juanfang Zhu
- Stomatology Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| |
Collapse
|
7
|
Carelli S, Passaretti A, Petroni G, Zanza A, Testarelli L, Cicconetti A. Five Years Follow-up of Short Implants Placed in Atrophic Maxilla with Simultaneous Sinus Floor Transcrestal Elevation. Acta Stomatol Croat 2021; 55:177-185. [PMID: 34248151 PMCID: PMC8255046 DOI: 10.15644/asc55/2/7] [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: 03/26/2021] [Accepted: 05/17/2021] [Indexed: 10/31/2022] Open
Abstract
Objective Many authors have tried to face the anatomical limitations resulting from maxillary bone atrophy. Up to five millimeters bone height, the lateral sinus floor elevation is the most commonly used and validated strategy to achieve the prosthetic rehabilitation. However, the disadvantages of this technique are its invasiveness and delayed rehabilitation. The aim of this paper was to assess 5 years clinical outcome of implants placed with a technique that allows the percrestal sinus floor elevation and the immediate implant placement. Materials and Methods 30 transcrestal sinus floor elevations with immediate implant placement were performed in severely atrophic maxillae. Implant survival, marginal bone level variation, harvested bone height variation and periodontal indices were assessed. Results After a five year follow up none of the thirty implants were lost. The mean value of vertical harvested bone loss was 5%. The mean crestal bone loss was -0.33 mm (Standard Deviation (SD) 0.11 mm). The mean value of periodontal indices was respectively: PD 1.22 mm (SD 0.72 mm), PI 17.47% (SD 15.01 mm), BOP 9, 87%.,(SD 19.17 mm). Conclusion The results obtained are comparable with success criteria in implant rehabilitation. The reported technique proved to be successful in the population observed, with minimal trauma and reduced invasiveness.
Collapse
Affiliation(s)
| | | | - Giulia Petroni
- Department of Oral and Maxillo-Facial Sciences, "Sapienza" University of Rome, Italy
| | - Alessio Zanza
- Department of Oral and Maxillo-Facial Sciences, "Sapienza" University of Rome, Italy
| | - Luca Testarelli
- Department of Oral and Maxillo-Facial Sciences, "Sapienza" University of Rome, Italy
| | - Andrea Cicconetti
- Department of Oral and Maxillo-Facial Sciences, "Sapienza" University of Rome, Italy
| |
Collapse
|
8
|
Farina R, Simonelli A, Franceschetti G, Travaglini D, Consolo U, Minenna L, Schincaglia GP, Riccardi O, Bandieri A, Trombelli L. Implant-supported rehabilitation following transcrestal and lateral sinus floor elevation: analysis of costs and quality of life from a bi-center, parallel-arm randomized trial. Minerva Dent Oral Sci 2021; 71:16-24. [PMID: 33988332 DOI: 10.23736/s2724-6329.21.04539-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
AIM to comparatively evaluate costs and specific aspects of oral-health related quality of life (OhRQoL) related to the period between the surgery phase of transcrestal and lateral sinus floor elevation (tSFE and lSFE, respectively) and 6 months after delivery of implant-supported prosthesis. METHODS A bi-center, parallel-arm, randomized trial comparatively evaluating tSFE and lSFE when applied concomitantly with implant placement was conducted. At 6 months after prosthesis delivery, data on cost-associated items related to the post-surgery period and selected aspects of OhRQoL were collected. RESULTS Analyses of costs and quality of life was conducted on 56 patients (tSFE: 28; lSFE: 28) and 54 patients (tSFE: 26; lSFE: 28), respectively. Significantly lower dose of anesthetic (2 vs 3 vials), amount of xenograft (420 mg vs 1975 mg), and duration of surgery (54' vs 86') were observed for tSFE compared to lSFE. No significant differences in the number of additional surgical sessions, postoperative exams, specialist consultations and drug consumption were found between groups. In a limited fraction of patients in both groups, improvements were observed for pain (tSFE: 3.8%; lSFE: 7.4%), comfort in eating any food (tSFE: 11.5%; lSFE: 3.6%), self-consciousness (tSFE: 19.2%; lSFE: 14.3%), and satisfaction about life (tSFE: 19.2%; lSFE: 10.7%). CONCLUSIONS The surgery phase of maxillary sinus floor elevation is characterized by more favorable cost-associated items for tSFE compared to lSFE. Differently, tSFE and lSFE do not differ for either costs related to the post-surgery phases or impact of the implant-supported rehabilitation on specific aspects of OhRQoL.
Collapse
Affiliation(s)
- Roberto Farina
- Operative Unit of Dentistry, University-Hospital of Ferrara, Ferrara, Italy - .,Research Centre for the Study of Periodontal and Peri-implant Diseases, University of Ferrara, Ferrara, Italy -
| | - Anna Simonelli
- Research Centre for the Study of Periodontal and Peri-implant Diseases, University of Ferrara, Ferrara, Italy
| | | | - Domenico Travaglini
- Operative Unit of Dentistry and Maxillofacial Surgery, Department Integrated Activity - Specialist Surgeries, University-Hospital of Modena, Modena, Italy.,Department of Specialistic Surgeries Head-Neck, University of Modena and Reggio Emilia, Modena, Italy
| | - Ugo Consolo
- Operative Unit of Dentistry and Maxillofacial Surgery, Department Integrated Activity - Specialist Surgeries, University-Hospital of Modena, Modena, Italy.,Department of Specialistic Surgeries Head-Neck, University of Modena and Reggio Emilia, Modena, Italy
| | - Luigi Minenna
- Research Centre for the Study of Periodontal and Peri-implant Diseases, University of Ferrara, Ferrara, Italy
| | - Gian Pietro Schincaglia
- Research Centre for the Study of Periodontal and Peri-implant Diseases, University of Ferrara, Ferrara, Italy.,Department of Periodontics, School of Dentistry, West Virginia University, Morgantown WV, USA
| | - Orio Riccardi
- Research Centre for the Study of Periodontal and Peri-implant Diseases, University of Ferrara, Ferrara, Italy.,Private practice Torre Pedrera, Rimini, Italy
| | - Alberto Bandieri
- Operative Unit of Dentistry and Maxillofacial Surgery, Department Integrated Activity - Specialist Surgeries, University-Hospital of Modena, Modena, Italy.,Department of Specialistic Surgeries Head-Neck, University of Modena and Reggio Emilia, Modena, Italy
| | - Leonardo Trombelli
- Operative Unit of Dentistry, University-Hospital of Ferrara, Ferrara, Italy.,Research Centre for the Study of Periodontal and Peri-implant Diseases, University of Ferrara, Ferrara, Italy
| |
Collapse
|
9
|
Single-Crown, Short and Ultra-Short Implants, in Association with Simultaneous Internal Sinus Lift in the Atrophic Posterior Maxilla: A Three-Year Retrospective Study. MATERIALS 2020; 13:ma13092208. [PMID: 32403457 PMCID: PMC7254405 DOI: 10.3390/ma13092208] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 04/27/2020] [Accepted: 05/08/2020] [Indexed: 02/07/2023]
Abstract
As the atrophic posterior maxilla often presents serious limitations for dental implant procedures, a minimally invasive technique was proposed. The study aimed to retrospectively evaluate the outcomes of short and ultra-short locking-taper implants, placed in combination with a modified osteotome sinus floor elevation procedure (internal sinus lift technique) in the posterior maxilla. A total of 31 patients received 51 locking-taper implants. Clinical and radiographic examinations were performed before treatment, at loading time, and after three years. Seven implants of 8.0 mm, 23 implants of 6.0 mm, and 21 implants 5.0 mm in length were rehabilitated with single-crown restorations. Implant survival at three-year follow-up was 96.08%. Pre-operative residual crestal bone height of 5.2 (1.41) (median (interquartile range)) mm increased to 7.59 (1.97) mm at the 36-month follow-up, with an average intra-sinus bone height gain of 3.17 ± 1.13 (mean ± standard deviation) mm. Mean peri-implant crestal bone loss was 0.29 (0.46) mm and mean first bone-to-implant contact point shifted apically to 0.12 (0.34) mm. It can be suggested with confidence that implants used in the study, placed in conjunction with an internal sinus floor elevation technique, can be restored with single crowns as a predictable treatment for the edentulous regions of the posterior maxilla.
Collapse
|
10
|
Franceschetti G, Farina R, Minenna L, Riccardi O, Stacchi C, Di Raimondo R, Maietti E, Trombelli L. The impact of graft remodeling on peri-implant bone support at implants placed concomitantly with transcrestal sinus floor elevation: A multicenter, retrospective case series. Clin Oral Implants Res 2019; 31:105-120. [PMID: 31532857 DOI: 10.1111/clr.13541] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 08/08/2019] [Accepted: 09/03/2019] [Indexed: 12/16/2022]
Abstract
OBJECTIVES To evaluate the impact on peri-implant bone support (as assessed on periapical radiographs) of the remodeling dynamics of varying graft biomaterials used for transcrestal sinus floor elevation (tSFE). METHODS The study is a multicenter, retrospective series of cases undergone tSFE (performed according to the Smart Lift technique) and concomitant implant placement. At operator's discretion, tSFE was performed with bone core (BC) alone or supplemented by deproteinized bovine or porcine bone mineral (DBBM and DPBM, respectively), synthetic hydroxyapatite in a collagen matrix (S-HA), or ß-tricalcium phosphate (ß-TCP). Immediately after surgery, at 6-12 months post-surgery, and at later (≥24 months) follow-up intervals, the percentage proportion of the implant surface in direct contact with the radiopaque area was calculated for the entire implant surface (totCON%). Also, the height of the graft apical to the implant apex (aGH) was assessed. RESULTS At 6-12 months following tSFE, median totCON% was 100%, with a median aGH of 1.4 mm. A tendency of aGH to decrease in height was observed at later follow-up intervals for sites treated with all grafting procedures. In all treatment groups, the majority of the implant surface was still surrounded by the radiopaque area at the longest follow-up visits. CONCLUSIONS Although the height of the peri-implant radiopaque area apical to the implant apex tends to reduce overtime at sites which have received tSFE, the peri-implant bone support seems to be maintained long term irrespective of the graft material used.
Collapse
Affiliation(s)
- Giovanni Franceschetti
- Research Centre for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Ferrara, Italy
| | - Roberto Farina
- Research Centre for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Ferrara, Italy.,Operative Unit of Dentistry, University-Hospital of Ferrara, Ferrara, Italy
| | - Luigi Minenna
- Research Centre for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Ferrara, Italy
| | - Orio Riccardi
- Research Centre for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Ferrara, Italy.,Private practice, Rimini, Italy
| | | | | | - Elisa Maietti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy.,Center of Clinical Epidemiology, University of Ferrara, Italy
| | - Leonardo Trombelli
- Research Centre for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Ferrara, Italy.,Operative Unit of Dentistry, University-Hospital of Ferrara, Ferrara, Italy
| |
Collapse
|
11
|
Jin HY, Teng MH, Wang D, Li X, Liang JY, Wang WX, Jiang S, Zhao BD. Modified Disk-Up Sinus Reamer for Sinus Floor Elevation and Simultaneous Implant Placement: An Animal Study with Miniature Pigs. J INVEST SURG 2019; 33:520-529. [PMID: 30644766 DOI: 10.1080/08941939.2018.1545881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objective: The disk-up sinus reamer (DSR) is a modified instrument used to elevate the maxillary sinus floor. This study aimed to compare the effects of modified DSR sinus floor elevation (DSFE) with osteotome sinus floor elevation (OSFE), both with simultaneous implant placement. Methods: Twelve miniature pigs were treated with DSFE on one side and OSFE on the other. Implants 9 mm in length were placed in six pigs without grafting, while implants 11 mm in length were placed in the other six pigs with grafting. After submerged healing for 3 months, vertical bone gain (VBG), general and histological observation, and bone contact ratio (BCR) were analyzed. Results: The mean maxillary residual bone height (RBH) when implants were placed was 6.45 ± 0.36 mm. In the no-grafting group, DSFE and OSFE had a similar VBG after 3 months. The grafting group with DSFE recorded a significantly higher VBG (VBG0: 7.83 ± 0.44 mm, VBG1: 7.54 ± 0.40 mm) than the graft group with OSFE (VBG0: 5.45 ± 0.56 mm, VBG1: 4.34 ± 2.15 mm) (p < 0.05). One implant became loose and the sinus mucosa of three pigs appeared metallic in color on the control side (OSFE). Conclusions: The effect of OSFE and DSFE is similar when there is no need for grafting. DSFE seems a better alternative method for sinus floor elevation with grafting when more VBG is needed.
Collapse
Affiliation(s)
- Hang-Ying Jin
- Affiliated Hospital of Qingdao University, College of Stomatology, Qingdao University, Qingdao, China
| | - Min-Hua Teng
- Affiliated Hospital of Qingdao University, Qingdao, China
| | - Duode Wang
- Qingdao Jimo People's hospital, Jimo, China
| | - Xin Li
- Affiliated Hospital of Qingdao University, Qingdao, China
| | - Jia-Yue Liang
- Affiliated Hospital of Qingdao University, College of Stomatology, Qingdao University, Qingdao, China
| | - Wen-Xue Wang
- Affiliated Hospital of Qingdao University, College of Stomatology, Qingdao University, Qingdao, China
| | - Shuai Jiang
- Affiliated Hospital of Qingdao University, College of Stomatology, Qingdao University, Qingdao, China
| | - Bao-Dong Zhao
- Affiliated Hospital of Qingdao University, College of Stomatology, Qingdao University, Qingdao, China
| |
Collapse
|
12
|
Abstract
The craniofacial complex is composed of fundamental components such as blood vessels and nerves, and also a variety of specialized tissues such as craniofacial bones, cartilages, muscles, ligaments, and the highly specialized and unique organs, the teeth. Together, these structures provide many functions including speech, mastication, and aesthetics of the craniofacial complex. Craniofacial defects not only influence the structure and function of the jaws and face, but may also result in deleterious psychosocial issues, emphasizing the need for rapid and effective, precise, and aesthetic reconstruction of craniofacial tissues. In a broad sense, craniofacial tissue reconstructions share many of the same issues as noncraniofacial tissue reconstructions. Therefore, many concepts and therapies for general tissue engineering can and have been used for craniofacial tissue regeneration. Still, repair of craniofacial defects presents unique challenges, mainly because of their complex and unique 3D geometry.
Collapse
Affiliation(s)
- Weibo Zhang
- Department of Orthodontics, School of Medicine, School of Engineering, Tufts University, Boston, Massachusetts 02111
| | - Pamela Crotty Yelick
- Department of Orthodontics, School of Medicine, School of Engineering, Tufts University, Boston, Massachusetts 02111
| |
Collapse
|
13
|
Dong Y, Liu W, Lei Y, Wu T, Zhang S, Guo Y, Liu Y, Chen D, Yuan Q, Wang Y. Effect of gelatin sponge with colloid silver on bone healing in infected cranial defects. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2016; 70:371-377. [PMID: 27770905 DOI: 10.1016/j.msec.2016.09.015] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 08/17/2016] [Accepted: 09/06/2016] [Indexed: 02/05/2023]
Abstract
Oral infectious diseases may lead to bone loss, which makes it difficult to achieve satisfactory restoration. The rise of multidrug resistant bacteria has put forward severe challenges to the use of antibiotics. Silver (Ag) has long been known as a strong antibacterial agent. In clinic, gelatin sponge with colloid silver is used to reduce tooth extraction complication. To investigate how this material affect infected bone defects, methicillin-resistant Staphylococcus aureus (MRSA) infected 3-mm-diameter cranial defects were created in adult female Sprague-Dawley rats. One week after infection, the defects were debrided of all nonviable tissue and then implanted with gelatin sponge with colloid silver (gelatin/Ag group) or gelatin alone (gelatin group). At 2 and 3days after debridement, significantly lower mRNA expression levels of IL-6 and TNF-α and lower plate colony count value were detected in gelatin/Ag group than control. Micro-CT analysis showed a significant increase of newly formed bone volume fraction (BV/TV) in gelatin/Ag treated defects. The HE stained cranium sections also showed a faster rate of defect closure in gelatin/Ag group than control. These findings demonstrated that gelatin sponge with colloid silver can effectively reduce the infection caused by MRSA in cranial defects and accelerate bone healing process.
Collapse
Affiliation(s)
- Yuliang Dong
- State Key Laboratory of Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Weiqing Liu
- State Key Laboratory of Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Yiling Lei
- Dental Implant Center, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Tingxi Wu
- Division of Oral Biology and Medicine, School of Dentistry, University of California Los Angeles (UCLA), Los Angeles, California, USA
| | - Shiwen Zhang
- State Key Laboratory of Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Yuchen Guo
- State Key Laboratory of Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Yuan Liu
- State Key Laboratory of Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Demeng Chen
- Division of Oral Biology and Medicine, School of Dentistry, University of California Los Angeles (UCLA), Los Angeles, California, USA
| | - Quan Yuan
- State Key Laboratory of Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, China; Dental Implant Center, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yongyue Wang
- State Key Laboratory of Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, China; Dental Implant Center, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
| |
Collapse
|
14
|
Inlay osteotome sinus floor elevation with concentrated growth factor application and simultaneous short implant placement in severely atrophic maxilla. Sci Rep 2016; 6:27348. [PMID: 27250556 PMCID: PMC4890302 DOI: 10.1038/srep27348] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2016] [Accepted: 05/17/2016] [Indexed: 11/08/2022] Open
Abstract
Sinus floor elevation with simultaneous implant placement in severely atrophic maxilla is challenging. The aim of this retrospective study was to evaluate the short-term performance of modified osteotome sinus floor elevation (OSFE) with concentrated growth factor (CGF) application and concurrent placement of a short implant in cases with residual bone height (RBH) of 2-4 mm. Twenty-five short implants were installed in 16 patients with mean RBH of 3.23 mm using modified OSFE with CGFs from January 2012 to April 2014. Postoperatively, the implants were clinically evaluated, and vertical bone gain (VBG) was measured using cone beam computed tomography. The mean duration of follow-up was 19.88 months (12-32 months). All the implants were stable with an overall survival rate of 100%. The mean VBG immediately after surgery was 9.21 mm. Six months later, significant reduction of alveolar bone height (2.90 ± 0.22 mm) was found (P < 0.05). During the second 6-month period, further alveolar bone resorption (0.14 ± 0.11 mm) was noted but without significance (P > 0.05). Within the limits of this study, modified OSFE with CGF application and simultaneous short implant placement could yield predictable clinical results for severely atrophic maxilla with RBH of 2-4 mm.
Collapse
|
15
|
Sinus floor elevation with a crestal approach using a press-fit bone block: a case series. Int J Oral Maxillofac Surg 2015; 44:1152-9. [DOI: 10.1016/j.ijom.2015.01.028] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2013] [Revised: 01/26/2015] [Accepted: 01/28/2015] [Indexed: 11/22/2022]
|
16
|
Paradigm shift in the management of the atrophic posterior maxilla. Case Rep Dent 2014; 2014:486949. [PMID: 25431689 PMCID: PMC4241701 DOI: 10.1155/2014/486949] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Accepted: 10/18/2014] [Indexed: 11/23/2022] Open
Abstract
When the posterior maxilla is atrophic, the reference standard of care would be to perform sinus augmentation with an autologous bone graft through the lateral approach and delayed implant placement. However, placement of short implants with the osteotome sinus floor elevation technique and without graft can be proposed for an efficient treatment of clinical cases with a maxillary residual bone height of 4 to 8 mm. The use of grafting material is recommended only when the residual bone height is ≤4 mm. Indications of the lateral sinus floor elevation are limited to cases with a residual bone height ≤ 2 mm and fused corticals, uncompleted healing of the edentulous site, and absence of flat cortical bone crest or when the patient wishes to wear a removable prosthesis during the healing period. The presented case report illustrates osteotome sinus floor elevation with and without grafting and simultaneous implant placement in extreme conditions: atrophic maxilla, short implant placement, reduced healing time, and single crown rehabilitation. After 6 years, all placed implants were functional with an endosinus bone gain.
Collapse
|
17
|
Teng M, Cheng Q, Liao J, Zhang X, Mo A, Liang X. Sinus Width Analysis and New Classification with Clinical Implications for Augmentation. Clin Implant Dent Relat Res 2014; 18:89-96. [PMID: 25041134 DOI: 10.1111/cid.12247] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
PURPOSE To measure the distances between the medial and lateral sinus wall (sinus width [SW]) at different levels on cone beam computed tomography (CBCT) and apply those SW values to formulate a new sinus classification. MATERIALS AND METHODS Edentulous sites adjacent to maxillary sinuses with inadequate residual bone height (RBH) were included from the CBCT database. SW was measured at the heights of 1, 3, 5, 7, and 9 mm from the sinus floor. Mean SW was stratified into different groups by RBH, study sites (first and second premolars and molars), and measurement levels. Statistical analyses were conducted with commercially available software (IBM SPSS Statistics 19, SPSS Inc., Chicago, IL, USA). RESULTS A total 186 patients (mean age 50.4 years) with 267 edentulous sites were included. Mean SW was wider at molar sites, higher measurement levels, and sites with less RBH. Narrow, average, or wide sinuses were classified based on the 33rd and 67th percentile SW values at 1-, 5-, and 9-mm measurement levels, respectively. CONCLUSIONS SW at different levels relating to sinus floor elevation was measured. The proposed classification could contribute to estimate the difficulty of sinus augmentation, useful for the selection of surgical approaches. Further studies are required to testify its clinical implications.
Collapse
Affiliation(s)
- Minhua Teng
- State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, Sichuan, China.,Department of Oral Implantology, National Clinical Key Specialty, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Qian Cheng
- Department of Orthodontics, Hospital of Stomatology, Luzhou Medical College, Luzhou, Sichuan, China.,Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Luzhou Medical College, Luzhou, Sichuan, China
| | - Jian Liao
- Department of Prosthodontics, Affiliated Hospital of GuiYang Medical University, Guiyang, Guizhou, China
| | - Xuan Zhang
- Department of Science and Education, AVIC 363 Hospital, Chengdu, Sichuan, China
| | - Anchun Mo
- Department of Oral Implantology, National Clinical Kay Specialty, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Xing Liang
- Department of Prothodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| |
Collapse
|