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Blanco J, García Alonso A, Hermida-Nogueira L, Castro AB. How to explain the beneficial effects of leukocyte- and platelet-rich fibrin. Periodontol 2000 2024. [PMID: 38923566 DOI: 10.1111/prd.12570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 03/06/2024] [Accepted: 04/15/2024] [Indexed: 06/28/2024]
Abstract
The survival of an organism relies on its ability to repair the damage caused by trauma, toxic agents, and inflammation. This process involving cell proliferation and differentiation is driven by several growth factors and is critically dependent on the organization of the extracellular matrix. Since autologous platelet concentrates (APCs) are fibrin matrices in which cells, growth factors, and cytokines are trapped and delivered over time, they are able to influence that response at different levels. The present review thoroughly describes the molecular components present in one of these APCs, leukocyte- and platelet-rich fibrin (L-PRF), and summarizes the level of evidence regarding the influence of L-PRF on anti-inflammatory reactions, analgesia, hemostasis, antimicrobial capacity, and its biological mechanisms on bone/soft tissue regeneration.
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Affiliation(s)
- Juan Blanco
- Department of Surgery (Stomatology, Unit of Periodontology), Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Angel García Alonso
- Platelet Proteomics Group, Center for Research in Molecular Medicine and Chronic Diseases (CIMUS), Santiago de Compostela University, Santiago de Compostela, Spain
| | - Lidia Hermida-Nogueira
- Platelet Proteomics Group, Center for Research in Molecular Medicine and Chronic Diseases (CIMUS), Santiago de Compostela University, Santiago de Compostela, Spain
| | - Ana B Castro
- Department of Oral Health Sciences, Section of Periodontology, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
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Park WB, Shin J, Shin S, Hong JY. A Clinical Approach for the Removal of a Large Antral Pseudocyst with Simultaneous Maxillary Sinus Augmentation: A Case Series. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:838. [PMID: 38793021 PMCID: PMC11122721 DOI: 10.3390/medicina60050838] [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: 04/19/2024] [Revised: 05/14/2024] [Accepted: 05/17/2024] [Indexed: 05/26/2024]
Abstract
For a large benign lesion within the maxillary sinus, such as an antral pseudocyst, maxillary sinus floor augmentation is more commonly performed using a two-stage approach. This involves first removing the lesion, and then, re-entry following several months of healing. In this case series, we described the "one-bony-window" approach, which is a technical surgical modification of the previous one-stage approach, for simultaneous cyst removal and maxillary sinus floor augmentation. Four patients with large maxillary antral pseudocysts were included. The "one-bony-window" approach involves the preparation of a large window opening of approximately 15 mm × 20 mm at the lateral wall. A mesiodistally extended intentional perforation was made in the upper part of the exposed membrane to enhance the access for instrumentation. The antral pseudocyst was removed in its entirety without being deformed to prevent rupture or leakage of the cystic contents. Subsequent detachment and elevation of the Schneiderian membrane at the sinus floor significantly reduced the perforation site, and bone grafting with implant placement was performed simultaneously. This alleviated the need to surgically repair the perforation. The lateral opening was either uncovered or repositioned using bony window lids. Healing abutments were connected after six months, and the final prosthesis was placed after two months. At the 1-year follow-up, the antral pseudocysts had resolved with no specific recurrence, and the stability of the augmented sinus was maintained with excellent implant survival. Within the limitations of our findings, the "one-bony-window" technique can be suggested for the simultaneous removal of large antral pseudocysts and maxillary sinus floor augmentation with favorable clinical outcomes.
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Affiliation(s)
- Won-Bae Park
- Private Practice in Periodontics and Implant Dentistry, Seoul 02771, Republic of Korea;
| | - Jina Shin
- Department of Dentistry, Graduate School, Kyung Hee University, Seoul 02447, Republic of Korea;
| | - Seungil Shin
- Department of Periodontology, College of Dentistry, Kyung Hee University Dental Hospital, Kyung Hee University, Seoul 02447, Republic of Korea;
| | - Ji-Youn Hong
- Department of Periodontology, College of Dentistry, Kyung Hee University Dental Hospital, Kyung Hee University, Seoul 02447, Republic of Korea;
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Altay B, Çoban E, Yurttaş M, Arık Ö, Türkoğlu A. Dental patients' tinnitus profile: prevalence, types, and associated factors with oral and maxillofacial diseases. Acta Odontol Scand 2024; 83:210-218. [PMID: 38682700 DOI: 10.2340/aos.v83.40572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 03/29/2024] [Indexed: 05/01/2024]
Abstract
INTRODUCTION Maxillofacial diseases may pose a risk factor for the onset of tinnitus, and may influence the severity of its symptoms. The objective of this study was to investigate the prevalence of tinnitus among patients routinely visiting the Faculty of Dentistry and to assess the relationship between tinnitus and maxillofacial diseases. MATERIALS AND METHODS This was a prospective cross-sectional study conducted on 3,626 patients. Demographic data, information on tinnitus symptoms, temporomandibular disorder (TMD) presence, the existence of trigger points in masticatory muscles, toothache, and bruxism were evaluated. RESULTS Tinnitus was detected in 385 patients, resulting in a prevalence rate of 10.61%. Of the patients, 38.4% were male and 61.6% were female, and the mean age was 42.66 ± 16.34 years. Tinnitus was categorised as normal in 47.8% of the patients and pathological in 52.2% of the patients. Bruxism was identified in 65.5% of the patients, toothache in 42.9%, TMD in 33.8%, and masticatory trigger points in 27.0% of the patients. A tendency towards tinnitus provoked by toothache was observed in 5.9% of the patients. The presence of pathological tinnitus was found to increase the risk by 1.839 times for toothache and 1.456 times for bruxism. CONCLUSION There may be an association between oral and maxillofacial diseases and tinnitus, especially bruxism and toothache. Therefore, the evaluation of these conditions may be a routine part of tinnitus management.
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Affiliation(s)
- Berkan Altay
- Department of Oral and Maxillofacial Surgery, Kırıkkale University, Kırıkkale, Turkey
| | - Elif Çoban
- Department of Oral and Maxillofacial Surgery, Kırıkkale University, Kırıkkale, Turkey.
| | - Melike Yurttaş
- Department of Oral and Maxillofacial Radiology, Kütahya Health Sciences University, Kütahya, Turkey
| | - Özlem Arık
- Department of Biostatistics, Kütahya Health Sciences University, Kütahya, Turkey
| | - Arif Türkoğlu
- Department of Oral and Maxillofacial Radiology, Kütahya Health Sciences University, Kütahya, Turkey
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Mureşan AN, Dandoczi CA, Tudose RC, Hostiuc S, Rusu MC. Anatomical Possibilities of the Alveolar Bone at the Upper Second Premolar Level. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:726. [PMID: 38792909 PMCID: PMC11123058 DOI: 10.3390/medicina60050726] [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: 04/04/2024] [Revised: 04/24/2024] [Accepted: 04/26/2024] [Indexed: 05/26/2024]
Abstract
Background and Objectives: The upper posterior teeth are typically regarded as being exclusively inferior to the maxillary sinus (MS). The expansion of the nasal fossa above the maxillary alveolar base (MAB) needs better investigation. The hypothesis was raised that the MAB in the upper premolar region, which is usually addressed by surgeons for the elevation of the antral floor, is not exclusively beneath the MS. Therefore, we aimed to document the possible upper relations of the MAB as antral, nasal, or both. Materials and Methods: A total of 145 CBCT scans were used to study four types of MAB: type 1-antral; type 2-antral with a palatal recess; type 3-antral and nasal; type 4-nasal. In type 2, the orthoradial width of the alveolar bone, the rectilinear width of the antral floor, and the maximum depth of the palatal recess were measured. For type 3, the MAB width and the straight widths of the antral and nasal segments of the MAB were measured. Results: Type 1 was found in 67.24%, type 2 in 13.45%, type 3 in 16.21%, and type 4 in 3.1% of the 290 MSs investigated. Palatal recesses were found in 11.72% of the MSs on the right side and 15.17% of the MSs on the left side. Types 1 and 2 exhibited strongly statistically significant bilateral symmetry (Pearson's Chi2 = 86.42, p < 0.001). Type 3 correlated equally with contralateral types 1 and 3. The bilateral symmetry for types 1-3 was stronger in the males (Pearson's Chi2 = 47.83, p < 0.001) than in the females (Pearson's Chi2 = 56.96, p < 0.001). There were no statistically significant associations between sex and the unilateral anatomical type. Conclusions: The MAB in the upper second premolar area should not be considered to be exclusively antral during surgeries or in anatomical teaching.
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Affiliation(s)
- Alexandru Nicolae Mureşan
- Division of Anatomy, Department 1, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, RO-020021 Bucharest, Romania (R.C.T.)
- Research Department, “Dr. Carol Davila” Central Military Emergency Hospital, RO-010825 Bucharest, Romania
| | - Carol Antonio Dandoczi
- Division of Anatomy, Department 1, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, RO-020021 Bucharest, Romania (R.C.T.)
| | - Răzvan Costin Tudose
- Division of Anatomy, Department 1, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, RO-020021 Bucharest, Romania (R.C.T.)
| | - Sorin Hostiuc
- Division of Legal Medicine and Bioethics, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, RO-020021 Bucharest, Romania
| | - Mugurel Constantin Rusu
- Division of Anatomy, Department 1, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, RO-020021 Bucharest, Romania (R.C.T.)
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Deng Y, Ma R, He Y, Yu S, Cao S, Gao K, Dou Y, Ma P. Biomechanical analysis of the maxillary sinus floor membrane during internal sinus floor elevation with implants at different angles of the maxillary sinus angles. Int J Implant Dent 2024; 10:11. [PMID: 38472687 DOI: 10.1186/s40729-024-00530-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 03/05/2024] [Indexed: 03/14/2024] Open
Abstract
OBJECTIVE This study analyzed and compared the biomechanical properties of maxillary sinus floor mucosa with implants at three different maxillary sinus angles during a modified internal sinus floor elevation procedure. METHODS 3D reconstruction of the implant, maxillary sinus bone, and membrane were performed. The maxillary sinus model was set at three different angles. Two internal maxillary sinus elevation models were established, and finite element analysis was used to simulate the modified maxillary sinus elevation process. The implant was elevated to 10 mm at three maxillary sinus angles when the maxillary sinus floor membrane was separated by 0 and 4 mm. The stress of the maxillary sinus floor membrane was analyzed and compared. RESULTS When the maxillary sinus floor membrane was separated by 0 mm and elevated to 10 mm, the peak stress values of the implant on the maxillary sinus floor membrane at three different angles were as follows: maxillary sinus I: 5.14-78.32 MPa; maxillary sinus II: 2.81-73.89 MPa; and maxillary sinus III: 2.82-51.87 MPa. When the maxillary sinus floor membrane was separated by 4 mm and elevated to 10 mm, the corresponding values were as follows: maxillary sinus I: 0.50-7.25 MPa; maxillary sinus II: 0.81-16.55 MPa; and maxillary sinus III: 0.49-22.74 MPa. CONCLUSION The risk of sinus floor membrane rupture is greatly reduced after adequate dissection of the maxillary sinus floor membrane when performing modified internal sinus elevation in a narrow maxillary sinus. In a wide maxillary sinus, the risk of rupture or perforation of the wider maxillary sinus floor is reduced, regardless of whether traditional or modified internal sinus elevation is performed at the same height.
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Affiliation(s)
- Yinxin Deng
- Dental Implant Center, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, 4 Tiantan Xili, Beijing, Dongcheng District, 100050, China
- Department of Stomatology, Beijing Hospital of Integrated Traditional Chinese and Western Medicine, No. 3 Yongding Road East Street, Beijing, HaiDian District, 100039, China
| | - Ruihong Ma
- Dental Implant Center, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, 4 Tiantan Xili, Beijing, Dongcheng District, 100050, China
| | - Yilin He
- Dental Implant Center, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, 4 Tiantan Xili, Beijing, Dongcheng District, 100050, China
| | - Shujia Yu
- Dental Implant Center, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, 4 Tiantan Xili, Beijing, Dongcheng District, 100050, China
| | - Shiyu Cao
- Dental Implant Center, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, 4 Tiantan Xili, Beijing, Dongcheng District, 100050, China
| | - Kang Gao
- Dental Implant Center, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, 4 Tiantan Xili, Beijing, Dongcheng District, 100050, China
| | - Yiping Dou
- Dental Implant Center, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, 4 Tiantan Xili, Beijing, Dongcheng District, 100050, China
| | - Pan Ma
- Dental Implant Center, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, 4 Tiantan Xili, Beijing, Dongcheng District, 100050, China.
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Park WB, Bae MS, Park W, Lim HC, Han JY. A Novel Approach for the Treatment of Recurrent Oroantral Fistula Occurring at an Infected Sinus Augmentation Site. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:343. [PMID: 38399630 PMCID: PMC10890197 DOI: 10.3390/medicina60020343] [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: 01/17/2024] [Revised: 02/08/2024] [Accepted: 02/17/2024] [Indexed: 02/25/2024]
Abstract
Closing a recurrent oroantral fistula (OAF) that occurs at an infected sinus augmentation site is a challenge for clinicians. The recurrent OAF has a detrimental impact on bone regeneration and subsequent implant placement. This case report includes three cases in which sinus graft infection and OAF occurred after maxillary sinus augmentation (MSA). In these cases, treatments to control sinus infection were performed using an otolaryngologist; then, intraoral interventions comprising mucosal flap procedures, bone grafts, and barrier membrane applications were performed 2-5 times by oral surgeons. Nevertheless, OAF recurred persistently. The failure to stop OAF recurrence may be due to the inability to effectively block air pressure at the OAF site. Following a comprehensive debridement of the infected tissue at the previous sinus augmentation site, a pouch was created through sinus mucosal elevation. The perforated sinus mucosa at the OAF site was covered with a non-resorbable membrane in one case and with resorbable collagen membranes in the other two cases, followed by bone grafting within the pouch. Lastly, this procedure was completed by blocking the entrance of the pouch with a cortical bone shell graft and a resorbable collagen membrane. The cortical bone shell graft, obstructing the air pressure from the nasal cavity, facilitated bone formation, and, ultimately, allowed for implant placement. Within the limitations of the present case report, the application of a guided bone regeneration technique involving a cortical bone shell graft and a barrier membrane enabled the closure of the recurrent OAF and subsequent implant placement.
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Affiliation(s)
- Won-Bae Park
- Department of Periodontology, School of Dentistry, Kyung Hee University, Seoul 02447, Republic of Korea;
- Private Practice in Periodontics and Implant Dentistry, Seoul 02771, Republic of Korea
| | - Min-Soo Bae
- With Dental Clinic, #401 Dae-oh bldg, 53-1, Yeouinaru-ro, Yeongdeungpo-gu, Seoul 07273, Republic of Korea;
| | - Wonhee Park
- Department of Prosthodontics, Division of Dentistry, College of Medicine, Hanyang University, 222-1 Wangsimni-ro, Seongdong-gu, Seoul 04763, Republic of Korea;
| | - Hyun-Chang Lim
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, School of Dentistry, Kyunghee daero 23, Dongdaemoon-gu, Seoul 02447, Republic of Korea
| | - Ji-Young Han
- Department of Periodontology, Division of Dentistry, College of Medicine, Hanyang University, 222-1 Wangsimni-ro, Seongdong-gu, Seoul 04763, Republic of Korea
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Shi S, Han L, Su J, Guo J, Yu F, Zhang W. Clinical efficacy of transcrestal sinus floor augmentation, in comparison with lateral approach, in sites with residual bone height ≤6 mm: A systematic review and meta-analysis. Clin Oral Implants Res 2023; 34:1151-1175. [PMID: 37548090 DOI: 10.1111/clr.14155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 07/05/2023] [Accepted: 07/19/2023] [Indexed: 08/08/2023]
Abstract
OBJECTIVE This paper addressed two focused questions: Focused question 1 (Q1) "what is the clinical efficacy of transcrestal sinus floor augmentation (TSFA), as compared to lateral sinus floor augmentation (LSFA) in sites with residual bone height (RBH) ≤6 mm, in randomized clinical trials (RCTs) and controlled clinical trials (CCTs)?"; Focused question 2 (Q2) "what is the estimated effectiveness of TSFA for outcomes in Q1, in RCTs, CCTs or cohort studies?" MATERIALS AND METHODS An electronic search (PubMed, EMBASE, The Cochrane Central Register of Controlled Trials) and hand search were conducted from January 1986 until December 2022. All eligible clinical studies expressly reporting TSFA in sites with RBH ≤6 mm were included. The data were extracted, and the risk of bias in individual studies was evaluated. Meta-analysis was performed whenever possible. RESULTS Seven RCTs were included for Q1 and 25 studies (9 RCTs, 2 CCTs, 14 single arm cohort studies) for Q2. Q1: Meta-analysis did not show significant difference in the implant survival, sinus membrane perforation and marginal bone loss between TSFA and LSFA groups. Q2: Meta-analysis showed TSFA had a high implant survival rate (96.5%, 95% CI: 93.2%-98.9%) at least 1 year after surgery, and limited sinus membrane perforation (5.4%, 95% CI: 2.7%-8.8%). The results also presented higher patient satisfaction for TSFA. CONCLUSION With the limitations of the present study (high risk of bias in individual studies), it can be concluded that there was no significant difference in implant survival, Schneiderian membrane perforation and MBL between two approaches in sites with RBH ≤6 mm.
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Affiliation(s)
- Shaojie Shi
- Department of Stomatology, 920th Hospital of Joint Logistics Support Force, Kunming, China
| | - Luyao Han
- Department of Pulmonary and Critical Care Medicine, Xijing Hospital, Air Force Medical University, Xi'an, China
| | - Jun Su
- Department of Stomatology, 920th Hospital of Joint Logistics Support Force, Kunming, China
| | - Jianmei Guo
- Department of Stomatology, 920th Hospital of Joint Logistics Support Force, Kunming, China
| | - Fan Yu
- Department of Stomatology, 927th Hospital of Joint Logistics Support Force, Pu'er, China
| | - Wenyun Zhang
- Department of Stomatology, 920th Hospital of Joint Logistics Support Force, Kunming, China
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Faggion CM. Educational needs versus medical indications for oral and maxillofacial surgical procedures: Can they co-exist in harmony? JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101470. [PMID: 37061038 DOI: 10.1016/j.jormas.2023.101470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 04/06/2023] [Accepted: 04/12/2023] [Indexed: 04/17/2023]
Affiliation(s)
- Clovis Mariano Faggion
- Department of Periodontology and Operative Dentistry, Faculty of Dentistry, University Hospital Münster, Münster, Germany.
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Rezaei A, Gholami P. Three-dimensional guided lateral window sinus lift and simultaneous implant placement: A dental technique. J Prosthet Dent 2023:S0022-3913(23)00546-2. [PMID: 37758554 DOI: 10.1016/j.prosdent.2023.07.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 07/28/2023] [Accepted: 07/28/2023] [Indexed: 09/29/2023]
Abstract
Lateral window sinus floor elevation is typically performed blind, and complications may be encountered. Guided surgery can help make the procedure more predictable with fewer complications and a shorter surgical time. The presented technique uses a surgical template for simultaneous implant placement and sinus floor elevation. An implant platform is used for determining the size, shape, and location of the window and the osteotomy depth. The technique uses a Ø5 mm bone profiler with a stop compatible with the surgical guide design to conduct the osteotomy, conservatively guiding the lateral window osteotomy in 3 dimensions.
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Affiliation(s)
| | - Paria Gholami
- Doctoral student, Faculty of Dentistry, Tehran University of Medical Sciences, Tehran, Iran..
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Nakajima Y, Apaza Alccayhuaman KA, Botticelli D, Lang NP, De Rossi EF, Xavier SP. Mucosal adhesion phenomenon after maxillary sinus floor elevation: A preclinical study. Clin Oral Implants Res 2023; 34:967-978. [PMID: 37403596 DOI: 10.1111/clr.14123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 06/04/2023] [Accepted: 06/21/2023] [Indexed: 07/06/2023]
Abstract
AIM To describe the histological events that occur after maxillary sinus floor elevation when the elevated and undetached sinus mucosa are in close proximity or in contact with each other. MATERIALS AND METHODS From 76 rabbits, 152 elevated maxillary sinuses were analyzed histologically. Sites without adhesions were classified as "No proximity," whereas the adhesion stages were divided into "Proximity," "Fusion," and "Synechia stages." The width of the pseudostratified columnar epithelium and the distance between the two layers of the elevated and undetached sinus mucosae were measured at various standardized positions. RESULTS Thirty-one sites presenting with adhesions were found. Twelve sites were in the proximity stage," presenting cilia of the two epithelial layers that were shortened and interlinked within the mucous context. Hyperactivity of the goblet cells was also observed. In the other cases, the hyperplastic epithelium showed attempts to reach the contralateral mucosa. The 15 "fusion stage" sites presented regions with epithelial cells of the two mucosal layers that penetrated each other. Four sites presented "synechiae stages," represented by bridges of connective tissue connecting the two lamina propria. CONCLUSIONS Close proximity or tight contact between the elevated and undetached mucosa adhering to the bone walls might occur after maxillary sinus floor elevation. This induced hyperplasia of the epithelial cells and adhesion of the two layers until synechiae formation.
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Affiliation(s)
- Yasushi Nakajima
- Department of Oral Implantology, Osaka Dental University, Osaka, Japan
- ARDEC Academy, Rimini, Italy
| | | | | | | | | | - Samuel Porfirio Xavier
- ARDEC Academy, Rimini, Italy
- Department of Oral and Maxillofacial Surgery and Periodontology, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
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Díaz L, Fan S, Urrutia P, Uriarte X, Fodich I, Torres A, Sáenz-Ravello G. Correlation between periodontal phenotype and sinus membrane thickness: A systematic review. Clin Oral Implants Res 2023; 34:881-891. [PMID: 37427881 DOI: 10.1111/clr.14121] [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: 02/11/2023] [Revised: 06/11/2023] [Accepted: 06/14/2023] [Indexed: 07/11/2023]
Abstract
AIM To assess the correlation between the periodontal phenotype (PP) and sinus membrane thickness (SMT) in humans. METHODS This review was conducted according to the PRISMA guidelines. Two reviewers independently carried out electronic and manual literature searches of studies published in English, German, and Spanish, from 1970 to September 2022 in four electronic databases, PubMed/Medline, Scopus, Cochrane Library, and Web of Science, in addition to gray literature. Studies that assessed the correlation between PP and SMT in adults (aged 18 years) were included. Methodological quality was evaluated using the Appraisal Tool for Cross-Sectional Studies (AXIS) for articles that met the eligibility criteria. RESULTS Six studies, including 510 patients, were considered for qualitative analysis. All included studies were cross-sectional, and the correlation between the PP and SMT was evaluated, finding a positive and high correlation in 83.3% of them, based on a value of ≥0.7. All the included studies were assessed with a high overall risk of bias. CONCLUSIONS Periodontal phenotype and sinus membrane thickness are likely correlated. Nevertheless, further standardized studies are required to draw definitive conclusions.
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Affiliation(s)
- Leonardo Díaz
- Faculty of Dentistry, Postgraduate School, University of Chile, Santiago, Chile
- Department of Oral and Maxillofacial Surgery, University Medical Center of the Johannes-Gutenberg University, Mainz, Germany
- Perioplastic Institute, Santiago, Chile
| | - Shengchi Fan
- Department of Oral and Maxillofacial Surgery, University Medical Center of the Johannes-Gutenberg University, Mainz, Germany
| | - Pablo Urrutia
- Perioplastic Institute, Santiago, Chile
- Postgraduate Implant Dentistry Department, School of Dentistry, Universidad Andrés Bello, Santiago, Chile
| | | | - Ivo Fodich
- Postgraduate Implant Dentistry Department, School of Dentistry, Universidad Andrés Bello, Santiago, Chile
| | - Alfredo Torres
- Faculty of Dentistry, Postgraduate School, University of Chile, Santiago, Chile
- Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Gustavo Sáenz-Ravello
- Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile
- Center for Surveillance and Epidemiology of Oral Diseases, Faculty of Dentistry, University of Chile, Santiago, Chile
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Prajapati S, Ninneman S, Zarrabi I, Daubert D, Wang IC, Hsu YT. Risk factors and longitudinal regenerative outcomes of sinus membrane perforation during lateral window sinus floor elevation: A retrospective analysis up to 9 years. J Periodontol 2023; 94:1045-1054. [PMID: 36748281 DOI: 10.1002/jper.22-0424] [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: 07/18/2022] [Revised: 01/26/2023] [Accepted: 01/31/2023] [Indexed: 02/08/2023]
Abstract
BACKGROUND Lateral-window sinus floor elevation (LSFE) is a reliable procedure to reconstruct the posterior maxilla for implant therapy. This retrospective study aimed to investigate risk factors associated with Schneiderian membrane perforation (SMP) occurrence during LSFE and longitudinal regenerative outcomes following LSFE up to 9 years. METHODS Patients who had LSFE between 2010 and 2019 were included. All demographic and surgical-related data were retrieved from existing electronic health records. Radiographs were used to evaluate the vertical dimensional changes of ridge and graft materials and the potential anatomic factors of SMP. RESULTS A total of 122 LSFE procedures in 99 patients were included in the study. Mean ridge height gain and graft shrinkages were 9.5 ± 3.47 and 1.57 ± 2.85 mm. The influence of the healing period on graft shrinkage showed a positive trend; the longer the healing period, the greater the graft shrinkage (p = 0.09). The pathology in the sinus showed a positive correlation with SMP (p = 0.07). However, other anatomical factors did not negatively impact SMP and subsequent ridge height gain (p > 0.05). CONCLUSIONS With inherent limitation, the findings with up to 9 years of follow-up indicate a consistent ridge remodeling lasting for about 3 years after LSFE procedures. SMP or membrane thickening may not significantly affect the ridge gain following LSFE. The healing period had the most significant influence on graft shrinkage, showing that the longer the healing time between LSFE and implant placement, the greater the graft shrinkage.
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Affiliation(s)
| | - Shale Ninneman
- Department of Periodontics, University of Washington School of Dentistry, Seattle, Washington, USA
| | | | - Diane Daubert
- Department of Periodontics, University of Washington School of Dentistry, Seattle, Washington, USA
| | - I-Chung Wang
- Department of Periodontics, University of Washington School of Dentistry, Seattle, Washington, USA
| | - Yung-Ting Hsu
- Department of Periodontics, University of Washington School of Dentistry, Seattle, Washington, USA
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Cipollina A, Ceddia M, Di Pietro N, Inchingolo F, Tumedei M, Romasco T, Piattelli A, Specchiulli A, Trentadue B. Finite Element Analysis (FEA) of a Premaxillary Device: A New Type of Subperiosteal Implant to Treat Severe Atrophy of the Maxilla. Biomimetics (Basel) 2023; 8:336. [PMID: 37622941 PMCID: PMC10452205 DOI: 10.3390/biomimetics8040336] [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: 06/14/2023] [Revised: 07/25/2023] [Accepted: 07/28/2023] [Indexed: 08/26/2023] Open
Abstract
Extreme atrophy of the maxilla still poses challenges for clinicians. Some of the techniques used to address this issue can be complex, risky, expensive, and time consuming, often requiring skilled surgeons. While many commonly used techniques have achieved very high success rates, complications may arise in certain cases. In this context, the premaxillary device (PD) technique offers a simpler approach to reconstruct severely atrophic maxillae, aiming to avoid more complicated and risky surgical procedures. Finite element analysis (FEA) enables the evaluation of different aspects of dental implant biomechanics. Our results demonstrated that using a PD allows for an optimal distribution of stresses on the basal bone, avoiding tension peaks that can lead to bone resorption or implant failure. ANSYS® was used to perform localized finite element analysis (FEA), enabling a more precise examination of the peri-crestal area and the PD through an accurate mesh element reconstruction, which facilitated the mathematical solution of FEA. The most favorable biomechanical behavior was observed for materials such as titanium alloys, which helped to reduce stress levels on bone, implants, screws, and abutments. Additionally, stress values remained within the limits of basal bone and titanium alloy strengths. In conclusion, from a biomechanical point of view, PDs appear to be viable alternatives for rehabilitating severe atrophic maxillae.
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Affiliation(s)
| | - Mario Ceddia
- Department of Mechanics, Mathematics and Management, Politecnico di Bari University, 70125 Bari, Italy; (M.C.); (B.T.)
| | - Natalia Di Pietro
- Department of Medical, Oral and Biotechnological Sciences, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (T.R.); (A.S.)
- Center for Advanced Studies and Technologies (CAST), “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
| | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy;
| | - Margherita Tumedei
- Department of Medical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy;
| | - Tea Romasco
- Department of Medical, Oral and Biotechnological Sciences, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (T.R.); (A.S.)
- Center for Advanced Studies and Technologies (CAST), “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
| | - Adriano Piattelli
- School of Dentistry, Saint Camillus International University of Health and Medical Sciences, 00131 Rome, Italy;
- Facultad de Medicina, UCAM Universidad Católica San Antonio de Murcia, 30107 Murcia, Spain
| | - Alessandro Specchiulli
- Department of Medical, Oral and Biotechnological Sciences, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (T.R.); (A.S.)
| | - Bartolomeo Trentadue
- Department of Mechanics, Mathematics and Management, Politecnico di Bari University, 70125 Bari, Italy; (M.C.); (B.T.)
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Park JH, Kim YG, Suh JY, Lee DH, Kim JW, Lee JM. Longitudinal Study of Bone Height Change between Two Approaches for Sinus Floor Elevation. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1132. [PMID: 37374336 DOI: 10.3390/medicina59061132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 05/19/2023] [Accepted: 05/23/2023] [Indexed: 06/29/2023]
Abstract
Background and Objectives: The purpose of this study is to assess the long-term maintenance of each approach of sinus elevation, the crestal approach and lateral approach, by comparing the radiographic results of each technique. Materials and Methods: In total, 103 patients who had undergone an implant procedure with either the crestal approach or lateral approach method applied to their maxillary molar edentulous area were included. Using orthopantomographs, the radiographic changes were consistently evaluated over 3 years after the procedure (immediately after procedure and 1 year, 2 years and 3 years after implant placement) Results: The radiographic evaluation after 3 years of implantation with sinus elevation showed a significant amount of bone formation (8.07 mm for crestal approach and 12.00 mm for lateral approach method). The largest amount of grafted height loss occurred during the 1 year, but the resorption was minimal (0.98 mm for crestal approach and 0.95 mm for lateral approach method) over the entire 3 years. Conclusions: Although the lateral approach showed more bone growth, the amount of bone resorption was similar to that of the crestal approach. Both methods showed the highest amount of bone resorption in the first year, and the amount of change thereafter was insignificant. It is judged that both methods can be used according to the situation to help implant placement.
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Affiliation(s)
- Jun-Hyeong Park
- Department of Periodontology, Kyungpook National University School of Dentistry, Daegu 41940, Republic of Korea
| | - Yong-Gun Kim
- Department of Periodontology, Kyungpook National University School of Dentistry, Daegu 41940, Republic of Korea
| | - Jo-Young Suh
- Department of Periodontology, Kyungpook National University School of Dentistry, Daegu 41940, Republic of Korea
| | - Du-Hyeong Lee
- Department of Prosthodontics, Kyungpook National University School of Dentistry, Daegu 41940, Republic of Korea
| | - Jin-Wook Kim
- Department of Oral and Maxillofacial Surgery, Kyungpook National University School of Dentistry, Daegu 41940, Republic of Korea
| | - Jae-Mok Lee
- Department of Periodontology, Kyungpook National University School of Dentistry, Daegu 41940, Republic of Korea
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15
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Omori Y, Botticelli D, Migani S, Ferreira Balan V, Pires Godoy E, Xavier SP. Sinus Mucosal Damage Triggered by Synthetic or Xenogeneic Bone Substitutes: A Histological Analysis in Rabbits. J Funct Biomater 2022; 13:257. [PMID: 36412898 PMCID: PMC9680494 DOI: 10.3390/jfb13040257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 11/11/2022] [Accepted: 11/17/2022] [Indexed: 11/22/2022] Open
Abstract
Background: It has been shown in rabbit models that the sinus mucosa in contact with graft particles might experience a progressive thinning and perforations. The phenomenon depends on the graft used. Hence, the aim of the present study was to compare the damaging effects of a synthetic of a xenogeneic graft. Methods: Forty New Zealand rabbits received a bilateral sinus elevation. Both sinuses of twenty rabbits were grafted with a biphasic 60% hydroxyapatite and 40% β-tricalcium phosphate while the other twenty received a deproteinized bovine bone mineral graft. Thinned sites (<40 µm) and perforations on the mucosa in contact with graft particles were evaluated after 2 and 10 weeks (ten animals each period). The width of the pseudostratified epithelium was also measured as control. Results: After 2 weeks of healing, 61 thinned sites were detected in the Synthetic group and 49 in the Xenogeneic group. After 10 weeks, the number of thinned mucosae increased to 79 sites in the Synthetic group (p = 0.222 between periods), and to 114 sites in the Xenogeneic group (p = 0.030 between groups; p = 0.001 between periods). Perforations were few in the 2-week period, two in two sinuses out of 20 in the Synthetic group, and four in two sinuses out of 20 in the Xenogeneic group (p = 0.721). In the 10-week period, the perforations increased to eight in the Synthetic group, distributed in six sinuses out of 20, and to sixteen in the Xenogeneic group, distributed in 11 sinuses out of 20 (p = 0.082). The pseudostratified epithelium presented a reduced width at the thinned sites. Conclusions: The contact with synthetic or xenogeneic grafts will induce thinning and possible perforations of the sinus mucosa. This effect will increase over time, and it is stronger at the xenogeneic than the synthetic graft.
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Affiliation(s)
- Yuki Omori
- Department of Oral Implantology, Osaka Dental University, 8-1 Kuzuhahanazonocho, Osaka 573-1121, Japan
| | | | - Stefano Migani
- ARDEC Academy, Viale Giovanni Pascoli 67, 47923 Rimini, Italy
| | - Vitor Ferreira Balan
- Department of Oral and Maxillofacial Surgery and Periodontology, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café-Subsetor Oeste-11 (N-11), Ribeirão Preto 14040-904, Brazil
| | - Eduardo Pires Godoy
- Department of Oral Biology, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-904, Brazil
| | - Samuel Porfirio Xavier
- Department of Oral and Maxillofacial Surgery and Periodontology, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café-Subsetor Oeste-11 (N-11), Ribeirão Preto 14040-904, Brazil
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16
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Clinical and Histological Healing after Maxillary Sinus Floor Elevation. Dent J (Basel) 2022; 10:dj10070134. [PMID: 35877408 PMCID: PMC9324517 DOI: 10.3390/dj10070134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 07/13/2022] [Indexed: 02/01/2023] Open
Abstract
Sinus floor elevation is a surgical procedure that allows for the insertion of the implant in the posterior region of the maxilla in case of insufficient volume of native bone. Several studies have reported a high success rate, and this has helped to spread this surgical procedure around the world. The subject has been extensively studied and this could lead researchers to think that no new scientific evidence can be provided. However, new ideas and discoveries show that research never reaches a conclusion, and that new information can be added all the time. This collection aimed to provide new evidence that could be added to daily clinical work and to provide new ideas for future research.
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17
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Tilted Implants and Sinus Floor Elevation Techniques Compared in Posterior Edentulous Maxilla: A Retrospective Clinical Study over Four Years of Follow-Up. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12136729] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The aim of this study was to evaluate the implant survival rate, marginal bone loss, and surgical and prosthetic complications of implants placed through sinus floor elevation and tilted implants engaged in basal bone to bypass the maxillary sinus. Sixty patients were enrolled for this study. According to the residual bone height of the posterior maxilla, the sample was divided into three groups of 20 patients: Group A (lateral sinus floor elevation), Group B (transcrestal sinus floor elevation), and Group C (tilted implants employed to bypass the sinus floor). Follow-up visits were performed one week after surgery, at three and six months, and then once a year for the next 4 years. The outcomes were the implant survival rate, marginal bone loss, and surgical and prosthetic complications. Although Groups A, B, and C demonstrated implant survival rates of 83.3%, 86.7%, and 98.3%, respectively, the statistical analysis showed no statistically significant difference between groups. Statistically significant differences between groups were also not found concerning marginal bone loss, as recorded by intra-oral X-ray measurements during follow-up examinations. Regarding complications, it was not possible to perform a statistical analysis. To reduce possible surgical risks, implant placement in basal bone could be preferred.
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