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Fu M, Ye Y, Pu R, Zhu D, Yang G, Jiang Z. Patient and implant-related risk factors for implant failure of one-stage lateral sinus floor elevation: A 2- to 10-year retrospective study. Clin Implant Dent Relat Res 2024. [PMID: 39219251 DOI: 10.1111/cid.13380] [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: 05/06/2024] [Revised: 07/24/2024] [Accepted: 08/02/2024] [Indexed: 09/04/2024]
Abstract
OBJECTIVES This retrospective study aimed to evaluate the early and late implant failure rates of one-stage lateral sinus floor elevation (LSFE) and to identify the patient and implant-related risk factors associated with these failures. MATERIALS AND METHODS All patients treated with one-stage LSFE from January 2014 to December 2021 were evaluated for inclusion. A total of 618 patients with 936 implants met the inclusion criteria. Clinical and radiographic information about patient and implants was collected. Univariate and multivariate Cox proportional hazards frailty regression models were performed to identify risk factors for early and late implant failure. RESULTS The cumulative implant survival rate was 95.62% (95% CI 93.90%-97.68%), with 16 early implant failures and 25 late implant failures. The Cox analysis indicated that ≤3 mm residual bone height (RBH) was associated with a higher early failure rate. For late implant failure, smoking habit, ≤3 mm RBH, and certain implant brand were independent risk factors. Narrow sinus ostium, long infundibulum, and flat thickening of Schneiderian membrane might be non-independent risk factors for late implant failure. No significance was found in other variables, including age, periodontitis history, implant characteristics (position, diameter, length, protrusion length, marginal bone loss), surgeon experience, healing time, opposing dentition, and prosthesis. CONCLUSIONS One-stage LSFE is a predictable treatment for patients with atrophic maxilla. ≤3 mm RBH increased the risk of early implant failure, while smoking habit, ≤3 mm RBH, and certain implant brand were independent risk factors for late implant failure.
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Affiliation(s)
- Mengdie Fu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China
| | - Yuer Ye
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China
| | - Rui Pu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China
| | - Danji Zhu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China
| | - Guoli Yang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China
| | - Zhiwei Jiang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China
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Aldahlawi S, Nourah D, Alturkistani E, AlBander W, Azab RY. Anatomical Factors Affecting the Complexity of Maxillary Sinus Augmentation in Saudi Patients: A Cone Beam Computed Tomography (CBCT) Study. Cureus 2024; 16:e68462. [PMID: 39360048 PMCID: PMC11446327 DOI: 10.7759/cureus.68462] [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] [Accepted: 09/02/2024] [Indexed: 10/04/2024] Open
Abstract
AIM This study aims to evaluate the anatomical variations of the maxillary sinus and determine the difficulty score of maxillary sinus augmentation (MSA) in Saudi patients seeking dental implant rehabilitation of the posterior maxilla using cone beam computed tomography (CBCT). METHODOLOGY CBCT records of dental patients seeking treatment at a University Dental Teaching Hospital between 2019 and 2023 were retrospectively analyzed. Measurements were obtained from CBCT images, including membrane thickness, sinus width, buccal bone thickness, presence of maxillary sinus septa, residual alveolar ridge height, angle of the buccolingual sinus wall, and the presence of the alveolar antral artery (AAA). The difficulty score for MSA was determined based on these anatomical factors. RESULTS A total of 107 maxillary sinuses in 86 subjects were evaluated. The average membrane thickness was 2.23 mm, with males showing significantly higher thickness than females. Sinus septa were found in 54 (50.5%) sinuses, with 18 (17%) of sinuses having interfering septa. Twenty-three (21.5%) sinuses had a residual alveolar ridge height of less than 4 mm. The average angle of the buccolingual sinus wall was 79.39°, indicating a high prevalence of wide-shaped sinuses. The average sinus width was 14.09 mm, with 55 sinuses (51.4%) less than 15 mm. The average buccal bone thickness was 1.07 mm, in 29 (27%) sinuses, the thickness was more than 2 mm. AAA was visualized in 60 (56%) of sinuses, with 45 (42%) of sinuses having AAA interfering with the MSA window. CONCLUSIONS In this study, most sinuses were classified as simple or moderate difficulty, with higher membrane thickness, presence of septa, and AAA being the significant risk factors for complications. These findings provide valuable insights for implant surgeons in Saudi patients seeking dental implant rehabilitation of the posterior maxilla, enabling them to anticipate and minimize potential complications during MSA procedures.
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Affiliation(s)
- Salwa Aldahlawi
- Department of Basic and Clinical Oral Science, Faculty of Dental Medicine, Umm Al-Qura University, Makkah, SAU
| | - Dalia Nourah
- Department of Basic and Clinical Oral Science, Faculty of Dental Medicine, Umm Al-Qura University, Makkah, SAU
| | - Ehdaa Alturkistani
- Department of Periodontics, Faculty of Dental Medicine, Umm Al-Qura University, Makkah, SAU
| | - Wejdan AlBander
- Department of Periodontics, Faculty of Dental Medicine, Umm Al-Qura University, Makkah, SAU
| | - Raneem Y Azab
- Department of Dentistry, Umm Al-Qura University, Makkah, SAU
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Liu H, Duan J, Zeng P, Shi M, Zeng J, Chen S, Gong Z, Chen Z, Qin J, Chen Z. Intelligently Quantifying the Entire Irregular Dental Structure. J Dent Res 2024; 103:378-387. [PMID: 38372132 DOI: 10.1177/00220345241226871] [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] [Indexed: 02/20/2024] Open
Abstract
Quantitative analysis of irregular anatomical structures is crucial in oral medicine, but clinicians often typically measure only several representative indicators within the structure as references. Deep learning semantic segmentation offers the potential for entire quantitative analysis. However, challenges persist, including segmentation difficulties due to unclear boundaries and acquiring measurement landmarks for clinical needs in entire quantitative analysis. Taking the palatal alveolar bone as an example, we proposed an artificial intelligence measurement tool for the entire quantitative analysis of irregular dental structures. To expand the applicability, we have included lightweight networks with fewer parameters and lower computational demands. Our approach finally used the lightweight model LU-Net, addressing segmentation challenges caused by unclear boundaries through a compensation module. Additional enamel segmentation was conducted to establish a measurement coordinate system. Ultimately, we presented the entire quantitative information within the structure in a manner that meets clinical needs. The tool achieved excellent segmentation results, manifested by high Dice coefficients (0.934 and 0.949), intersection over union (0.888 and 0.907), and area under the curve (0.943 and 0.949) for palatal alveolar bone and enamel in the test set. In subsequent measurements, the tool visualizes the quantitative information within the target structure by scatter plots. When comparing the measurements against representative indicators, the tool's measurement results show no statistically significant difference from the ground truth, with small mean absolute error, root mean squared error, and errors interval. Bland-Altman plots and intraclass correlation coefficients indicate the satisfactory agreement compared with manual measurements. We proposed a novel intelligent approach to address the entire quantitative analysis of irregular image structures in the clinical setting. This contributes to enabling clinicians to swiftly and comprehensively grasp structural features, facilitating the design of more personalized treatment plans for different patients, enhancing clinical efficiency and treatment success rates in turn.
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Affiliation(s)
- H Liu
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, Guangdong, China
| | - J Duan
- State Key Laboratory of Environmental Adaptability for Industrial Products, National Electric Apparatus Research Institute Co., Ltd, Guangzhou, Guangdong, China
| | - P Zeng
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, Guangdong, China
| | - M Shi
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, Guangdong, China
| | - J Zeng
- School of Computer Science and Engineering, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - S Chen
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, Guangdong, China
| | - Z Gong
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, Guangdong, China
| | - Z Chen
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, Guangdong, China
| | - J Qin
- State Key Laboratory of Environmental Adaptability for Industrial Products, National Electric Apparatus Research Institute Co., Ltd, Guangzhou, Guangdong, China
| | - Z Chen
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, Guangdong, China
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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.
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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.
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Zeng P, Song R, Lin Y, Li H, Chen S, Shi M, Cai G, Gong Z, Huang K, Chen Z. Abnormal maxillary sinus diagnosing on CBCT images via object detection and 'straight-forward' classification deep learning strategy. J Oral Rehabil 2023; 50:1465-1480. [PMID: 37665121 DOI: 10.1111/joor.13585] [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: 02/23/2023] [Revised: 04/06/2023] [Accepted: 08/18/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND Pathological maxillary sinus would affect implant treatment and even result in failure of maxillary sinus lift and implant surgery. However, the maxillary sinus abnormalities are challenging to be diagnosed through CBCT images, especially for young dentists or dentists in grassroots medical institutions without systematical education of general medicine. OBJECTIVES To develop a deep-learning-based screening model incorporating object detection and 'straight-forward' classification strategy to screen out maxillary sinus abnormalities on CBCT images. METHODS The large area of background noise outside maxillary sinus would affect the generalisation and prediction accuracy of the model, and the diversity and imbalanced distribution of imaging manifestations may bring challenges to intellectualization. Thus we adopted an object detection to limit model's observation zone and 'straight-forward' classification strategy with various tuning methods to adapt to dental clinical need and extract typical features of diverse manifestations so that turn the task into a 'normal-or-not' classification. RESULTS We successfully constructed a deep-learning model consist of well-trained detector and diagnostor module. This model achieved ideal AUROC and AUPRC of 0.953 and 0.887, reaching more than 90% accuracy at optimal cut-off. McNemar and Kappa test verified no statistical difference and high consistency between the prediction and ground truth. Dentist-model comparison test showed the model's statistically higher diagnostic performance than dental students. Visualisation method confirmed the model's effectiveness in region recognition and feature extraction. CONCLUSION The deep-learning model incorporating object detection and straightforward classification strategy could achieve satisfying predictive performance for screening maxillary sinus abnormalities on CBCT images.
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Affiliation(s)
- Peisheng Zeng
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, China
| | - Rihui Song
- School of Biomedical Engineering, Sun Yat-sen University, Guangzhou, China
| | - Yixiong Lin
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, China
| | - Haopeng Li
- School of Computer Science and Engineering, Sun Yat-sen University, Guangzhou, China
| | - Shijie Chen
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, China
| | - Mengru Shi
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, China
| | - Gengbin Cai
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, China
| | - Zhuohong Gong
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, China
| | - Kai Huang
- School of Computer Science and Engineering, Sun Yat-sen University, Guangzhou, China
| | - Zetao Chen
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, China
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Lyu M, Xu D, Zhang X, Yuan Q. Maxillary sinus floor augmentation: a review of current evidence on anatomical factors and a decision tree. Int J Oral Sci 2023; 15:41. [PMID: 37714889 PMCID: PMC10504247 DOI: 10.1038/s41368-023-00248-x] [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: 07/04/2023] [Revised: 08/30/2023] [Accepted: 08/31/2023] [Indexed: 09/17/2023] Open
Abstract
Maxillary sinus floor augmentation using lateral window and crestal technique is considered as predictable methods to increase the residual bone height; however, this surgery is commonly complicated by Schneiderian membrane perforation, which is closely related to anatomical factors. This article aimed to assess anatomical factors on successful augmentation procedures. After review of the current evidence on sinus augmentation techniques, anatomical factors related to the stretching potential of Schneiderian membrane were assessed and a decision tree for the rational choice of surgical approaches was proposed. Schneiderian membrane perforation might occur when local tension exceeds its stretching potential, which is closely related to anatomical variations of the maxillary sinus. Choice of a surgical approach and clinical outcomes are influenced by the stretching potential of Schneiderian membrane. In addition to the residual bone height, clinicians should also consider the stretching potential affected by the membrane health condition, the contours of the maxillary sinus, and the presence of antral septa when evaluating the choice of surgical approaches and clinical outcomes.
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Affiliation(s)
- Mingyue Lyu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Dingyi Xu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xiaohan Zhang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Quan Yuan
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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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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9
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Eberlikose H, Yilmaz D, Gulen O. Characteristics of maxillary sinus ostia and their correlation with anatomic variations of the osteomeatal complex: Indications for sinus floor elevation. Niger J Clin Pract 2023; 26:992-997. [PMID: 37635585 DOI: 10.4103/njcp.njcp_863_22] [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] [Indexed: 08/29/2023]
Abstract
Background Knowledge of the anatomy and variations of the maxillary sinus is essential for reducing oral surgery complications, such as sinus floor elevation, and increasing surgery success. The CBCT images of 385 patients were examined. Materials and Methods The prevalence, localization, and height of PMO (Primer Maxillary Ostium) and AMO (Accessory Maxillary Ostium) were evaluated with respect to sex, dentition, dental treatment, Schneiderian membrane (SM) thickness, concha bullosa, Haller Cells, and septal deviation. Results The PMO was present in 87.3% of all patients. Further analysis showed that the mean PMO diameter was 1.42 ± 0.62 mm. Although 11.6% of the PMO was in the inferior region, 60.4% was in the middle and 28% in the superior region. The effect of age and SM on the height and diameter of the PMO was found to be statistically significant. An AMO was present in 20% of the CBCT images. The mean AMO diameter was 2.55 ± 1.25 mm. Although 45.4% of the AMO was in the inferior region, 48% was in the middle and 6.6% was in the superior region. Moreover, SM thickness seemed to influence the height. A significant positive relationship was found between the PMO and AMO height. Also, a significant relationship was observed between the presence of the AMO and septum deviation. Conclusion The presence of the AMO, PMO diameter, and height should be added to the preoperative evaluation criteria for the success of sinus floor evaluation. Specifically, sinonasal and demographic conditions should be carefully examined preoperatively for the long-term success of the surgery.
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Affiliation(s)
- H Eberlikose
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ankara Medipol University, Ankara, Türkiye
| | - D Yilmaz
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Gazi University, Ankara, Türkiye
| | - O Gulen
- Dentomaxillofacial Radiologist, Private Practice Instead of Oral Radiolog, Turkish Ministry of Health, Türkiye
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Testori T, Tavelli L, Scaini R, Saibene AM, Felisati G, Barootchi S, Decker AM, Deflorian MA, Rosano G, Wallace SS, Zucchelli G, Francetti L, Wang HL. How to avoid intraoperative and postoperative complications in maxillary sinus elevation. Periodontol 2000 2023; 92:299-328. [PMID: 37345386 DOI: 10.1111/prd.12480] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 11/01/2022] [Accepted: 11/13/2022] [Indexed: 06/23/2023]
Abstract
Maxillary sinus floor elevation, via the lateral approach, is one of the most predictable bone augmentation procedures performed in implant dentistry. but both intra- and postoperative complications can occur, and some of them are severe. Our aim is as follows: To review the pertinent literature on the topic, especially assessing the risk factors related to complications. To give clinical recommendations to minimize intra- and postoperative complications with the ultimate scope of improving the standard of clinical care and patient safety.
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Affiliation(s)
- Tiziano Testori
- IRCCS Galeazzi -Sant'Ambrogio Hospital, Dental Clinic, Section of Implant Dentistry and Oral Rehabilitation, Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
- Division of Periodontology, Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Lorenzo Tavelli
- Division of Periodontology, Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Riccardo Scaini
- IRCCS Galeazzi -Sant'Ambrogio Hospital, Dental Clinic, Section of Implant Dentistry and Oral Rehabilitation, Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
| | - Alberto Maria Saibene
- Otolaryngology Unit, Santi Paolo e Carlo Hospital, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Giovanni Felisati
- Otolaryngology Unit, Santi Paolo e Carlo Hospital, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Shayan Barootchi
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Ann Marie Decker
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Matteo Antonio Deflorian
- IRCCS Galeazzi -Sant'Ambrogio Hospital, Dental Clinic, Section of Implant Dentistry and Oral Rehabilitation, Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
| | - Gabriele Rosano
- Academy of Craniofacial Anatomy, Como, Italy
- Lake Como Institute Implant Advanced Training Center, Como, Italy
| | - Stephen S Wallace
- Department of Periodontics, Columbia University College of Dental Medicine, New York City, New York, USA
- Private Practice, Waterbury, Connecticut, USA
| | - Giovanni Zucchelli
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Luca Francetti
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- IRCCS Galeazzi -Sant'Ambrogio Hospital, Dental Clinic, Dean of the Dental Clinic, Milan, Italy
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
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11
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Morgan N, Meeus J, Shujaat S, Cortellini S, Bornstein MM, Jacobs R. CBCT for Diagnostics, Treatment Planning and Monitoring of Sinus Floor Elevation Procedures. Diagnostics (Basel) 2023; 13:1684. [PMID: 37238169 PMCID: PMC10217207 DOI: 10.3390/diagnostics13101684] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/05/2023] [Accepted: 05/06/2023] [Indexed: 05/28/2023] Open
Abstract
Sinus floor elevation (SFE) is a standard surgical technique used to compensate for alveolar bone resorption in the posterior maxilla. Such a surgical procedure requires radiographic imaging pre- and postoperatively for diagnosis, treatment planning, and outcome assessment. Cone beam computed tomography (CBCT) has become a well-established imaging modality in the dentomaxillofacial region. The following narrative review is aimed to provide clinicians with an overview of the role of three-dimensional (3D) CBCT imaging for diagnostics, treatment planning, and postoperative monitoring of SFE procedures. CBCT imaging prior to SFE provides surgeons with a more detailed view of the surgical site, allows for the detection of potential pathologies three-dimensionally, and helps to virtually plan the procedure more precisely while reducing patient morbidity. In addition, it serves as a useful follow-up tool for assessing sinus and bone graft changes. Meanwhile, using CBCT imaging has to be standardized and justified based on the recognized diagnostic imaging guidelines, taking into account both the technical and clinical considerations. Future studies are recommended to incorporate artificial intelligence-based solutions for automating and standardizing the diagnostic and decision-making process in the context of SFE procedures to further improve the standards of patient care.
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Affiliation(s)
- Nermin Morgan
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven, 3000 Leuven, Belgium
- Department of Oral Medicine, Faculty of Dentistry, Mansoura University, Mansoura 35516, Egypt
| | - Jan Meeus
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Campus Sint-Rafael, 3000 Leuven, Belgium
| | - Sohaib Shujaat
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven, 3000 Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Campus Sint-Rafael, 3000 Leuven, Belgium
- King Abdullah International Medical Research Center, Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh 11426, Saudi Arabia
| | - Simone Cortellini
- Department of Oral Health Sciences, Section of Periodontology, KU Leuven, 3000 Leuven, Belgium
- Department of Dentistry, University Hospitals Leuven, KU Leuven, 3000 Leuven, Belgium
| | - Michael M. Bornstein
- Department of Oral Health & Medicine, University Center for Dental Medicine Basel UZB, University of Basel, 4058 Basel, Switzerland
| | - Reinhilde Jacobs
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven, 3000 Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Campus Sint-Rafael, 3000 Leuven, Belgium
- Department of Dental Medicine, Karolinska Institute, 141 04 Huddinge, Sweden
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12
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Xue H, Wen J, Liu C, Shuai X, Zhang X, Kang N. Modified transcrestal sinus floor elevation with concomitant implant placement in edentulous posterior maxillae with residual bone height of 5 mm or less: a non-controlled prospective study. Int J Oral Maxillofac Surg 2023; 52:495-502. [PMID: 36058822 DOI: 10.1016/j.ijom.2022.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 08/15/2022] [Accepted: 08/15/2022] [Indexed: 11/26/2022]
Abstract
The aim of this study was to describe a modified transcrestal sinus floor elevation (mTSFE) technique and to evaluate its clinical effectiveness and reliability when residual bone height is severely reduced. Forty-three maxillary edentulous patients who met the inclusion criteria were enrolled. All patients underwent the mTSFE technique; 66 dental implants were inserted simultaneously. Patient-reported outcomes were assessed 2 weeks after surgery. Prosthetic crowns were placed 6 months after surgery. Radiographic analyses and clinical analyses were conducted to assess the clinical effectiveness and feasibility of mTSFE during a follow-up period of 2-8 years. The mean vertical bone increase after surgery was 8.09 mm, and it decreased to 6.56 mm at 6 months after surgery. Two cases of membrane perforation occurred during surgery and one implant was lost in the third year after surgery; the survival rate at the implant level was 98.48%. No severe postoperative complication was reported and the subjective feeling of patients was acceptable. This mTSFE technique could simplify the operative procedure and might be helpful to reduce intraoperative trauma, as well as to alleviate postoperative discomfort.
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Affiliation(s)
- H Xue
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Prosthodontics, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University, School of Medicine; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai, China
| | - J Wen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - C Liu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - X Shuai
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - X Zhang
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu, China
| | - N Kang
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu, China; Department of Oral Implantology (National Key Clinical Department), West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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Betin-Noriega C, Urbano-Del Valle SE, Saldarriaga-Naranjo CI, Obando-Castillo JL, Tobón-Arroyave SI. Analysis of risk variables for association with maxillary sinus mucosal thickenings: a cone-beam computed tomography-based retrospective study. Surg Radiol Anat 2023; 45:417-429. [PMID: 36752834 PMCID: PMC10039820 DOI: 10.1007/s00276-023-03090-2] [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: 11/03/2022] [Accepted: 01/19/2023] [Indexed: 02/09/2023]
Abstract
PURPOSE This study aimed to determine which patient-related, anatomical, pathologic, or iatrogenic variables may be directly associated with and which may have a modifying effect on the generation of maxillary sinus (MS) mucosal thickenings. METHODS A total of 278 cone-beam computed tomography (CBCT) scans obtained from 114 males and 164 females were evaluated. The protocol included the assessment of 21 candidate variables, of which 18 were bilateral and 3 were unique. The relationship among the study variables and the mucosal thickenings were examined individually and adjusted for confounding using univariate and multivariate binary logistic regression models. RESULTS The prevalence of mucosal thickenings was 71.20% at patient level and 53.40% at sinus level. The ostium height > 28.15 mm, the infundibulum length ≤ 9.55 mm, the infundibulum width ≤ 0.50 mm, along the occurrence of periapical lesions and slight-to-severe periodontal bone loss acted as strong/independent risk variables for MS mucosal thickenings. Confounding and interaction relationships between MS height and depth, and between the alveolar process type and the presence of foreign materials with respect to age stratum > 47.50 years might be also associated with the mucosal thickenings. CONCLUSIONS While increased ostium height, decreased infundibulum length/width, the presence of periapical lesions and periodontal involvement might be the foremost indicator variables for MS mucosal thickenings, there are synergistic relationships among the increased sinus height and depth as well as aging regarding atrophic/partially atrophic alveolar process status and the presence of foreign materials that may be also associated with a greater proportion of these mucosal abnormalities.
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Affiliation(s)
- Carolina Betin-Noriega
- Graduate Oral and Maxillofacial Surgery Program, Faculty of Dentistry, University of Antioquia, Medellín, Colombia
| | | | | | | | - Sergio Iván Tobón-Arroyave
- Graduate Oral and Maxillofacial Surgery Program, Faculty of Dentistry, University of Antioquia, Medellín, Colombia.
- Laboratory of Immunodetection and Bioanalysis, Faculty of Dentistry, University of Antioquia, Calle 70 N° 52-21, Medellín, Colombia.
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14
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Jiang X, He S, Bornstein MM, Wu Y, Ye L, Wang F. Effects of different grafting materials on volumetric changes in the Schneiderian membrane following lateral maxillary sinus floor elevation: a preliminary study. BMC Oral Health 2023; 23:102. [PMID: 36793033 PMCID: PMC9933314 DOI: 10.1186/s12903-023-02789-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 02/02/2023] [Indexed: 02/17/2023] Open
Abstract
OBJECTIVES To investigate the potential influence of different grafting materials on maxillary sinus membrane dimensions and ostium patency following lateral sinus floor elevation (SFE) as assessed using cone-beam computed tomography (CBCT). MATERIALS AND METHODS A total of 40 sinuses in 40 patients were included. Twenty sinuses were referred for SFE with deproteinized bovine bone mineral (DBBM), and the remaining 20 sinuses were grafted with calcium phosphate (CP). CBCT was performed prior to and 3 to 4 days after surgery. The dimensions of the Schneiderian membrane volume and ostium patency were evaluated, and potential relationships between volumetric changes and any associated factors were analyzed. RESULTS The median increase in membrane-whole cavity volume ratios was 43.97% in the DBBM group and 67.58% in the CP group, demonstrating no statistically significant difference (p = 0.17). The rates of increased obstruction after SFE were 11.1% for the DBBM group versus 44.4% for the CP group (p = 0.03). The graft volume was found to be positively correlated with the postoperative membrane-whole cavity volume ratio (r = 0.79; p < 0.01) and the membrane-whole cavity volume ratio increase (r = 0.71; p < 0.01). CONCLUSIONS The two grafting materials seem to have a similar effect on transient volumetric changes in the sinus mucosa. However, the choice of grafting material should still be made with caution since sinuses grafted using DBBM exhibited less swelling and less ostium obstruction.
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Affiliation(s)
- Xinke Jiang
- grid.16821.3c0000 0004 0368 8293Department of Oral Implantology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Shamin He
- grid.16821.3c0000 0004 0368 8293Department of Second Dental Center, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Michael M. Bornstein
- grid.6612.30000 0004 1937 0642Department of Oral Health & Medicine, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
| | - Yiqun Wu
- grid.16821.3c0000 0004 0368 8293Department of Second Dental Center, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Lijuan Ye
- Department of Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China.
| | - Feng Wang
- Department of Oral Implantology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China.
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15
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Clinical, radiographic characterizations and complications of maxillary molar in a periodontitis population: a retrospective study based on CBCT radiography. Clin Oral Investig 2023; 27:2335-2346. [PMID: 36607492 DOI: 10.1007/s00784-022-04845-8] [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: 07/07/2022] [Accepted: 12/26/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVE This study was aimed to delineate the clinical, CBCT radiographic characteristics, and complications of maxillary molar in a periodontitis population. MATERIALS AND METHODS Medical records and CBCT images were utilized to identify adult patients with periodontitis in a tertiary referral dental hospital between June 2019 and December 2020. CBCT scan images were used to characterize the detailed bone thickness, absorbing height, and position of maxillary molar as well as their associated conditions. All relevant descriptive epidemiological data, clinical information, radiographic details, and associated complications were recorded and statistically analyzed. RESULTS According to the above criteria, 577 eligible periodontitis patients were enrolled and defined as research cohort here with mean age 45 ± 4.8 years. Male patients outnumbered females with a gender ratio of 1.23:1. Our results demonstrated that the bone loss of maxillary first molar was more serious than that of second molar with tooth position symmetry. The occurrence of various complications (periodontal abscess, pulp lesions, furcation lesion, and mucosal thickening) was significantly correlated to periodontal-related clinical parameters of maxillary molar. CONCLUSIONS Our results demonstrated the more serious bone loss of maxillary first molar with tooth position symmetry. The occurrence of various complications was significantly correlated to periodontal-related clinical parameters. Our findings offer valuable information concerning the clinical, radiographic characteristics, and complications of maxillary molar in a periodontitis population. CLINICAL RELEVANCE These findings are beneficial for clinicians to comprehensively understand the bone status, pathogenesis, and clinical management of maxillary molar in periodontitis.
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Yeung AWK, Hung KF, Li DTS, Leung YY. The Use of CBCT in Evaluating the Health and Pathology of the Maxillary Sinus. Diagnostics (Basel) 2022; 12:diagnostics12112819. [PMID: 36428879 PMCID: PMC9689855 DOI: 10.3390/diagnostics12112819] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 11/15/2022] [Accepted: 11/15/2022] [Indexed: 11/19/2022] Open
Abstract
The use of cone-beam computed tomography (CBCT) has been increasing in dental practice. This narrative review summarized the relevance and utilizations of CBCT to visualize anatomical structures of the maxillary sinus and common pathologies found in the maxillary sinus. The detection/visualization rate, the location and the morphometric characteristics were described. For sinus anatomy, the reviewed features included the posterior superior alveolar artery, sinus pneumatization, sinus hypoplasia, sinus septa, and primary and accessory sinus ostia. For pathology, the following items were reviewed: membrane thickening associated with periapical lesions/periodontal lesions, mucous retention cyst, and antrolith. The visualization and assessment of the maxillary sinus is very important prior to procedures that take place in close proximity with the sinus floor, such as tooth extraction, implant insertion, and sinus floor elevation. Some sinus pathologies may be associated with odontogenic lesions, such as periapical diseases and periodontal bone loss.
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Affiliation(s)
- Andy Wai Kan Yeung
- Oral and Maxillofacial Radiology, Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Kuo Feng Hung
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Dion Tik Shun Li
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Yiu Yan Leung
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
- Correspondence:
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17
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Anatomical Characteristics of the Accessory Maxillary Ostium in Three-Dimensional Analysis. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58091243. [PMID: 36143920 PMCID: PMC9501023 DOI: 10.3390/medicina58091243] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/03/2022] [Accepted: 09/05/2022] [Indexed: 11/17/2022]
Abstract
Background and Objectives: The accessory maxillary ostium (AMO) can interfere with ventilation and drainage of the maxillary sinus, and therefore the importance of evaluating the anatomical features of the AMO has been emphasized. This study aimed to evaluate anatomical characteristics of the AMO together with the natural ostium (NO) using three-dimensional (3D) analysis and to assess the relationship between the AMO and maxillary sinus pathologies. Materials and Methods: This retrospective study included 394 sinuses in 197 patients. Using 3D computed tomography images, the prevalence of the AMO and concurrent sinus pathologies were examined. For patients with an AMO, 3D spatial positions of the AMO and NO related to adjacent anatomic structures and dimensions of the AMO and NO were evaluated. Results: A total of 84 sinuses showed single or multiple AMO, with a prevalence of 21.3%. The AMO was located superiorly by 30.1 mm from the maxillary sinus floor, inferiorly by 1.3 mm from the orbital floor, and posteriorly by 22.4 mm from the anterior sinus wall. The AMO was located 5.4 mm posteriorly and 0.7 mm inferiorly from the NO. On the same coronal plane as the NO or AMO, height from the maxillary sinus floor to the NO and AMO ranged from 19.4 to 45.8 mm and 14.5 mm to 41.9 mm, respectively. The mean horizontal and vertical dimensions were 5.9 mm and 4.6 mm for the NO and 2.8 mm and 3.0 mm for the AMO. We detected a significant association between the presence of the AMO and the mucosal thickening (p = 0.029). Conclusions: The results of this study suggest that, although the AMO and NO are mostly located in positions that do not limit sinus-related surgeries, such as maxillary sinus floor augmentation, the AMO and NO are also found in lower positions, which may be a detriment to the postoperative physiological function of the maxillary sinus and affect treatment outcomes.
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Baba Y, Kato Y, Takahashi K. Proposal for a Paradigm Shift in Personalized Medicine for Patients with a Maxillary Edentulous Jaw by ENT Specialist and Dentist Cooperation. J Pers Med 2022; 12:jpm12081289. [PMID: 36013238 PMCID: PMC9409749 DOI: 10.3390/jpm12081289] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 08/01/2022] [Accepted: 08/02/2022] [Indexed: 11/16/2022] Open
Abstract
With the spread of oral implant therapy, serious medical complications related to implant surgery are becoming a social problem. Although the number of complications after implant surgery in the edentulous jaw is decreasing in Japan, maxillary-sinus-related complications (MSRCs) have reached the highest number since 2012. It is essential to identify and eliminate possible predisposing risk factors for MSRCs at an early stage to prevent MSRCs. In this review article, we highlight the causal factors of postoperative complications with or without sinus augmentation for the maxillary molar region to achieve optimal treatment outcomes and reduce complications. In particular, we focus on anatomical variations that can cause the impairment of maxillary sinus drainage. Furthermore, we emphasize that the paradigm for personalized medicine for patients with a maxillary edentulous jaw by ENT specialist and dentist cooperation is shifting from the traditional assessment of maxillary sinus pathologies alone to the new assessment of anatomic variations that can cause the impairment of maxillary sinus drainage in addition to maxillary sinus pathologies.
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Affiliation(s)
- Yuh Baba
- Department of General Clinical Medicine, Ohu University School of Dentistry, 31-1, Mitsumido, Tomita-machi, Koriyama City 963-8611, Fukushima, Japan
- Correspondence: ; Tel.: +81-24-932-9331
| | - Yasumasa Kato
- Department of Oral Function and Molecular Biology, Ohu University School of Dentistry, 31-1, Mitsumido, Tomita-machi, Koriyama City 963-8611, Fukushima, Japan
| | - Keiso Takahashi
- Division of Periodontics, Department of Conservative Dentistry, Ohu University School of Dentistry, 31-1, Mitsumido, Tomita-machi, Koriyama City 963-8611, Fukushima, Japan
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BULUT A, ÖZER AM. Erişkinlerde Maxiller Sinüs Septa ve Mukozal Kalınlaşmanın KIBT ile Değerlendirilmesi. İSTANBUL GELIŞIM ÜNIVERSITESI SAĞLIK BILIMLERI DERGISI 2022. [DOI: 10.38079/igusabder.949252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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20
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Evaluation of Related Factors of Maxillary Sinusitis After Le Fort I Osteotomy Based on Computed Tomography: A Retrospective Case-Control Study. J Craniofac Surg 2022; 33:1795-1799. [PMID: 34980838 DOI: 10.1097/scs.0000000000008450] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 11/30/2021] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT Maxillary sinusitis is 1 of the postoperative complications of the Le Fort I osteotomy, this study investigated the related factors of maxillary sinusitis after Le Fort I osteotomy. A total of 23 cases, 92 controls, and 11 related factors were included in this case-control study with a 1:4 case-control ratio. The risk factors for maxillary sinusitis after Le Fort I were examined by least absolute shrinkage and selection operator multivariate conditional logistic regression and least absolute shrinkage and selection operator multivariate linear regression. The patency of maxillary sinus ostium at 6 months after surgery was significantly associated with maxillary sinusitis after Le Fort I osteotomy. Compared with the obstructed maxillary sinus ostium, the percentage of the volume of the healthy air cavity in the complete sinus cavity increased 70.7% when the maxillary sinus ostium was unobstructed, and 95% confidence interval was 0.610 to 0.805. Similarly, when the maxillary sinus ostium was wide, the percentage increased 6.0% compared with the narrow 1, and 95% confidence interval was 0.013 to 0.107. This study indicated that the patency of maxillary sinus ostium has an important impact on maxillary sinusitis after Le Fort I osteotomy. Close attention should be paid to maintain the maxillary sinus ostium and the drainage of maxillary sinuses unobstructed in a clinical setting.
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Amid R, Kadkhodazadeh M, Moscowchi A, Nami M. Effect of Schneiderian Membrane Thickening on the Maxillary Sinus Augmentation and Implantation Outcomes: A Systematic Review. J Maxillofac Oral Surg 2021; 20:534-544. [PMID: 34776681 DOI: 10.1007/s12663-021-01551-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 03/19/2021] [Indexed: 11/25/2022] Open
Abstract
Background Schneiderian membrane thickness may influence the final clinical outcome of sinus augmentation and dental implantation. Mucosal thickening has been regarded as a contributing factor for post-treatment complications. This study aimed to systematically review the available literature on the association between mucosal thickening and potential complications related to sinus augmentation and implant placement. Methods An electronic search was carried out in MEDLINE, Embase, and Web of Science by two independent reviewers. It was complemented by manual search of the reference lists of all relevant studies. The studies reporting on sinus augmentation and dental implantation in cases with preoperative mucosal thickening were considered eligible for this study. Results The initial search yielded 1032 articles. Five hundred and sixty-four records were screened by title and abstract, and 57 studies succeeded the inclusion criteria for full-text evaluation. Finally, 10 records remained for data extraction. The included studies assessed sinus augmentation and implantation procedures in 765 patients, 324 (42.3%) of them showed mucosal thickening. Increased membrane thickness did not significantly elevate the frequency of sinus augmentation complications. In addition, the overall implant survival rate was 99.03%. Conclusions Within the limitations of the present study, the presence of mucosal thickening might not be a risk factor for sinus augmentation and implant survival rate.
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Affiliation(s)
- Reza Amid
- Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahdi Kadkhodazadeh
- Research Institute for Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Anahita Moscowchi
- Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Majedeh Nami
- Department of Prosthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Daneshjoo Blvd, Evin, Shahid Chamran Highway, Tehran, Iran
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22
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Shao Q, Li J, Pu R, Feng Y, Jiang Z, Yang G. Risk factors for sinus membrane perforation during lateral window maxillary sinus floor elevation surgery: A retrospective study. Clin Implant Dent Relat Res 2021; 23:812-820. [PMID: 34750940 DOI: 10.1111/cid.13052] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 10/01/2021] [Accepted: 10/14/2021] [Indexed: 12/26/2022]
Abstract
PURPOSE To analyze the sinus membrane perforation (SMP) rate and its potential risk factors during lateral window maxillary sinus floor elevation (LSFE). MATERIALS AND METHODS For patients with LSFEs at Department of Implantology, Stomatology Hospital, School of Medicine, Zhejiang Universitiy during January 2014 to December 2020, patient-related risk factors (age/sex/smoking habit), surgery-related risk factors (operator experiment/number of tooth units/technique of osteotomy/surgical approach), and maxillary sinus-related risk factors (residual bone height/sinus membrane thickness/lateral wall thickness/maxillary sinus contours/presence of septa/blood vessels at the lateral maxillary sinus wall) were compared between perforated and nonperforated sites and were evaluated for their influence affecting SMP. RESULTS The study sample comprised 278 LSFE procedures in 278 patients; a total of 47 LSFE procedures (16.91%) presented SMP. Four significant factors were identified: smoking habit (p < 0.001), thin (≤1.5 mm) sinus membrane (p = 0.027), maxillary sinus contours (p < 0.001), and presence of septa (p = 0.001). The SMP rate of irregular, narrow tapered, and tapering sinus contours was significantly higher than that of ovoid and square one (p < 0.05). CONCLUSION In general, smoking habit, thin sinus membrane, irregular, narrow tapered, and tapering sinus contours, and presence of septa may increase the risk of SMP during LSFE.
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Affiliation(s)
- Qin Shao
- Department of Implantology, The Affiliated Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Key Laboratory of Oral Biomedical Research of Zhejiang Province, Zhejiang University School of Stomatology, Hangzhou, China
| | - Jialu Li
- Department of Implantology, The Affiliated Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Key Laboratory of Oral Biomedical Research of Zhejiang Province, Zhejiang University School of Stomatology, Hangzhou, China
| | - Rui Pu
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, Zhejiang University School of Stomatology, Hangzhou, China.,Department of Hospital-Acquired Infection Control, The Affiliated Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yuting Feng
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, Zhejiang University School of Stomatology, Hangzhou, China.,Department of Preventive Dentistry, The Affiliated Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zhiwei Jiang
- Department of Implantology, The Affiliated Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Key Laboratory of Oral Biomedical Research of Zhejiang Province, Zhejiang University School of Stomatology, Hangzhou, China
| | - Guoli Yang
- Department of Implantology, The Affiliated Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Key Laboratory of Oral Biomedical Research of Zhejiang Province, Zhejiang University School of Stomatology, Hangzhou, China
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Vaddi A, Villagran S, Muttanahally KS, Tadinada A. Evaluation of available height, location, and patency of the ostium for sinus augmentation from an implant treatment planning perspective. Imaging Sci Dent 2021; 51:243-250. [PMID: 34621651 PMCID: PMC8479432 DOI: 10.5624/isd.20200218] [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: 08/17/2020] [Revised: 03/04/2021] [Accepted: 03/13/2021] [Indexed: 11/27/2022] Open
Abstract
Purpose The objective of this study was to evaluate the amount of height available for a maxillary sinus augmentation procedure without blocking the ostium and jeopardizing the drainage of the ostiomeatal complex using cone-beam computed tomography (CBCT) imaging. Materials and Methods A total of 200 sinonasal complexes comprising 100 dentate and 100 edentulous scans were retrospectively assessed using CBCT. Invivo 5.0, a CBCT reconstruction program, was used for image evaluation. The coronal section demonstrating the ostiomeatal complex was selected as a reference view to perform measurements of the sinus. The measurements were done by 2 evaluators in separate sessions. Comparative analyses of measurements were performed between dentate and edentulous patients and between male and female patients. Results The safe height to which the sinus can be elevated without compromising the integrity of the ostiomeatal complex was calculated for each sinus. In the presence of significant mucosal thickening, the height available for augmentation was calculated by subtracting the height of mucosal thickening from the sinus floor to the location of the ostium. In this study, the available height was approximately 27.05 mm for dentate and 23.40 mm for edentulous patients. The inter-operator reliability was excellent for all the parameters evaluated. Conclusion This retrospective study with a limited number of patients from a single university-based site shows that CBCT is valuable in evaluating the location and patency of the ostium for planning sinus augmentation procedures for dental implant placement.
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Affiliation(s)
- Anusha Vaddi
- Section of Oral and Maxillofacial Radiology, Division of Oral and Maxillofacial Diagnostic Sciences, University of Connecticut School of Dental Medicine, Farmington, CT, USA
| | - Sofia Villagran
- Division of General Dentistry, University of Connecticut School of Dental Medicine, Farmington, CT, USA
| | - Kavya Shankar Muttanahally
- Section of Oral and Maxillofacial Radiology, Division of Oral and Maxillofacial Diagnostic Sciences, University of Connecticut School of Dental Medicine, Farmington, CT, USA
| | - Aditya Tadinada
- Section of Oral and Maxillofacial Radiology, Division of Oral and Maxillofacial Diagnostic Sciences, University of Connecticut School of Dental Medicine, Farmington, CT, USA
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Ridge preservation in maxillary molar extraction sites with severe periodontitis: a prospective observational clinical trial. Clin Oral Investig 2021; 26:2391-2399. [PMID: 34622309 DOI: 10.1007/s00784-021-04204-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 09/22/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To assess alveolar bone changes and treatment modality alterations after ridge preservation on maxillary molar extraction sockets with severe periodontitis, compared to natural healing. MATERIAL AND METHODS Thirty-six maxillary infected-molar teeth either receiving ridge preservation (RG group) or undergoing natural healing (NT group) were investigated. Cone-beam computed tomography (CBCT) scanning was performed immediately after surgery (the baseline) and repeated 6 months later to measure the linear and volumetric changes of the sockets. RESULTS Based on radiographic measurements, alveolar bone width decreased by 1.58 ± 4.61 mm in the NT group but increased by 3.74 ± 4.17 mm in the RG group (p < 0.05). Significant increases in ridge height at the center of both the NT (7.54 ± 4.54 mm) and RG (9.20 ± 3.26 mm) groups were observed. Mean sinus pneumatization was 0.19 ± 0.45 mm in the RG group and 0.59 ± 0.63 mm in the NT group (p < 0.05). The relative increase in total ridge volume was 8.0% and 35.5% in the NT and RG group, respectively (p < 0.05). Implant placement with additional sinus augmentation procedure was performed in 16.7% of the RG group cases, whereas 50% in the NT group cases. CONCLUSIONS Ridge preservation in the maxillary molar extraction sockets with severe periodontitis can improve alveolar ridge dimensions and decrease the necessity of advanced regenerative procedures at implant placement compared to natural healing. CLINICAL RELEVANCE Ridge preservation on maxillary molar extraction sockets with severe periodontitis maintained the vertical bone height more efficiently and resulted in less need for sinus augmentation procedures at 6 months compared to natural healing.
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Park WB, Herr Y, Chung JH, Shin SI, Han JY, Lim HC. Long-term effects of sinus membrane perforation on dental implants placed with transcrestal sinus floor elevation: A case-control study. Clin Implant Dent Relat Res 2021; 23:758-768. [PMID: 34383373 DOI: 10.1111/cid.13038] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 07/02/2021] [Accepted: 07/26/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND There is a little comparative data on implants placed transcrestally with/without sinus membrane (SM) perforation. PURPOSE To compare the clinical and radiological outcomes of implants with maxillary sinus perforation and those without SM perforation. MATERIALS AND METHODS Among 560 transcrestally placed implants in 324 patients, the patients who underwent cone-beam computed tomographic radiography (CBCT) were included. The following groups were established: implants with SM perforation (group P) and implants without SM perforation based on postoperative panoramic radiographs and patient records (group NP). Group NP was further divided into subgroups based on CBCT taken at the last patient visit: group NP1 consisting of implants with no protrusion or <1 mm of protrusion and group NP2 consisting of implants with ≥1 mm of protrusion. Mixed linear regression was performed for the factors affecting SM thickening and marginal bone loss. Mixed survival analysis was also performed. RESULTS A total of 379 implants in 221 patients were eligible. The mean follow-up period was 112.03 ± 54.2 months. Twenty-six implants failed (2 and 24 implants in groups P and NP, respectively), mainly due to peri-implant bone loss. No statistically significant difference was noted between the groups in SM thickness (2.4 ± 2.8 mm, 2.1 ± 3.4 mm, and 2.5 ± 3.5 mm in groups P, NP1, and NP2, respectively, p > 0.05). Marginal bone loss in group NP1 was significantly greater than that in the other groups. In the mixed model, SM perforation was not a determinant of sinus membrane thickening and implant survival in the mixed models and the survival analysis, respectively. CONCLUSIONS SM perforation in transcrestal sinus augmentation did not affect implant survival and SM thickening.
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Affiliation(s)
- Won-Bae Park
- Private Practice in Periodontics and Implant Dentistry, Seoul, South Korea
| | - Yeek Herr
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, School of Dentistry, Kyung Hee University, Seoul, South Korea
| | - Jong-Hyuk Chung
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, School of Dentistry, Kyung Hee University, Seoul, South Korea
| | - Seung-Il Shin
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, School of Dentistry, Kyung Hee University, Seoul, South Korea
| | - Ji-Young Han
- Division of Dentistry, Department of Periodontology, College of Medicine, Hanyang University, Seoul, South Korea
| | - Hyun-Chang Lim
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, School of Dentistry, Kyung Hee University, Seoul, South Korea
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26
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de Souza Fernandes AC, Barreto Nascimento GI, de Souza Pereira F, Galil KA, Bitencourt Farias IO, R Rebello IMC, Barreto MA. Gingival Biotype and Its Relationship With the Maxillary Membrane and Lateral Wall Thickness. J ORAL IMPLANTOL 2021; 47:280-286. [PMID: 32870278 DOI: 10.1563/aaid-joi-d-19-00247] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The purpose of this study was to analyze the risk of the maxillary sinus lift technique and the correlation between the thickness of the gingiva, maxillary sinus membrane, and the maxillary sinus lateral wall. Cone-beam computerized tomograhy (CBCT) records of 32 adult dentate patients (10 male/22 female) were analyzed. The gingival thickness records of the dental units were compared with the thickness measurements of the membrane and lateral wall of the maxillary sinus. The gingival biotypes varied between 1.1 mm (thin) and 1.6 mm (thick), with a small association with sex. The thickness of the sinus membrane presented a small association between sexes (0.2 mm, female/0.3 mm, male) and gingival biotypes (Cohen d = .52). The lateral wall presented a weak association between the biotypes (1.3 mm, thin/1.1 mm, thick). There was also no correlation between the membrane and lateral wall (r = -.22). The volume dimension related to the graft area of the sinus was 4 mm3 for men and 5 mm3 for women. There was a weak correlation of gingival thickness compared with membrane thickness and lateral wall of the sinus (r = .304/r = -.31). Gingival thickness does not appear to be a reliable thickness predictor of the membrane or lateral wall of the maxillary sinus. The analysis of maxillary sinus anatomical structures through CBCT is the most reliable technique to identify the thickness of the membrane and lateral wall of the maxillary sinus before surgery. We believe that new studies are necessary to confirm our findings.
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Affiliation(s)
| | | | | | - Khadry A Galil
- University of Western Ontario - UWO, Schulich School of Medicine and Dentistry, Department of Anatomy and Cell Biology, Ontario, Canada
| | | | - Iêda M Crusoé R Rebello
- Federal University of Bahia - UFBA, Dental School, Department of Oral Diagnosis, Division of Oral Radiology, Bahia, Brazil
| | - Maurício Andrade Barreto
- Bahiana School of Medicine and Public Health - BAHIANA, Department of Implantology, Bahia, Brazil
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Sinus Mucosa Thickness Changes and Ostium Involvement after Maxillary Sinus Floor Elevation in Sinus with Septa. A Cone Beam Computed Tomography Study. Dent J (Basel) 2021; 9:dj9080082. [PMID: 34435994 PMCID: PMC8391700 DOI: 10.3390/dj9080082] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 07/13/2021] [Accepted: 07/19/2021] [Indexed: 01/15/2023] Open
Abstract
Background: A thickening of the sinus mucosa is observed after sinus floor augmentation. The objective of this retrospective study was to evaluate the influence of the presence of septa in the dimensional variation and ostium involvement over time of the Schneiderian mucosa after sinus floor augmentation. Materials and Methods: Fifteen sinuses with septa (septa group) and 15 without (control group) were selected. CBCTs taken before surgery, and were analyzed after 1 week and after 9 months. Schneiderian membrane thickness changes over time and involvement of the ostium were evaluated. Results: Four perforations occurred in the septa group and none in the control group. After 1 week of healing, the sinus mucosa thickness increased in height by 5.7 mm and 7.1 mm in the septa and control groups, respectively. In this period, the patency of the ostium decreased in both groups, and three infundibula were obstructed in the septa group, and five in the control group. The mucosa was thicker and the edema was closer to the ostium in the control compared to in the septa group. After 9 months of healing, the dimensions regressed to normal pattern and no obstruction of the infundibula were observed. No statistically significant differences were found between septa and control groups. Conclusions: after one week of healing, the sinus mucosa increased in dimensions in both septa and control groups. However, the sinus mucosa presented a tendency of being thicker and closer to the ostium, resulting in a higher number of infundibula obstructions, in the control group compared to in the septa group. After 9 months, the sinus mucosa regressed to normal dimensions and no obstructions of the infundibula were observed in any group.
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Park WB, Kim YJ, Park JS, Han JY, Lim HC. Complication and Salvage of Sinus Floor Elevation in the Maxillary Sinus With Asymptomatic and Noncalcified Fungus Colonization: A Case Report. J ORAL IMPLANTOL 2021; 47:242-248. [PMID: 32663302 DOI: 10.1563/aaid-joi-d-20-00127] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The present study aimed to report (1) the sequela of sinus floor elevation (SFE) in the posterior maxilla with severe sinus membrane thickening and an undiagnosed fungal colonization but a patent ostium and (2) a treatment course without implant removal. A 73-year-old woman underwent dental implant placement in the left posterior maxillary area. Although the patient was asymptomatic, severe sinus membrane thickening with Haller cells was observed on a radiographic examination, but the ostium was patent. After SFE and simultaneous implant placement, the patient developed acute sinusitis and was referred to an otolaryngologist. Functional endoscopic sinus surgery (FESS) was performed, resulting in resolution of the infection and salvage of the augmentation and the implant. The histopathologic examination revealed the fungal ball that could not be diagnosed on preoperative dental radiography. During the 2 years after the delivery of the final prosthesis, a significant reduction in membrane thickness was observed. The implants were functioning well. Clinicians should recognize fungal colonization as an etiology of sinus membrane thickening and provide proper pre- and postoperative management, including FESS.
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Affiliation(s)
- Won-Bae Park
- Department of Periodontology, School of Dentistry, Kyung Hee University, Private Practice in Periodontics and Implant Dentistry, Seoul, Korea
| | - Young-Jin Kim
- Nowon Eulji Medical Center, Eulji University, Private Practice in Otorhinolaryngology Clinic, Seoul, Korea
| | - Jung Soo Park
- Department of Periodontology, Korea University Anam Hospital, Seoul, Korea
| | - Ji-Young Han
- Department of Periodontology, Division of Dentistry, Hanyang University, College of Medicine, Seoul, Korea
| | - Hyun-Chang Lim
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, School of Dentistry, Kyung Hee University, Seoul, Republic of Korea
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Wei Y, Zhang B, Yang G, Xu T, Hu W, Chung KH. Effect of ridge preservation at molar extraction sites with severe periodontitis on the Schneiderian membrane thickness changes: a pilot study. BMC Oral Health 2021; 21:184. [PMID: 33845803 PMCID: PMC8040225 DOI: 10.1186/s12903-021-01546-8] [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: 10/31/2020] [Accepted: 03/30/2021] [Indexed: 11/15/2022] Open
Abstract
Background Information regarding the reaction of bone augmentation in terms to sinus mucosa thickness of periodontally compromised molar extraction sites is limited. This retrospective study aimed to analyze the effect of ridge preservation procedures following the extraction of molars with severe periodontitis on the healing pattern of adjacent maxillary sinus mucosal membranes. Methods Thirty-one periodontally compromised maxillary molar teeth either receiving ridge preservation (test group, n = 20) or undergoing spontaneous healing (control group, n = 11) were investigated. Cone-beam computed tomography (CBCT) scanning was performed before the extraction procedure and repeated 6 months later. The mucosa thickness (MT) of the adjacent periodontally compromised molar tooth was measured from CBCT images before tooth extraction and after 6 months of healing at nine assigned measurement points. The data were analyzed at α = 0.05. Results The prevalence of pre-extraction maxillary sinus mucosal thickening was 60.0% and 63.6% in the test and control groups, respectively. The average MT of the thickened sinus mucosa before tooth extraction was 3.78 ± 2.36 mm in the test group and 4.63 ± 3.20 mm in the control group (P = 0.063). The mean mucosal thickening reductions in the thickened MT subjects after 6 months of healing were 2.20 ± 2.05 mm (test group) and 2.64 ± 2.70 mm (control group), P = 0.289. The differences of MT between the time prior to extraction and after 6 months of healing were statistically significant within both groups (P < 0.05). Conclusions Following extraction of molars with severe periodontitis, a reduction in swelling of the Schneiderian membrane has been observed regardless of the addition of a DBBM socket graft. However, a mucosal thickness > 2 mm was still frequently observed.
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Affiliation(s)
- Yiping Wei
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Disease, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun Avenue South, Haidian District, Beijing, 100081, People's Republic of China
| | - Bo Zhang
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Disease, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun Avenue South, Haidian District, Beijing, 100081, People's Republic of China.,Department of Stomatology, Beijing Friendship Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Gang Yang
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Disease, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun Avenue South, Haidian District, Beijing, 100081, People's Republic of China
| | - Tao Xu
- Department of Emergency, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Disease, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, People's Republic of China
| | - Wenjie Hu
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Disease, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun Avenue South, Haidian District, Beijing, 100081, People's Republic of China.
| | - Kwok-Hung Chung
- Department of Restorative Dentistry, University of Washington, Seattle, WA, USA
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30
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Changes in Maxillary Sinus Mucosal Thickening following the Extraction of Teeth with Advanced Periodontal Disease: A Retrospective Study Using Cone-Beam Computed Tomography. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6688634. [PMID: 33860050 PMCID: PMC8009702 DOI: 10.1155/2021/6688634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 03/06/2021] [Accepted: 03/13/2021] [Indexed: 11/17/2022]
Abstract
Objectives To explore the alterations in maxillary sinus mucosal thickening after extracting teeth with severe periodontal disease using cone-beam computed tomography (CBCT). Methods 30 patients with severe periodontal disease of maxillary posterior teeth that needed to be extracted and who were radiographically diagnosed with mucosal thickening (MT) in the maxillary sinus participated in the study. CBCT scans were taken before tooth extraction and 2-29 months after tooth extraction. The postextraction follow-up time was divided into two groups: group 1 (<4 months) and group 2 (≥4 months). Dimensions of maxillary sinus MT, including the MT zone length (SL) and the maximum thickness of the MT zone (ST), were evaluated preextraction and postextraction; the residual ridge height (RRH) was evaluated at the sites of extracted and nonextracted teeth. Result Of the 24 patients with unilateral tooth extraction, there was a statistically significant difference in MT between the extraction and nonextraction sides (p < 0.05). The RRH at the site of the extracted teeth was significantly lower than that of the nonextracted teeth (p < 0.05). MT decreased significantly after tooth extraction on the extraction side but not on the nonextraction side. There was no significant difference between group 1 and group 2 regarding the reduction in mucosal thickness over time. Conclusions Severe periodontitis can cause MT in the maxillary sinus. The RRH was lower at the sites of extracted teeth. MT reduced quickly by a thorough debridement after tooth extraction in 4 months. MT will not decrease further over time.
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Munakata M, Yamaguchi K, Sato D, Yajima N, Tachikawa N. Factors influencing the sinus membrane thickness in edentulous regions: a cone-beam computed tomography study. Int J Implant Dent 2021; 7:16. [PMID: 33649993 PMCID: PMC7921232 DOI: 10.1186/s40729-021-00298-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 02/02/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND During implant treatment in the maxillary molar area, maxillary sinus floor augmentation is often performed to ameliorate the reduced alveolar bone height attributable to bone remodeling and pneumatization-induced expansion of the maxillary sinus. However, this augmentation may cause complications such as misplaced implants, artery damage, and maxillary sinus mucosal perforation; infections like maxillary sinusitis; and postsurgical complications such as bone graft leakage and postoperative nasal hemorrhaging. To reduce the complications during maxillary sinus floor augmentation and postoperative infections, we performed retrospective investigations of various systemic and local factors that influence pre-operative sinus mucosal thickness (SMT) by using cone-beam computed tomography (CBCT). Subjects included patients who underwent maxillary sinus floor augmentation in an edentulous maxillary molar area with a lateral approach. Pre-operative SMT, existing bone mass, and nasal septum deviation were measured using CBCT images. Relationships between SMT and the following influencing factors were investigated: (1) age, (2) sex, (3) systemic disease, (4) smoking, (5) period after tooth extraction, (6) reason for tooth extraction, (7) residual alveolar bone height (RBH), (8) sinus septa, and (9) nasal septum deviation. Correlations were also investigated for age and RBH (p < 0.05). RESULTS We assessed 35 patients (40 sinuses; 11 male, 24 female). The average patient age was 58.90 ± 9.0 years (males, 57.9 ± 7.7 years; females, 59.9 ± 9.4 years; age range, 41-79 years). The average SMT was 1.09 ± 1.30 mm, incidence of SMT > 2 mm was 25.0%, incidence of SMT < 0.8 mm was 50.0%, and the average RBH was 2.14 ± 1.02 mm. The factors that influenced SMT included sex (p = 0.0078), period after tooth extraction (p = 0.0075), reason for tooth extraction (p = 0.020), sinus septa (p = 0.0076), and nasal septum deviation (p = 0.038). CONCLUSIONS Factors associated with higher SMT included male sex, interval following tooth extraction < 6 months, periapical lesions, sinus septa, and nasal septum deviation. Factors associated with SMT > 2 mm were sex and reason for tooth extraction, while factors associated with SMT < 0.8 mm were time following tooth extraction and nasal septum deviation. Despite the limitations of this study, these preoperative evaluations may be of utmost importance for safely conducting maxillary sinus floor augmentation.
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Affiliation(s)
- Motohiro Munakata
- Department of Implant Dentistry, Showa University School of Dentistry, 2-1-1, Kita-Senzoku, Ota-ku, 145-8515, Tokyo, Japan.
| | - Kikue Yamaguchi
- Department of Implant Dentistry, Showa University School of Dentistry, 2-1-1, Kita-Senzoku, Ota-ku, 145-8515, Tokyo, Japan
| | - Daisuke Sato
- Department of Implant Dentistry, Showa University School of Dentistry, 2-1-1, Kita-Senzoku, Ota-ku, 145-8515, Tokyo, Japan
| | - Naoko Yajima
- Department of Implant Dentistry, Showa University School of Dentistry, 2-1-1, Kita-Senzoku, Ota-ku, 145-8515, Tokyo, Japan
| | - Noriko Tachikawa
- Tokyo Medical and Dental University Dental Hospital, Tokyo Medical and Dental University, Tokyo, Japan
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Huang JQ, Hu CQ, Xia X, Guo SG, Gong JM, Wei HW. [Retrospective study on transcrestal sinus floor elevation with simultaneous implantation of short implants]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2020; 38:667-671. [PMID: 33377345 DOI: 10.7518/hxkq.2020.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To explore the changes in bone height of the maxillary sinus floor at different sinus ridge heights after transcrestal sinus floor elevation (tSFE) with the simultaneous implantation of short implants. METHODS A total of 74 Bicon short implants were implanted into 37 patients during the same period of maxillary sinus elevation. The residual bone height (RBH)<4 mm group has 43 sites, and the RBH≥4 mm group has 31 sites. After 5 years of follow-up observation, the implant survival rate and the change in bone height achieved in the maxillary sinus over time were measured and analyzed via clinical examination and X-ray imaging. RESULTS In the 74 implantation sites, the elevation height of the sinus floor was (6.64±1.32) mm and the bone height of the sinus floor was (3.35±1.29) mm 5 years after loading. No statistical difference was observed in the bone resorption of the implant neck between the RBH<4 mm and RBH≥4 mm groups. Meanwhile, a statistical difference was noted in the bone height obtained in the maxillary sinus between the two groups. CONCLUSIONS When RBH in the maxillary posterior tooth area was <4 mm, the simultaneous implantation of Bicon short implants with tSFE can achieve a high implant survival rate and bone gain in the maxillary sinus, but does not increase the absorption of the alveolar ridge bone.
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Affiliation(s)
- Jiang-Qin Huang
- Dept. of Stomatology, The Fourth Affiliated Hospital of Nanchang University, Nanchang 330009, China
| | - Chang-Qi Hu
- Dept. of Stomatology, The Fourth Affiliated Hospital of Nanchang University, Nanchang 330009, China
| | - Xun Xia
- Dept. of Stomatology, The Fourth Affiliated Hospital of Nanchang University, Nanchang 330009, China
| | - Shui-Gen Guo
- Dept. of Stomatology, The Fourth Affiliated Hospital of Nanchang University, Nanchang 330009, China
| | - Jin-Mei Gong
- Dept. of Stomatology, The Fourth Affiliated Hospital of Nanchang University, Nanchang 330009, China
| | - Hong-Wu Wei
- Dept. of Stomatology, The Fourth Affiliated Hospital of Nanchang University, Nanchang 330009, China
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Afrashtehfar KI, Katsoulis J, Koka S, Igarashi K. Single versus splinted short implants at sinus augmented sites: A systematic review and meta-analysis. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2020; 122:303-310. [PMID: 33002610 DOI: 10.1016/j.jormas.2020.08.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 07/08/2020] [Accepted: 08/26/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVE This review primarily evaluated the success, survival and failure rates of implants shorter than 10 mm restored with single-unit or splinted fixed dental prostheses in maxillary sinus augmented sites. MATERIAL AND METHODS Two reviewers independently performed the systematic search of electronic databases, including MEDLINE, EMBASE and CENTRAL, up to September 2019 with no language restriction. A supplemental hand search consisted of screening 13 journals. The inclusion criteria were: primary studies reporting implant, prosthetic and patient-reported outcome measures (PROMs) of extra-short and short implants placed in conjunction with sinus floor elevation in partially dentate patients, restored with single- and splinted-crowns for direct comparison, with a minimal 1-year follow-up. Weighted arithmetic mean (WAM) of the implant survival was performed according to the type of prosthesis. This was confirmed by using Review Manager software to perform meta-analysis. RESULTS Two observational studies reporting on 106 tapered, press-fit, sintered porous-surfaced implants with a length ranging from 5 mm to 9 mm were included in this systematic review. Of these, 20 and 86 implants were restored with single and splinted prostheses, respectively. The risk ratio (RR) was 1.16 (95% CI: .31-4.30, p = .58, I² = 0%) for individually restored implants failure when compared to splinted implants, indicating that short dental implants restored with single crowns could have a 16% higher possibility of failure if compared to implants with splinted crowns. The heterogeneity value was not statistically significative (p = .58). No statistical difference in the implant survival rate of the two types of analysed prostheses was observed after WAM (p= .923). The level of evidence for the included studies ranged from low (4) to fair (2B). CONCLUSION Similar clinical outcomes up to a 9-year follow-up were observed in single and splinted porous-surfaced implants shorter than 10 mm located in sites with sinus lift. However, the conclusion shall be interpreted with caution due to the level of evidence and limited number of included studies included in this systematic review.
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Affiliation(s)
- Kelvin I Afrashtehfar
- Department of Reconstructive Dentistry & Gerodontology, School of Dental Medicine, Faculty of Medicine, University of Bern, 3010 Bern, Switzerland; Department of Oral Surgery and Stomatology, School of Dental Medicine, Faculty of Medicine, University of Bern, 3010 Bern, Switzerland; Division of Restorative Dental Sciences, College of Dentistry, Ajman University, 346 Ajman City, UAE; Department of Restorative Dentistry, Edinburgh Dental Institute, University of Edinburgh, College of Medicine and Veterinary, Lauriston Place, Edinburgh, EH3 9HA, UK; Department of Oral Health Sciences, University of British Columbia, Vancouver, BC V6T 1Z3, Canada.
| | - Joannis Katsoulis
- Department of Reconstructive Dentistry & Gerodontology, School of Dental Medicine, Faculty of Medicine, University of Bern, 3010 Bern, Switzerland; Department of Preventive & Restorative Sciences, University of Pennsylvania School of Dental Medicine, Philadelphia, PA 19104, USA
| | - Sreenivas Koka
- Division of Advanced Prosthodontics, School of Dentistry, Loma Linda University, Loma Linda, CA 92350, US; Advanced Prosthodontics, UCLA School of Dentistry, Los Angeles, CA 90095, USA; MIT Sloan School of Management, Massachusetts Institute of Technology, Cambridge, MA 02142, USA
| | - Kensuke Igarashi
- Department of Reconstructive Dentistry & Gerodontology, School of Dental Medicine, Faculty of Medicine, University of Bern, 3010 Bern, Switzerland; Department of Life Science Dentistry, The Nippon Dental University, Niigata 951-8580, Japan
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An Anatomic Study on the Maxillary Sinus Mucosal Thickness and the Distance between the Maxillary Sinus Ostium and Sinus Floor for the Maxillary Sinus Augmentation. ACTA ACUST UNITED AC 2020; 56:medicina56090470. [PMID: 32937837 PMCID: PMC7559255 DOI: 10.3390/medicina56090470] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 09/08/2020] [Accepted: 09/11/2020] [Indexed: 12/01/2022]
Abstract
Background and objectives: The average rate of chronic sinusitis after maxillary implantation was approximately 5.1%. However, the evidence of predictive risk factors for sinusitis after implantation is lacking. The aim of this study was to perform an anatomic study on the maxillary sinus mucosal thickness (MSMT), the distance between the maxillary sinus ostium and sinus floor (MOD), and the MSMT/MOD ratio as a preoperative risk indicator for sinusitis after maxillary dental implantation. Materials and Methods: Between October 2008 and October 2019, all patients referred to the otolaryngology department were included in this study. A total of 120 patients were enrolled. The 95 patients who received no treatment prior to implantation were classified into Group A, the 16 patients who used antibiotics before implantation were classified into Group B, and the patients who had implants inserted after functional endoscopic sinus surgery were classified into Group C. The MSMT, MOD, MSMT/MOD ratio, anatomical factors associated with ostial obstruction, and the occurrence of postoperative sinusitis were reviewed. Results: There were significant group differences in MSMT (Group A vs. Group B, p = 0.001; Group B vs. Group C, p = 0.003; Group C vs. Group A, p < 0.0001). The MOD showed no significant difference among the three groups. The MSMT/MOD ratio showed significant differences between Groups A and B (p = 0.001), B and C (p < 0.0001), and C and A (p < 0.0001). Conclusions: It is important to check not only the proportion of the maxillary sinus occupying lesion, but also the status of the maxillary sinus osteomeatal complex when making therapeutic decisions. In addition, collaboration between dentists and otolaryngologists could improve outcomes in patients with maxillary sinus lesions.
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Oba Y, Tachikawa N, Munakata M, Okada T, Kasugai S. Evaluation of maxillary sinus floor augmentation with the crestal approach and beta-tricalcium phosphate: a cone-beam computed tomography 3- to 9-year follow-up. Int J Implant Dent 2020; 6:27. [PMID: 32648123 PMCID: PMC7347718 DOI: 10.1186/s40729-020-00225-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 05/04/2020] [Indexed: 12/29/2022] Open
Abstract
Background We performed maxillary sinus floor augmentation using the crestal approach and beta-tricalcium phosphate (β-TCP) and a long-term evaluation using cone-beam computed tomography (CBCT). Methods Twenty-three patients (30 implants) underwent sinus floor augmentation using the osteotome technique. Subjects underwent CBCT imaging before surgery, immediately after surgery, and at follow-up (≥ 3 years after surgery). We measured the changes in height of the augmented sinus floor (SL), the augmented bone above apex of the implant (BH), and the implant length that projected into the sinus (IL). Results The mean SL decreased from 6.54 ± 1.51 (immediately after surgery) to 3.11 ± 1.35 mm (follow-up). The mean BH decreased from 3.17 ± 0.97 to − 0.25 ± 1.19 mm; the maxillary sinus floor in many implants was near the apex at follow-up. The SL at follow-up showed a strong correlation with the IL (p = 0.0057). Conclusions Osteotome sinus floor elevation with beta-tricalcium phosphate was clinically effective. Cone-beam computed tomography analysis revealed that ≥ 3 years after surgery, the maxillary sinus floor was near the apex of the implant.
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Affiliation(s)
- Yoko Oba
- Clinic for Implant Dentistry, Dental Hospital, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, Japan
| | - Noriko Tachikawa
- Clinic for Implant Dentistry, Dental Hospital, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, Japan
| | | | - Tsuneji Okada
- Clinic for Implant Dentistry, Dental Hospital, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, Japan.
| | - Shohei Kasugai
- Clinic for Implant Dentistry, Dental Hospital, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, Japan
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Zhang B, Wei Y, Cao J, Xu T, Zhen M, Yang G, Chung KH, Hu W. Association between the dimensions of the maxillary sinus membrane and molar periodontal status: A retrospective CBCT study. J Periodontol 2020; 91:1429-1435. [PMID: 32146722 DOI: 10.1002/jper.19-0391] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Revised: 12/23/2019] [Accepted: 02/05/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND The information of the association between residual alveolar bone height and mucosal thickening is sparse. This study aimed to explore the effect of maxillary molar periodontal status on sinus mucosal thickening using cone-beam computed tomography (CBCT). METHODS One hundred ninety-four CBCT images were evaluated for the following parameters: age, sex, alveolar bone loss, maximum mucosal thickness (maxMT), minimum residual alveolar bone height (minRABH), and vertical infrabony pockets. The presence of mucosal thickening (maxMT > 2 mm) of the maxillary sinus was recorded. The parameters that could influence the dimensions of the maxillary sinus membrane were assessed. The data were analyzed using logistic regression, and multivariate linear regression with the significant level at α = 0.05. RESULTS Mucosal thickening was present in 32% of the analyzed CBCT images and increased in frequency as the periodontal status of the corresponding molar progressed from mild (2.6%) to moderate (14.9%) to severe (75.5%). Mucosal thickness was significantly increased in cases of moderate (odds ratio = 5.73, P < 0.05) and severe (odds ratio = 82.06, P < 0.001) alveolar bone loss. Multivariate linear regression revealed that alveolar bone loss and minRABH had a statistically significant influence on maxMT (P < 0.05). CONCLUSIONS Alveolar bone loss and minRABH were significantly associated with mucosal thickening of the maxillary sinus.
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Affiliation(s)
- Bo Zhang
- Department of Periodontology, National Clinical Research Center for Oral Disease, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Yiping Wei
- Department of Periodontology, National Clinical Research Center for Oral Disease, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Jie Cao
- Department of Periodontology, National Clinical Research Center for Oral Disease, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Tao Xu
- Department of Emergency, National Clinical Research Center for Oral Disease, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Min Zhen
- Department of Periodontology, National Clinical Research Center for Oral Disease, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Gang Yang
- Department of Periodontology, National Clinical Research Center for Oral Disease, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Kwok-Hung Chung
- Department of Restorative Dentistry, University of Washington, Seattle, WA, USA
| | - Wenjie Hu
- Department of Periodontology, National Clinical Research Center for Oral Disease, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, PR China
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Janner SFM, Dubach P, Suter VGA, Caversaccio MD, Buser D, Bornstein MM. Sinus floor elevation or referral for further diagnosis and therapy: A comparison of maxillary sinus assessment by ENT specialists and dentists using cone beam computed tomography. Clin Oral Implants Res 2020; 31:463-475. [PMID: 31991010 DOI: 10.1111/clr.13582] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 12/03/2019] [Accepted: 01/07/2020] [Indexed: 01/07/2023]
Abstract
OBJECTIVES To compare ear, nose, and throat (ENT) specialists and dentists assessing health or pathology of maxillary sinuses using cone beam computed tomography (CBCT). MATERIAL AND METHODS Two ENT specialists and two oral surgeons assessed 100 CBCT datasets of healthy patients referred for dental implant placement in the posterior maxilla and decided on the possibility of sinus floor elevation or the necessity for further diagnostic examinations based solely on radiographic findings. Inter-rater agreements within the same specialty were calculated with Cohen's kappa and overall agreements with Fleiss kappa, and factors influencing the decisions taken were evaluated using regression analyses. RESULTS The correlation between all four raters was generally fair to moderate. The intra-specialty comparison showed a lower correlation between dentists than between ENT specialists. Absence of membrane thickening and total or subtotal sinus opacification showed the highest predictive value for a consensus in favor of sinus floor elevation and ENT referral, respectively. Flat membrane thickening with an irregular surface morphology was associated with disagreement between the examiners. Dome-shaped membrane thickenings were often considered as to be referred by dentists but not by ENTs. CONCLUSION The assessment of maxillary sinuses using CBCT imaging exhibited unsatisfactory agreement between ENT specialists and oral surgeons. Referral guidelines based on accidental CBCT findings that aim to diagnose relevant sinus pathologies early and avoid unnecessary diagnostics and/or therapies are needed, and an initial proposal for such recommendations is provided. Further research on correct interpretation of sinus findings and a validation of the present recommendations are required.
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Affiliation(s)
- Simone F M Janner
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Patrick Dubach
- Department of Otorhinolaryngology, Head and Neck Surgery, Inselpital, University of Bern, Bern, Switzerland.,Department of Otorhinolaryngology, Head and Neck Surgery, Burgerspital Solothurn, Solothurn, Switzerland
| | - Valerie G A Suter
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Marco D Caversaccio
- Department of Otorhinolaryngology, Head and Neck Surgery, Inselpital, University of Bern, Bern, Switzerland
| | - Daniel Buser
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Michael M Bornstein
- Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.,Department of Oral Health & Medicine, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
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Evaluation of the Relationship Between Schneiderian Membrane Thickness and Sinus Floor Cortication Using Cone Beam Computed Tomography. ANADOLU KLINIĞI TIP BILIMLERI DERGISI 2020. [DOI: 10.21673/anadoluklin.466703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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French Otorhinolaryngology Society (SFORL) good practice guidelines for dental implant surgery close to the maxillary sinus. Eur Ann Otorhinolaryngol Head Neck Dis 2019; 137:53-58. [PMID: 31837968 DOI: 10.1016/j.anorl.2019.11.002] [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: 11/21/2022]
Abstract
OBJECTIVES To draw up guidelines for ENT management associated with dental implant surgery with or without sinus lift. MATERIALS AND METHODS The methodology followed the rules of laid down by the French Health Authority (HAS): "Methodological bases for drawing up professional recommendations by formalized consensus". The chosen method was the RAND/UCLA "RAND appropriateness method" (short version). RESULTS In the pre-implantation check-up, it is recommended to systematically screen for sinonasal pathology on medical interview and to favor 3D CT or cone-beam imaging. It is recommended that imaging include the entire maxillary sinus when the patient does not have sinonasal history or functional signs on interview. Otherwise, examination of all sinonasal cavities is recommended. This attitude enables simultaneous analysis of maxillary infrastructure for pre-implantation work-up and assessment of sinonasal cavity status. Sinus mucosal incidentalomas are very common in the healthy population and must be assessed with reference to the clinical, endoscopic and radiological context. CONCLUSION This formalized expert consensus establishes a common base of knowledge, to clarify the issues and clinical situations and to standardize practices.
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Wang H, Tan Z, You M, Liu WJ. [Imaging classification diagnosis and maxillary sinus floor augmentation of maxillary sinus cystic lesions]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2019; 37:457-462. [PMID: 31721489 DOI: 10.7518/hxkq.2019.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Maxillary sinus cystic lesions can often be found in cone-beam computed tomography (CBCT) images. However, whether this change affects the implementation of maxillary sinus floor augmentation remains unclear. Combining the common cystic change performance of CBCT, image classification diagnosis of maxillary sinus cystic change was introduced, and the indications and surgical methods of maxillary sinus floor augmentation and postoperative radiographic changes of mucous were analyzed. This procedure may help clinicians evaluate the feasibility and methods of maxillary sinus augmentation in maxillary sinus cystic changes.
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Affiliation(s)
- Hu Wang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Radiological, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Zhen Tan
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Implantation, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Meng You
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Radiological, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Wen-Jia Liu
- Dept. of Prosthodontics, Sichuan Hospital of Stomatology, Chengdu 610000, China
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Hsu YH, Pan WL, Chan CP, Pan YP, Lin CY, Wang YM, Chang CC. Cone-beam computed tomography assessment of Schneiderian membranes: Non-infected and infected membranes, and membrane resolution following tooth extraction: A retrospective clinical trial. Biomed J 2019; 42:328-334. [PMID: 31783993 PMCID: PMC6889225 DOI: 10.1016/j.bj.2019.03.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 03/17/2019] [Accepted: 03/27/2019] [Indexed: 11/07/2022] Open
Abstract
Background Cone-beam computed tomography (CBCT) presurgical assessment on the maxillary sinus can reduce the possibility of Schneiderian membrane perforation. This study examined Schneiderian membrane thickness (SMT) and its relationship with neighboring hard tissues for patients with and without membrane thickening. For patients with sinus infections, we evaluated dimensional changes of the SMT post-extraction relative to pre-extraction SMT and residual bone height (RBH). Methods CBCT images from 93 patients needing single-tooth implant reconstruction without (n = 83) and with (n = 14) odontogenic infected maxillary sinuses were assessed. SMT, RBH, and lateral wall thickness (LWT) were measured. Causes of extraction, RBH in the infection site, and retrospective post-extraction record of SMT were recorded for the thickened SMT group. Results Mean SMT for normal SMT group was 1.13 ± 0.43 mm, RBH was 6.26 ± 2.38 mm; upper and lower LWT was 1.85 ± 0.95 mm, and 3.07 ± 2.26 mm, respectively. RBH and LWT had no significant relationships with SMT. For thickened SMT group, mean values for SMT and RBH prior to extraction were 4.53 ± 2.46 mm and 1.97 ± 1.43 mm, respectively. Pre-extraction SMT had a moderately negative correlation with pre-extraction RBH. SMT resolution in thickened SMT group was observed by 2.80 ± 1.37 months post-extraction; post-extraction SMT was not significantly different from normal SMT group (p = .187). Conclusions Within the limitation of the sample size, thickened SMT induced by odontogenic infection subsides about 3 months following tooth extraction, and further sinus lifting implant surgery may be considered.
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Affiliation(s)
- Yuh-Hau Hsu
- Department of Periodontics, Chang Gung Memorial Hospital at Taipei, Taipei, Taiwan
| | - Whei-Lin Pan
- Department of Periodontics, Chang Gung Memorial Hospital at Taipei, Taipei, Taiwan; Graduate Institute of Dental and Craniofacial Science, Chang Gung University, Taoyuan, Taiwan.
| | - Chiu-Po Chan
- Department of Periodontics, Chang Gung Memorial Hospital at Taipei, Taipei, Taiwan; Graduate Institute of Dental and Craniofacial Science, Chang Gung University, Taoyuan, Taiwan
| | - Yi-Ping Pan
- Department of Nutrition, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan
| | - Cho-Ying Lin
- Department of Periodontics, Chang Gung Memorial Hospital at Taipei, Taipei, Taiwan
| | - Yuan-Min Wang
- Department of Periodontics, Chang Gung Memorial Hospital at Taipei, Taipei, Taiwan
| | - Chi-Ching Chang
- Department of Periodontics, Chang Gung Memorial Hospital at Taipei, Taipei, Taiwan
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Maxillary Sinus and Surrounding Bone Anatomy With Cone Beam Computed Tomography After Multiple Teeth Loss: A Retrospective Multicenter Clinical Study. IMPLANT DENT 2019; 28:226-236. [PMID: 31124819 DOI: 10.1097/id.0000000000000862] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of this multicenter study was to examine the residual alveolar bone anatomy and sinus mucosa pattern at maxillary sinus regions in multiple teeth loss. MATERIALS AND METHODS This study was conducted with cone beam computed tomography images of 518 patients (267 females and 251 males) with multiple posterior maxillary teeth loss. Variables associated with sinus membrane (SM), sinus dimensions, ostium, septa, sinus neighborhood, alveolar bone height and ridge width, posterior superior alveolar artery, and adjacent roots were evaluated. RESULTS No (58.2%) or flat (19.3%) thickening morphology was detected at most of the SMs. Membrane thickening and mucosal-like morphology was more prevalent for male patients (P = 0.005). The mean sinus width was relatively low (3.64 ± 3.33 mm) at the 5-mm level and showed an expected increase toward upper levels. Most of the sinus spaces were dimensionally average (39.5%) or wide (44.7%), and no effect of gender was observed in terms of sinus dimensions (P > 0.05). CONCLUSION Multiple teeth loss plays a role in creating an imaginary sinus anatomy constituted of a relatively narrow space compared with single-tooth loss cases, from 3.6-mm mean coronal width to 11.3 mm in the apical portion.
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Ritter A, Rozendorn N, Avishai G, Rosenfeld E, Koren I, Soudry E. Preoperative Maxillary Sinus Imaging and the Outcome of Sinus Floor Augmentation and Dental Implants in Asymptomatic Patients. Ann Otol Rhinol Laryngol 2019; 129:209-215. [PMID: 31631672 DOI: 10.1177/0003489419883292] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Preoperative maxillary sinus imaging findings have been suggested to be associated with complications and outcomes of sinus lift and dental implant procedures; nonetheless the evidence is controversial. The aim of this study was to examine the association between preoperative maxillary sinus imaging findings and outcomes of sinus lift and dental implant procedures in asymptomatic patients. METHODS We included all patients who underwent maxillary sinus lift and dental implant procedures between 2014 and 2017. Maxillary sinus imaging findings were extracted from pre-procedural dental computed tomography scans, and outcomes of the procedures were assessed. RESULTS A total of 145 procedures were included. No sinonasal symptoms were reported preoperatively. In 46% of cases maxillary sinus imaging was abnormal. The most common imaging finding was peripheral mucosal thickening (38%). Sinus floor cyst/polyp was identified in 13% of the cases, of which 47% occupied more than 50% of the sinus volume. Partial or complete opacification of the maxillary sinus was documented in 3% of cases. The sinus ostium and ostiomeatal complex were obstructed in 7% and 1%, respectively. Mucosal perforation was documented in 22% of cases and was inversely related to mucosal thickening (P = 0.011). Other minor post-operative complications did not correlate with radiological findings. Post-surgical sinusitis was not observed in any of the patients regardless of pre-surgical imaging findings. CONCLUSIONS Incidental maxillary sinus imaging findings such as mucosal swelling, cysts or polyps, regardless of their severity or size, and maxillary ostial obstruction may not need to be addressed prior to sinus augmentation and dental implant procedures in asymptomatic patients. Patients with complete sinus opacification should be referred to an otolaryngologist prior to surgery. Further controlled trials, in larger cohorts, are needed to corroborate our findings.
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Affiliation(s)
- Amit Ritter
- Department of Otolaryngology, Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Noa Rozendorn
- Department of Otolaryngology, Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Gal Avishai
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Oral and Maxillofacial Surgery, Rabin Medical Center, Petah Tikva, Israel
| | - Eli Rosenfeld
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Oral and Maxillofacial Surgery, Rabin Medical Center, Petah Tikva, Israel
| | - Ilan Koren
- Department of Otolaryngology, Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ethan Soudry
- Department of Otolaryngology, Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Kawakami S, Botticelli D, Nakajima Y, Sakuma S, Baba S. Anatomical analyses for maxillary sinus floor augmentation with a lateral approach: A cone beam computed tomography study. Ann Anat 2019; 226:29-34. [PMID: 31330302 DOI: 10.1016/j.aanat.2019.07.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 07/06/2019] [Accepted: 07/08/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Various anatomical references and structures should be analyzed prior approaching a surgery in the maxillary sinus. The objective of the present study was to evaluate the anatomical structures and references involved in sinus floor elevation with a lateral approach. MATERIALS AND METHODS Seventy-five patients planned for sinus floor elevation were included in the study. Eighty-eight maxillary sinuses were evaluated using cone beam computed tomographies (CBCTs). The nasal floor was used as main reference (X) and sinus mucosa width, bone crest height, palatal-nasal recess angle (PNR), sinus width at the level of the nasal floor, distance from the nasal floor to the base of the sinus (X-F), position of the posterior superior alveolar artery (PSAA height) and diameter (PSAA diameter), lateral bone wall width at 3mm (LW 3mm) and 9mm (LW 9mm) from the base of the sinus (F), patency of the ostium (OP), and presence and position of septa have been evaluated. RESULTS The mean dimensions and standard deviations were the following: mucosa thickness was 2.0±1.4mm, bone crest height 2.8±1.4mm, distance X-F 8.3±1.9mm, PNR angle 135.5±23.1, sinus width 12.6±4.2mm, X-F 8.3±1.9mm, PSAA height 14.4±2.9mm, PSAA diameter 1.1±0.4mm, LW 3mm 1.5±1.2, LW 9mm 1.3±0.6mm, OP 1.9±0.4mm. Septa were present in 19.3% of the sinuses evaluated and were located mostly in the molar region. CONCLUSIONS In conclusion, the analysis of the CBCT before sinus floor elevation allows the identification of anatomical structures and references that might be used for the planning of the surgical approach, aiming to improve the outcome of the treatment and to avoid possible complications.
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Affiliation(s)
- Shunsuke Kawakami
- Department of Oral Implantology, Osaka Dental University, Osaka, Japan
| | | | - Yasushi Nakajima
- Department of Oral Implantology, Osaka Dental University, Osaka, Japan
| | | | - Shunsuke Baba
- Department of Oral Implantology, Osaka Dental University, Osaka, Japan
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Küçükkurt S. Evaluation of the survival of implant placement simultaneously with sinus augmentation: relationship in maxillary sinus pathologies. Oral Radiol 2019; 36:225-237. [PMID: 31300933 DOI: 10.1007/s11282-019-00399-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 07/05/2019] [Indexed: 12/27/2022]
Abstract
OBJECTIVES This retrospective study aimed to evaluate the effects of existing maxillary sinus pathologies on the survival rates of dental implants placed simultaneously with sinus augmentation. METHODS Cone-beam computed tomography images of 88 patients (34 females, 54 males), who underwent sinus augmentation, were retrospectively analyzed and the patients were divided into two groups: with (pathology group) and without pathology (control group). All maxillary sinus pathologies were recorded and categorized into mucosal thickening ( ≥ 3 mm), antral pseudocyst (polypoid mucosal thickening), and complete opacification. Implant survival rates were evaluated after a mean follow-up period of 28.2 ± 9.8 months based on the patient's records and control radiographs. RESULTS A total of 115 maxillary sinuses of 88 patients with 168 dental implants were included in the study. Maxillary sinus pathology was detected in 45 patients in the pathology group and 43 patients in the control group. In the pathology group, one implant was lost out of 82 implants during the 27.8 ± 9.5 months follow-up period, while in the control group, 5 implants were lost out of 86 implants during the 25.1 ± 10 months follow-up period. There was no statistically significant difference in the survival rates between the two groups. CONCLUSIONS The study concluded that the presence of pathology in the maxillary sinus before surgery does not affect the survival rates of dental implants placed simultaneously with sinus augmentation. The most common pathology noted included mucosal thickening (61.4%), which was detected in 35 patients.
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Affiliation(s)
- Sercan Küçükkurt
- Department of Oral and Maxillofacial Surgery, Istanbul Aydın University, Istanbul, Turkey.
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Yu SJ, Lee YH, Lin CP, Wu AYJ. Computed tomographic analysis of maxillary sinus anatomy relevant to sinus lift procedures in edentulous ridges in Taiwanese patients. J Periodontal Implant Sci 2019; 49:237-247. [PMID: 31485374 PMCID: PMC6713807 DOI: 10.5051/jpis.2019.49.4.237] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Revised: 05/26/2019] [Accepted: 06/10/2019] [Indexed: 01/19/2023] Open
Abstract
Purpose To analyze the maxillary sinus anatomy over edentulous ridges in the bilateral posterior maxillary area in Taiwanese patients using cone-beam computed tomography (CBCT). Methods In total, 101 anatomical sites from 61 patients, including 32 premolar and 69 molar regions, were analyzed using CBCT. Measurements were made of the width and height of edentulous ridges, the thickness of the lateral wall of the maxillary sinus, and the presence of a sinus septum and the posterior superior alveolar artery (PSAA). A statistical analysis of the measurements was performed, and correlations among the measurements were assessed. Results The average ridge width was 10.26±3.16 mm, with a significantly greater ridge width in the second molar region than in the premolar region. The mean residual ridge height was 8.55±4.09 mm, and ridge height showed an opposite trend from ridge width for the premolar and molar regions. A sinus septum was present at 5.9% of the sites, and the PSAA was observed in 24.5%. The average thickness of the lateral wall of the maxillary sinus was 2.08±0.94 mm, with no significant difference between the tooth position and lateral wall thickness. Conclusions This study presents the anatomical features of the maxillary sinus, which should be considered in sinus lift procedures for implant placement, in the Taiwanese population. The use of CBCT is recommended to avoid intraoperative complications.
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Affiliation(s)
- Shun-Jen Yu
- Department of Periodontics, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yi-Hao Lee
- Department of Orthodontics, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Ching-Ping Lin
- Department of Periodontics, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Aaron Yu-Jen Wu
- Department of Dentistry, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
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Park WB, Han JY, Kang P, Momen-Heravi F. The clinical and radiographic outcomes of Schneiderian membrane perforation without repair in sinus elevation surgery. Clin Implant Dent Relat Res 2019; 21:931-937. [PMID: 30950206 DOI: 10.1111/cid.12752] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 01/25/2019] [Accepted: 02/08/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND The aim of this comparative study was to evaluate the clinical outcome of nonrepair of the perforated maxillary sinus membrane compared to the nonperforated cases. MATERIALS AND METHODS A retrospective comparative study was performed by identifying all lateral window sinus augmentation procedures, which were done during a defined period. Demographic data, systemic diseases, and smoking habits of patients were recorded. Thickness of the Schneiderian membrane and the amount of residual bone before surgery were measured by cone-beam computed tomography (CBCT). In case of perforation, no attempt was made to repair the membrane. Alloplast was used for bone augmentation. The thickness of the Schneiderian membrane and gained bone height were recorded using CBCT at the time of prosthesis delivery. RESULTS Sixty-three patients with 65 sinuses were included in this retrospective study. The rate of sinus perforation was 39%. There was a significant association between the presence of sinus pathoses before surgery and the occurrence of Schneiderian membrane perforation (P = 0.03). The Schneiderian membrane was significantly thicker in patients with perforation compared to the patients without perforation (P < 0.001). There was no correlation between the size of the perforation and the thickness of the Schneiderian membrane. Most of the perforations (83%) occurred at the mesial and middle part of the lateral window. The Schneiderian membrane thickness was decreased significantly in both groups after the sinus elevation procedure (P < 0.05). The bone graft height was stable over the follow-up period in both groups (P > 0.05). There was no implant failure in any of the groups. CONCLUSIONS Nonrepair of the Schneiderian membrane perforation did not adversely affect the clinical and radiographical outcomes. There were higher intraoperative and postoperative complications in the nonrepair group.
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Affiliation(s)
- Won-Bae Park
- Department of Periodontology, School of Dentistry, Kyung Hee University Private Practice in Periodontics and Implant Dentistry, Seoul, South Korea
| | - Ji-Young Han
- Department of Periodontology, Division of Dentistry, Hanyang University College of Medicine, Seoul, South Korea
| | - Philip Kang
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, New York, New York
| | - Fatemeh Momen-Heravi
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, New York, New York
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Evaluation of three-dimensional contraction of the volume of grafts after staged augmentation of the sinus floor, and an analysis of influential factors. Br J Oral Maxillofac Surg 2019; 57:323-329. [PMID: 30940406 DOI: 10.1016/j.bjoms.2019.03.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Accepted: 03/07/2019] [Indexed: 11/21/2022]
Abstract
Our aim was to evaluate the volume by which grafts contract after augmentation of the sinuses by three-dimensional analysis on cone-beam computed tomographs (CT), and to investigate the factors that influence the outcomes. The sinus floor was augmented with deproteinised bovine bone mineral in 58 patients with 123 edentulous sites related to 67 sinuses. The outcomes of augmentation were analysed by both linear and volumetric measurements on cone-beam CT images taken immediately after operation and six months later. Mathematical models were established to investigate the influence of anatomical characteristics of the sinuses and patient-related factors on contraction of the volume of the grafts. The mean reduction in the height of the grafts on site-based analysis was 17.8% after six months, and the contraction in volume on sinus-based analysis was 22.7 %. Of the edentulous sites 20/123 (16%) could not have implants 10 mm long inserted at the second stage operation because of insufficient bony height. Linear regression indicated that the type of edentulism (single or multiple teeth lost) was significantly associated with contraction in the volume of the grafts (p=0.006). Mixed model regression showed that the reduction in the height of the grafts was significantly influenced by the width of the sinus floor and the angle between the lateral and the medial wall of sinus (p=0.001, p=0.000). The reduction in height of the grafts and contraction in volume on linear and volumetric measurements six months after augmentation were roughly 18% and 22%, respectively. A wide sinus, large lateromedial angle, and loss of multiple teeth under the same sinus strongly predict that large amount of grafts will resorb. The anatomy of the sinus and patients' characteristics should be taken into consideration before treatment.
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Lundgren S, Johansson AS, Cricchio G, Lundgren S. Clinical outcome and factors determining new bone formation in lateral sinus membrane elevation with simultaneous implant placement without grafting material: A cross-sectional, 3-17 year follow-up study. Clin Implant Dent Relat Res 2019; 21:827-834. [PMID: 30919557 DOI: 10.1111/cid.12758] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Revised: 02/18/2019] [Accepted: 03/03/2019] [Indexed: 12/23/2022]
Abstract
BACKGROUND Lateral sinus membrane elevation with simultaneous implant placement without grafting material (graft-less LSFE) is a widely investigated method for bone augmentation of the maxillary sinus floor. Long-term follow-up studies are rare. PURPOSE This study aimed to investigate the long-term effects of implants placed with graft-less LSFE. MATERIALS AND METHODS The study group was comprised of 111 patients previously treated with graft-less LSFE. The first follow-up visit, which occurred after a mean of 5 years after surgery, included a clinical examination, cone beam computerized tomography, and panorama or intraoral radiography. The second follow-up included panorama or intraoral radiography, and it was conducted after a mean of 8 years. RESULTS Overall, 218 implants were placed in 127 sinuses. Nine of the 218 implants failed resulting in an overall implant survival of 95.9%. The average bone gain at the follow-up was 4.0 ±2.0 mm. CONCLUSION The implant-supported rehabilitation achieved using graft-less LSFE was stable over time, and there was no or little impact on sinus health. Furthermore, it was concluded that the new bone formation and the amount of bone gain is proportional to the length of the implant protruding into the sinus cavity.
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Affiliation(s)
- Sofia Lundgren
- Department of Oral and Maxillofacial Surgery, Umeå University, Umeå, Sweden
| | - Anders S Johansson
- Department of Oral and Maxillofacial Surgery, Umeå University, Umeå, Sweden
| | - Giovanni Cricchio
- Department of Oral and Maxillofacial Surgery, Umeå University, Umeå, Sweden.,In private practice Studio Odontoiatrico Associato "Passaggio dei Poeti", Palermo, Italy
| | - Stefan Lundgren
- Department of Oral and Maxillofacial Surgery, Umeå University, Umeå, Sweden
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Yeung AWK, Colsoul N, Montalvao C, Hung K, Jacobs R, Bornstein MM. Visibility, location, and morphology of the primary maxillary sinus ostium and presence of accessory ostia: a retrospective analysis using cone beam computed tomography (CBCT). Clin Oral Investig 2019; 23:3977-3986. [PMID: 30737619 DOI: 10.1007/s00784-019-02829-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 01/24/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES This retrospective study evaluated the visibility, location, and morphology of the primary maxillary ostium (PMO), as well as the presence and number of accessory maxillary ostia (AMO) in the maxillary sinus using cone beam computed tomography (CBCT). MATERIALS AND METHODS CBCT scans with a large field of view with both maxillary sinuses entirely visible, acquired from February 2016 to February 2018, were initially screened. Patients were included if there was no history of surgical intervention/trauma in the sinus region. Two observers evaluated the CBCTs for PMO and AMOs independently. PMO and AMOs were evaluated in axial, coronal, and sagittal CBCT views. In case of disagreement, a third observer served as a referee. The findings were correlated with age, gender, condition of the sinus mucosa, and status of the dentition to assess for potential influencing factors. RESULTS A total of 184 patients (368 maxillary sinuses) were included. PMO was present and patent in 346 (94.0%) of the 368 analyzed sinuses. Most of the PMOs were located above the attachment of and in the middle third of the inferior turbinate (76.1%) and exhibited a slit shape (71.1%). An AMO was present in 167 (45.5%) of the 368 analyzed sinuses, and 66 (17.9%) sinuses had multiple AMOs. Gender and sinus mucosa morphology were found to be influencing factors for the patency of the PMO. Furthermore, gender seems to be influencing the presence of an AMO. CONCLUSIONS Most of the analyzed maxillary sinus cavities in the present population had a patent PMO. Being male and having morphological changes of the sinus mucosa were factors associated with a reduced prevalence of a patent PMO. CLINICAL RELEVANCE A maxillary sinus with pathological findings of the mucosa seems to have a reduced prevalence of patent PMOs. Therefore, clinicians should take care to assess any clinical and radiographical sign indicating a potential maxillary sinusitis prior to surgical interventions in this region, especially in cases with planned sinus floor elevation.
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Affiliation(s)
- Andy Wai Kan Yeung
- Oral and Maxillofacial Radiology, Applied Oral Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Nicolas Colsoul
- Oral and Maxillofacial Radiology, Applied Oral Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Carla Montalvao
- Oral and Maxillofacial Radiology, Applied Oral Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Kuofeng Hung
- Oral and Maxillofacial Radiology, Applied Oral Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Reinhilde Jacobs
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven and Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,Department Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Michael M Bornstein
- Oral and Maxillofacial Radiology, Applied Oral Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.
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