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Sedeqi A, Koticha T, Al Sakka Y, Felemban M, Garaicoa-Pazmino C, Del Amo FSL. Volumetric changes and graft stability after lateral window sinus floor augmentation: A randomized clinical trial. Clin Implant Dent Relat Res 2024; 26:138-149. [PMID: 37849377 DOI: 10.1111/cid.13283] [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: 04/12/2023] [Revised: 08/10/2023] [Accepted: 09/11/2023] [Indexed: 10/19/2023]
Abstract
INTRODUCTION The present investigation compared the stability and volumetric changes of two different grafting material used for lateral window sinus floor augmentation (LWSFA). METHODS Sixteen patients with a total 20 maxillary sinuses in need of LWSFA were included in the present study. The sinuses were grafted with either 100% anorganic bovine bone mineral (ABBM) alone (Group 1) or a mixture (0.8:1 ratio) of ABBM and mineralized cortical allograft (MCA) (Group 2). Cone beam computer tomography (CBCT) was obtained pre-operatively, and at 2-weeks, and 6-months after LWSFA to perform linear measurements including lateral window dimensions, sinus anatomy, residual bone height/thickness (RBH/RBT), and Schneiderian membrane thickness (SMT), among others. Three-dimensional segmentation analysis was used to evaluate changes of bone graft volume/height (GV/GH). RESULTS A total of 10 sinuses per group were included in the analysis. No statistically significant difference was found in between groups regarding mean reduction of GV (Group 1: 14.87% ± 16.60%, Group 2: 18.06% ± 9.81%, p = 0.33). Among the linear measurements, only SMT revealed a significant increase after 2-weeks more pronounce in Group 1 (8.70 mm) when compared with Group 2 (5.70 mm) with plausible effect upon LWSFA outcomes. Sinus width showed weak positive correlation with GH reduction after 6 months. CONCLUSION This study demonstrated that both ABBM alone and ABBM + MCA represent suitable alternatives for LWSFA with adequate graft stability as they revealed similar volumetric and linear dimensional changes 6 months postoperatively.
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Affiliation(s)
- Ahmad Sedeqi
- Department of Periodontics, Al Amiri Hospital, Kuwait City, Kuwait
- Former, Department of Periodontics, University of Oklahoma Health Sciences Center - College of Dentistry, Oklahoma City, Oklahoma, USA
| | - Tapan Koticha
- Former, Department of Periodontics, University of Oklahoma Health Sciences Center - College of Dentistry, Oklahoma City, Oklahoma, USA
- Private Practice, Oklahoma City, OK, USA
| | - Yacoub Al Sakka
- Former, Department of Periodontics, University of Oklahoma Health Sciences Center - College of Dentistry, Oklahoma City, Oklahoma, USA
- Private Practice, Oklahoma City, OK, USA
| | - Mohammad Felemban
- Department of Maxillofacial Surgery and Diagnostic Science, Taif University, Taif, Saudi Arabia
| | - Carlos Garaicoa-Pazmino
- Department of Periodontics, University of Iowa College of Dentistry and Dental Clinics, Iowa City, Iowa, USA
- School of Dentistry, Espiritu Santo University, Samborondon, Ecuador
| | - Fernando Suárez-López Del Amo
- Former, Department of Periodontics, University of Oklahoma Health Sciences Center - College of Dentistry, Oklahoma City, Oklahoma, USA
- Department of Periodontics, University of Iowa College of Dentistry and Dental Clinics, Iowa City, Iowa, USA
- Department of Implant Surgery and Prosthodontics, School of Dentistry, Alfonso X El Sabio University, Madrid, Spain
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Park WB, Pandya M, Han JY, Kang P. Large Grafting Void Resembling a Surgical Ciliated Cyst following Maxillary Sinus Augmentation. Four Case Reports with Histological Observation. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58091300. [PMID: 36143978 PMCID: PMC9503402 DOI: 10.3390/medicina58091300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/07/2022] [Accepted: 09/15/2022] [Indexed: 11/25/2022]
Abstract
The cause and pathogenicity of grafting voids following lateral maxillary sinus augmentation (MSA) have not yet been elucidated. The first purpose of this case series is to introduce an unusually large grafting void that radiologically resembles a surgical ciliated cyst (SCC) at the sinus augmented site; the second is to observe the histological findings of these grafting voids. In four patients, MSA was performed using the lateral window technique. An unusually large grafting void appeared on cone-beam-computed tomography (CBCT) taken one week after surgery and except for one patient, there were no clinical symptoms. On CBCT taken six months after surgery, the grafting voids were slightly smaller in size but showed radiographic findings similar to those of SCC. During uncovering, grafting voids were removed through the lateral window site. Histologically, the grafting void was empty or filled with dense connective tissue, and no ciliated columnar epithelium or inflammatory cells were observed. Within the limitations of this case series, the large grafting voids generated after MSA was not converted to SCCs. Rather, they remained scar tissue, which could infringe the sinus bone graft and affect the apical bone support of the implant.
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Affiliation(s)
- Won-Bae Park
- Department of Periodontology, School of Dentistry, Kyung Hee University; Seoul 02447, Korea
- Private Practice in Periodontics and Implant Dentistry, Seoul 02771, Korea
| | - Meghan Pandya
- Division of Periodontics, Section of Oral and Diagnostic Sciences, Columbia University College of Dental Medicine, #PH7E-110, 630 W. 168 St., New York, NY 10032, USA
| | - Ji-Young Han
- Department of Periodontology, Division of Dentistry, College of Medicine, Hanyang University, 222-1 Wangsimni-ro, Seongdong-gu, Seoul 04763, Korea
- Correspondence: (J.-Y.H.); (P.K.)
| | - Philip Kang
- Division of Periodontics, Section of Oral and Diagnostic Sciences, Columbia University College of Dental Medicine, #PH7E-110, 630 W. 168 St., New York, NY 10032, USA
- Correspondence: (J.-Y.H.); (P.K.)
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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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Park WB, Kang KL, Han JY. Factors influencing long-term survival rates of implants placed simultaneously with lateral maxillary sinus floor augmentation: A 6- to 20-year retrospective study. Clin Oral Implants Res 2019; 30:977-988. [PMID: 31306519 DOI: 10.1111/clr.13505] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 07/04/2019] [Accepted: 07/08/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To evaluate the long-term influence of residual bone height (RBH), sinus membrane perforation and the presence of voids on the survival of implants placed simultaneously with lateral maxillary sinus floor augmentation (MSFA). MATERIALS AND METHODS A total of 207 patients (613 implants) who underwent MSFA from 1999 to 2003 and followed up until 2018 were included in this study. RBH and marginal bone loss were assessed using a series of panoramic and periapical radiographs. Cumulative survival rates (CSR) with log-rank tests and hazard ratios of implant failure according to RBH, membrane perforation, and the presence of voids were assessed. RESULTS The overall 10-year and 20-year CSRs were 95% (95% CI: 84.95%-85.05%) and 85% (95% CI: 84.95%-85.05%), respectively. CSR was significantly higher for implants with ≥3 mm RBH (n = 260, 92.4%) than those with <3 mm RBH (n = 353, 78.8%) (p = .002). CSR of non-smoking group (n = 312, 90.0%) was higher than that of smoking group (n = 301, 77.1%) (p = .009). There was no significant difference in the hazard ratio of implant failure between the perforated membrane group (n = 245) and the non-perforated group (n = 368). In two out of 11 patients with voids, the inflammation of peri-implantitis progressed into voids, resulting in severe bone resorption. CONCLUSIONS The survival of implants placed in <3 mm of RBH, even though it showed a lower CSR, could be considered acceptable. Neither sinus membrane perforation nor the presence of voids appeared to affect implant survival as long as supportive maintenance therapy with proper oral hygiene was provided.
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Affiliation(s)
- Won-Bae Park
- Department of Periodontology, School of Dentistry, Kyung Hee University, Seoul, Korea.,Private Practice in Periodontics and Implant Dentistry, Seoul, Korea
| | - Kyung Lhi Kang
- Department of Periodontology, School of Dentistry, Kyung Hee University, Seoul, Korea
| | - Ji-Young Han
- Department of Periodontology, Division of Dentistry, College of Medicine, Hanyang University, Seoul, Korea
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Yang HJ, Hwang SJ. Void space and long-term volumetric changes of maxillary sinus floor augmentation with comparison between hydroxyapatite soaked with bone morphogenetic protein 2 and anorganic bovine xenograft alone. J Craniomaxillofac Surg 2019; 47:1626-1632. [PMID: 31395420 DOI: 10.1016/j.jcms.2019.07.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 06/07/2019] [Accepted: 07/14/2019] [Indexed: 11/17/2022] Open
Abstract
PURPOSE We hypothesized that the void volume after maxillary sinus floor augmentation (MSFA) with recombinant human bone morphogenetic protein-2 (rhBMP-2) would be larger than that without rhBMP-2, and filled with bone in the long term. The aim of this study was to analyze the occurrence of void space and long-term volumetric changes after MSFA with rhBMP-2 and hydroxyapatite (BMP-2/H). MATERIAL AND METHODS In 25 subjects, MSFA was performed with BMP-2/H (group I) or an anorganic bovine xenograft (group II). Computed tomography scans were taken twice, at 3 months (T1) and at least 24 months (T2) after surgery. Total volume (TV), bone volume (BV), and void volume (VV) were measured and analysed statistically. RESULTS While similar amounts of graft material were used, the TV was significantly larger in group I than in group II (p = 0.014). The VV showed a tendency to be larger in group I than in group II. VV reduction up to T2 was significantly greater in group I than in group II. Consequently, the BV at T2 was significantly greater in group I than in group II by 36% (p = 0.014). CONCLUSION This study showed that our hypothesis was valid. rhBMP-2 is effective for long-term bone regeneration after MSFA.
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Affiliation(s)
- Hoon Joo Yang
- Orthognathic Surgery Center, Seoul National University Dental Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea; Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
| | - Soon Jung Hwang
- Hwang Soon Jung's Dental Clinic for Oral and Maxillofacial Surgery, Woonam Building, 2,3 F, 349, Gangnam-daero, Seocho-gu, Seoul, 06626, Republic of Korea.
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Benic GI, Elmasry M, Hämmerle CHF. Novel digital imaging techniques to assess the outcome in oral rehabilitation with dental implants: a narrative review. Clin Oral Implants Res 2015; 26 Suppl 11:86-96. [DOI: 10.1111/clr.12616] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2015] [Indexed: 11/26/2022]
Affiliation(s)
- Goran I. Benic
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center of Dental Medicine; University of Zurich; Zurich Switzerland
| | - Moustafa Elmasry
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center of Dental Medicine; University of Zurich; Zurich Switzerland
| | - Christoph H. F. Hämmerle
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center of Dental Medicine; University of Zurich; Zurich Switzerland
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