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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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Shiezadeh F, Taher M, Shooshtari Z, Arab H, Shafieian R. Using Platelet-Rich Fibrin in Combination With Allograft Bone Particles Can Induce Bone Formation in Maxillary Sinus Augmentation. J Oral Maxillofac Surg 2023; 81:904-912. [PMID: 37084762 DOI: 10.1016/j.joms.2023.03.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 03/26/2023] [Accepted: 03/27/2023] [Indexed: 03/31/2023]
Abstract
BACKGROUND Sinus pneumatization secondary to posterior maxillary tooth extraction can hinder proper implant installation. Maxillary sinus floor augmentation is a surgical procedure that has been proposed to overcome this issue. PURPOSE The aim of this study was to evaluate and compare the histomorphometric outcomes of sinus floor elevation using allograft bone particles with or without platelet-rich fibrin (PRF). STUDY DESIGN, SETTING, SAMPLE This randomized clinical trial included patients scheduled for maxillary sinus floor elevation in the Implant Department of Mashhad Dental School. Healthy adults with an edentulous maxilla and residual alveolar bone height of 3 mm or less were eligible to participate and were randomly allocated to intervention (A) or control (B) groups. Bone biopsies were obtained 6 months postoperatively. PREDICTOR VARIABLE The predictor variable was using a PRF membrane for maxillary sinus augmentation. In group A, sinus floor elevation was performed using PRF combined with bone allografts, while in group B only allograft particles were used. MAIN OUTCOME VARIABLES The primary outcome variables were the recorded postoperative histologic parameters, as in the area of newly formed bone, new bone marrow, and residual graft particles (μm2). The secondary outcome variables were the radiographically measured postoperative bone height and width at the graft site. COVARIATES Age and sex. ANALYSES Independent sample t-test was employed to compare the postoperative histomorphometric parameters between groups A and B. P value ≤ .05 was considered statistically significant. RESULTS A total of 20 patients (10 per group) completed the study. The mean rate of new bone formation was 43.25 ± 5.22% in group A and 38.25 ± 7.01% in group B. This difference was statistically insignificant (P = .087). The mean amount of newly formed bone marrow was significantly more in group A compared to group B (6.81 ± 2.19% vs 10.23 ± 4.49%; P = .044). The average amount of remaining particles was also significantly less in group A patients (9.35 ± 3.43% vs 13.18 ± 3.67%; P = .027). CONCLUSION AND RELEVANCE Incorporating PRF as an adjunctive grafting material results in fewer residual particles of allograft and in more bone marrow formation and may serve as a treatment option for developing the atrophic posterior maxilla.
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Affiliation(s)
- Farid Shiezadeh
- Associate Professor, Department of Periodontics, Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Milad Taher
- Assistant Professor, Department of Periodontics, Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zahra Shooshtari
- Dentist, Private Practice, Research Assistant, Department of Periodontics, Dental Research Center, Mashhad Dental School, Mashhad University of Medical Sciences, Mashhad, Iran
| | - HamidReza Arab
- Professor, Department of Periodontics, Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Reyhaneh Shafieian
- Assistant Professor, Department of Anatomy and Cell Biology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Wang X, Sun L, Wang L, Shi S, Zhang S, Song Y. Predictors of peri-implant bone remodeling outcomes after the osteotome sinus floor elevation: a retrospective study. BMC Oral Health 2022; 22:622. [PMID: 36539789 PMCID: PMC9764540 DOI: 10.1186/s12903-022-02592-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 11/14/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND This study aimed to evaluate the radiographic outcomes of implants after osteotome sinus floor elevation (OSFE), and further identify the separate predictors for these radiographic outcomes. METHODS In this retrospective cohort study, a total of 187 implants were inserted into 138 patients using the OSFE technique. Seventy-four patients in the grafted group, and 64 patients in the non-grafted group completed this study. The vertical bone gain (VBG) and marginal bone loss (MBL) at 3 years following surgery were assessed as outcome variables. Based on extensive literature results, variables considered potential predictors of outcome variables included sex, age, tooth position, implant length, implant diameter, with or without grafting materials, residual bone height, sinus width, bone density, and sinus membrane thickness. Subsequently, the binary logistic regression analysis was applied with VBG and MBL as dependent variables, respectively. The receiver operating characteristic curve (ROC) with its area under the curve (AUC) was performed to further determine the predictive value of these predictors. RESULTS One hundred and six implants in grafted group and 81 implants in the non-grafted group were analyzed. The average VBG was 2.12 ± 1.94 mm for the grafted group and 0.44 ± 1.01 mm for the non-grafted group at 3 years (P < 0.05). The mean MBL was 1.54 ± 1.42 mm for the grafted group and 1.13 ± 1.69 mm for the non-grafted group at 3 years (P > 0.05). After the adjustment for confounders, logistic regression analysis demonstrated that implant length, grafting, residual bone height, and sinus membrane thickness were predictors of VBG. The odds ratio for VBG was 3.90, 4.04, 4.13 and 2.62, respectively. Furthermore, grafting exhibited the largest AUC at 0.80. While tooth position and implant length were predictors of MBL, the odds ratio for MBL was 3.27 and 7.85, respectively. Meanwhile, implant length exhibited the largest AUC at 0.72. CONCLUSIONS OSFE with or without simultaneous grafting materials both showed predictable clinical outcomes. Additionally, the present study is the first quantitative and significant verification that VBG has a significant association with sinus membrane thickness, as well as residual bone height, implant length and grafting. Whereas tooth position and implant length are markedly associated with MBL.
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Affiliation(s)
- Xingxing Wang
- grid.233520.50000 0004 1761 4404State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Oral Implants, School of Stomatology, The Fourth Military Medical University, Xi’an, 710032 Shaanxi People’s Republic of China
| | - Lijuan Sun
- grid.233520.50000 0004 1761 4404State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Periodontology, School of Stomatology, The Fourth Military Medical University, Xi’an, 710032 Shaanxi People’s Republic of China
| | - Lei Wang
- grid.43169.390000 0001 0599 1243Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi’an Jiaotong University, Xi’an, 710004 Shaanxi People’s Republic of China
| | - Shaojie Shi
- 920th Hospital of Joint Logistics Support Force, Kunming, People’s Republic of China
| | - Sijia Zhang
- grid.233520.50000 0004 1761 4404State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Oral Implants, School of Stomatology, The Fourth Military Medical University, Xi’an, 710032 Shaanxi People’s Republic of China
| | - Yingliang Song
- grid.233520.50000 0004 1761 4404State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Oral Implants, School of Stomatology, The Fourth Military Medical University, Xi’an, 710032 Shaanxi People’s Republic of China
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Lombardi T, Lamazza L, Bernardello F, Ziętek G, Stacchi C, Troiano G. Clinical and radiographic outcomes following transcrestal maxillary sinus floor elevation with injectable xenogenous bone substitute in gel form: a prospective multicenter study. Int J Implant Dent 2022; 8:32. [PMID: 35867239 PMCID: PMC9307698 DOI: 10.1186/s40729-022-00431-5] [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: 04/01/2022] [Accepted: 07/11/2022] [Indexed: 11/25/2022] Open
Abstract
Purpose To investigate clinical and radiographic outcomes of transcrestal maxillary sinus floor elevation performed with an injectable xenograft in gel form, analyzing general, local and surgical variables possibly influencing the results. Methods Patients with residual crestal height < 5 mm underwent transcrestal sinus floor elevation with xenograft in gel form to allow the placement of a single implant. Simultaneous implant placement was performed when primary stability was ≥ 15 Ncm. Graft height was measured immediately after surgery (T0) and after 6 months of healing (T1). Univariate and multivariate regression models were built to assess associations between clinical variables with implant survival and graft height at T1. Results 71 patients underwent transcrestal sinus floor elevation and 54 implants were simultaneously placed. Delayed implant placement (at T1) was possible in 5 cases out of 17 (29.4%), whereas in 12 patients (70.6%) implant insertion was not possible or required additional sinus grafting. Implant survival rate, with a follow-up varying from 12 to 32 months after loading, was 100%. Mean pre-operative bone height was 3.8 ± 1.0 mm, at T0 was 13.9 ± 2.2 mm and at T1 was 9.9 ± 2.8 mm. Bone height at T1 was negatively influenced by membrane perforation at surgery (p = 0.004) and positively influenced by immediate implant insertion (p < 0.001). Conclusions Transcrestal sinus floor elevation performed with injectable xenograft gel resulted in 100% implant survival rate. However, immediate implant insertion seems a crucial factor to preserve vertical bone gain: one-stage technique seems to be the most predictable approach to optimize clinical outcomes with this approach. Trial registration clinicaltrials.gov, NCT05305521. Registered 31 March 2022—Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT05305521.
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Affiliation(s)
- Teresa Lombardi
- Department of Health Sciences, Magna Græcia University, 88100, Catanzaro, Italy
| | - Luca Lamazza
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00161, Rome, Italy
| | - Fabio Bernardello
- Studio Bernardello, via Bonvicini, 42, Terranegra di Legnago (VR), 37045, Verona, Italy.
| | | | - Claudio Stacchi
- Department of Medical, Surgical and Health Sciences, University of Trieste, 34100, Trieste, Italy
| | - Giuseppe Troiano
- Department of Clinical and Experimental Medicine, University of Foggia, 71122, Foggia, Italy
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Wang Z, Zhang J, Ren L, Yang G. Repositioning of the bone window in lateral sinus floor elevation with simultaneous implant placement: A retrospective radiographic study. Clin Oral Implants Res 2022; 33:816-833. [PMID: 35713366 DOI: 10.1111/clr.13963] [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: 04/25/2022] [Revised: 06/01/2022] [Accepted: 06/02/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To retrospectively evaluate whether repositioning the bone window leads to a better outcome of three-dimensional sinus augmentation in lateral sinus floor elevation (LSFE) with simultaneous implant placement. METHODS 34 patients with a total of 40 implants (14: test group, 26: control group) receiving LSFE with simultaneous implant placement were included in this retrospective research. CBCT images were taken before surgery, immediately and 6 months after surgery. The two-dimensional augmentation parameters, including apical bone height (ABH), endo-sinus bone gain (ESBG), and palatal/buccal bone height (PBH/BBH), and three-dimensional parameters, including augmentation volume (AV) and palatal/buccal augmentation volume (PAV/BAV), were measured. The lateral defect length (LDL) and lateral window length (LWL) were also measured to evaluate the lateral antrostomy recovery. RESULTS At the 6-month follow-up, the reduction rates at ABH, ESBG, and BBH of the test group (ABH: 10.41% ± 30.30%, ESBG: 2.55% ± 8.91%, BBH: 2.50% ± 8.65%) were significantly lower than those of the control group (ABH: 25.10% ± 22.02%, ESBG: 11.47% ± 9.79%, BBH: 7.10% ± 5.37%; p < .05). In addition, the test group showed better three-dimensional augmentation stability on the buccal side (BAV reduction: 15.51% ± 10.86% vs. 27.15% ± 12.61%; p < .05). Moreover, the LDL/LWL ratio of the test group was significantly lower than that of the control group (p < .05). CONCLUSION Within the limitations of this study, repositioning of the bone window in LSFE with simultaneous implant placement could contribute to endo-sinus augmentation stability on the buccal side at the 6-month follow-up. Moreover, it would also facilitate recovery of the lateral antrostomy defect.
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Affiliation(s)
- Zhikang Wang
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Jing Zhang
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Lingfei Ren
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Guoli Yang
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, China
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Maxillary Sinus Osteoma as a Support for Dental Implant Associated to Sinus Augmentation Procedure: A Case Report and Literature Review. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12115435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Background: Maxillary sinus augmentation is a method extensively used to restore sufficient bone volume in the posterior maxilla to allow for the placement of fixtures. The purpose of the present case report was to describe a rare case of sinus osteoma used for implant support and to review the relevant literature. Materials and Methods: A 58-year-old man with a radiopaque intrasinusal lesion was referred for rehabilitation of the maxilla. The lesion was probably an osteoma and involved the nasal wall of the maxillary sinus. After discussing the options with the patient, he agreed to maintain the lesion and a sinus augmentation with a bone graft. A part of the osteoma was partially removed for histological analysis while avoiding perforation or tearing of the schneiderian membrane. After six months, 6 implants (Bone System Implant, Milano, Italy) were placed in the maxilla, two of which were inserted in the osteoma. Results: The two implants placed in the osteoma were perfectly osseointegrated. The graft material appeared well-integrated with no local signs of inflammation. No postoperative events or symptoms were reported after the surgery stages and at a 6-month follow-up. Regarding the two implants placed in the osteoma: article selection identified 9 case reports, 2 case series, and 1 retrospective study for a total of 58 subjects, 35 males and 25 females. The patients’ ages were heterogeneous and ranged between 12 and 79 years old. Conclusions: In the present case, we decided to leave the osteoma because it was asymptomatic and used as dental implant support. The effectiveness of the present investigation can provide useful guidance for surgeons and dentists in the management of similar clinical situations.
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Stacchi C, Bernardello F, Spinato S, Mura R, Perelli M, Lombardi T, Troiano G, Canullo L. Intraoperative complications and early implant failure after transcrestal sinus floor elevation with residual bone height ≤5 mm: A retrospective multicenter study. Clin Oral Implants Res 2022; 33:783-791. [PMID: 35578774 PMCID: PMC9543216 DOI: 10.1111/clr.13959] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 04/06/2022] [Accepted: 05/02/2022] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Clinical indications for maxillary sinus floor elevation with transcrestal techniques have increased in recent years even in sites with minimal residual bone height (RBH). Nevertheless, limited information is currently available on incidence of intraoperative complications and early implant failure in these cases. MATERIAL AND METHODS This retrospective multicenter study was performed on anonymized clinical and radiographic records of patients who underwent transcrestal sinus floor elevation in seven clinical centers. Influence of different factors related to patient, sinus anatomy and surgical technique on the incidence of intraoperative complications and early implant failure rate after transcrestal sinus lift were investigated. RESULTS A total of 430 patients treated with transcrestal sinus floor elevation for single implant insertion in sites with RBH ≤5 mm were included in the final analysis. After one year of loading, 418 implants out of 430 were satisfactorily in function. Early implant failure was recorded in 12 cases (2.8%), resulting significantly associated with the presence of large sinus cavities and with the occurrence of membrane perforation. The following adverse events were recorded: membrane perforation (7.2%), acute sinusitis (0.9%), implant displacement into the sinus cavity (0.7%), oro-antral fistula (0.2%) and benign paroxysmal positional vertigo (0.5% of osteotome cases). A strong direct correlation between sinus membrane perforation and bucco-palatal sinus width (p=0.000) was demonstrated. CONCLUSIONS Early implant failure after transcrestal sinus elevation showed significant direct correlation with bucco-palatal maxillary sinus width and the presence of membrane perforation. Sinus membrane perforation was strongly associated with bucco-palatal sinus width (extremely low perforation rate in narrow and much higher incidence in wide sinuses).
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Affiliation(s)
- Claudio Stacchi
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | | | | | | | | | - Teresa Lombardi
- Department of Health Sciences, University "Magna Graecia", Catanzaro, Italy
| | - Giuseppe Troiano
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
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Stacchi C, Rapani A, Lombardi T, Bernardello F, Nicolin V, Berton F. Does new bone formation vary in different sites within the same maxillary sinus after lateral augmentation? A prospective histomorphometric study. Clin Oral Implants Res 2022; 33:322-332. [PMID: 34978096 PMCID: PMC9306466 DOI: 10.1111/clr.13891] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 12/27/2021] [Accepted: 12/28/2021] [Indexed: 12/27/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate histomorphometric outcomes of lateral maxillary sinus augmentation in different areas of the same cavity and to correlate results to bucco-palatal sinus width (SW) and residual bone height (RBH). MATERIAL AND METHODS Patients needing maxillary sinus floor elevation (RBH <5 mm) to insert two nonadjacent implants were treated with lateral augmentation using a composite graft. Six months later, two bone-core biopsies (mesial/distal) were retrieved in implant insertion sites. SW and RBH were measured on cone beam computed tomography, and correlations between histomorphometric and anatomical parameters were evaluated by multivariate linear regression analysis. RESULTS Twenty patients underwent sinus augmentation, and eighteen were included in the final analysis (two dropouts for membrane perforation). Mean newly formed mineralized tissue percentage (%NFMT) after 6 months in mesial and distal sites was 17.5 ± 4.7 and 11.6 ± 4.7, respectively (p = .0004). Multivariate linear regression showed a strong negative correlation between SW and %NFMT (β coefficient=-.774, p < .0001) and no correlation between RBH and %NFMT (β coefficient =-.038, p = .825). CONCLUSIONS The present study confirms that %NFMT after lateral sinus augmentation occurs at different rates in different anatomical areas of the same maxillary sinus, showing a strong negative correlation with SW, whereas no influence of RBH was observed. Clinicians should regard SW as a guide for graft selection and to decide duration of the healing period. Researchers should consider SW as a predictor variable, when comparing regenerative outcomes of different biomaterials by using maxillary sinus as an experimental model.
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Affiliation(s)
- Claudio Stacchi
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Antonio Rapani
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Teresa Lombardi
- Department of Health Sciences, University 'Magna Graecia', Catanzaro, Italy
| | | | - Vanessa Nicolin
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Federico Berton
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
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Zheng X, Huang L, Huang S, Mo A, Zhu J. Influence of anatomical factors related to maxillary sinus on outcomes of transcrestal sinus floor elevation. J Dent Sci 2022; 17:438-443. [PMID: 35028068 PMCID: PMC8740080 DOI: 10.1016/j.jds.2021.07.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 07/12/2021] [Indexed: 02/08/2023] Open
Abstract
Background/purpose Graft bone maturation and remodeling in the maxillary sinus require adequate angiogenesis and osteoprogenitor cells migration from the surrounding bony walls and Schneiderian membrane. This study aimed to evaluate the influence of anatomical factors related to maxillary sinus on the outcomes of transcrestal sinus floor elevation using cone-beam computed tomography (CBCT). Materials and methods Forty-five patients (63 elevated sites) were included in this study. CBCT were obtained preoperatively, immediately and 6 months after surgery. The anatomical features of residual bone height, maxillary sinus width, maxillary sinus angle and Schneiderian membrane thickness were measured on preoperative CBCT. Descriptive statistics and correlation analysis were conducted to evaluate the influence of anatomical factors on outcome parameters, including sinus lift height, graft bone resorption and marginal bone loss. Results The results showed that there was a positive correlation between sinus width and graft bone resorption. A significantly positive correlation between sinus angle and graft bone resorption was also found. Conclusion Our findings indicate that the anatomical factors of maxillary sinus (sinus width and sinus angle) have influence on the linear change of bone grafts after transcrestal sinus floor elevation.
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Affiliation(s)
- Xiaofei Zheng
- Stomatology Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Lirong Huang
- State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, China.,Dental Implant Center, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Si Huang
- State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, China.,Dental Implant Center, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Anchun Mo
- State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, China.,Dental Implant Center, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Juanfang Zhu
- Stomatology Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Kuo PY, Lin CY, Chang CC, Wang YM, Pan WL. Grafted bone remodeling following transcrestal sinus floor elevation: A cone-beam computed tomography study. Biomed J 2020; 44:627-635. [PMID: 34740571 PMCID: PMC8640548 DOI: 10.1016/j.bj.2020.05.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 04/30/2020] [Accepted: 05/04/2020] [Indexed: 01/09/2023] Open
Abstract
Background Transcrestal sinus floor elevation is a reliable procedure when additional bone height is needed for maxillary implant placement. However, the grafted bone undergoes remodeling and the dimensional stability of grafted bone height may be affected by several clinical factors, including graft material, sinus anatomy and the morphology of grafted space. Methods This retrospective study examined patients who had undergone transcrestal sinus floor elevation with synthetic biphasic calcium phosphate and single implant placement. The reduction of sinus graft height (GHR) after 6–8 months healing period was measured with cone-beam computed tomography (CBCT) images. Correlating factors, including vertical amount of implant protrusion (IP), sinus width, and the morphology of grafted space were analyzed by Spearman's correlation test. Results A total of 25 implant sites were analyzed. The mean GHR was 0.57 ± 0.49 mm, which was positively correlated with IP, vertical elevation height (VEH), and the ratio of vertical to horizontal elevation of the grafted space. However, GHR was not correlated with sinus width and mesial-distal or buccal-palatal width of the grafted space. Conclusions Synthetic biphasic calcium phosphate used in transcrestal sinus floor elevation underwent shrinkages and graft remodeling. Grafted height reduction was associated with IP, VEH, and the ratio of vertical to horizontal elevation of the grafted space.
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Affiliation(s)
- Pe-Yi Kuo
- Department of Periodontics, Chang Gung Memorial Hospital at Taipei, Taipei, Taiwan
| | - Cho-Ying Lin
- 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
| | - Yuan-Min Wang
- 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; Department of Nutrition, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan.
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11
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Block MS. Bone Levels Are Preserved After Simultaneous Sinus Elevation at Time of Implant Placement. J Oral Maxillofac Surg 2019; 77:2019-2026. [PMID: 31348872 DOI: 10.1016/j.joms.2019.06.177] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 06/19/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE The purpose of this study was to confirm that after simultaneous implant placement and vertical bone augmentation in the posterior maxilla, the immediate postoperative bone height is maintained after 2 to 3 years of follow-up. PATIENTS AND METHODS Consecutive patients treated with implant placement in the posterior maxilla were evaluated. Cone-beam scans were taken preoperatively; immediately after implant placement; and for the sinus-grafted cases, 2 to 3 years after surgery. Crestal bone heights were measured. Patients were grouped according to the use of sinus augmentation or no sinus augmentation at the time of implant placement. RESULTS The increase in bone height was significant in the graft group when we compared immediate and 3-year follow-up measurements (P < .00001). In the graft group, there were no significant differences in bone height when we compared the immediate and 3-year follow-up periods (P = .31). CONCLUSIONS Simultaneous sinus floor elevation with grafting at implant placement results in stable bone levels after 2 to 3 years' follow-up.
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Fresh Frozen Allogeneic Bone Block in Maxillary Sinus Floor Elevation: Histomorphometric Analysis of a Bone Specimen Retrieved 15 Years after Grafting Procedure. APPLIED SCIENCES-BASEL 2019. [DOI: 10.3390/app9061119] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Nowadays implant-prosthetic rehabilitations are one of the best solutions for rehabilitating our patients. These allow obtaining rehabilitations with optimal functional and aesthetic performances. Often patients, who undergo implant-prosthetic therapy, have the conditions of edentulias, single or multiple, that have been going on for some time. This, according to the literature, produces resorption of the alveolar bone, a process that is complicated in the posterior area of the upper arch by a pneumatization of the maxillary sinuses. The loss of vertical height, so that the implant fixtures can be inserted, requires a maneuver called maxillary sinus floor elevation. This procedure, now safely performed with piezoelectric instruments, allows increasing bone height through bone grafting. In this study, the tissue obtained from a patient, after 15 years from the intervention, was evaluated by histological and SEM analyses. The bone healing in the patient has led to a perfect integration between the patient’s bone and the fresh frozen allograft used, however still present and detectable after 15 years.
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Bertl K, Mick RB, Heimel P, Gahleitner A, Stavropoulos A, Ulm C. Variation in bucco-palatal maxillary sinus width does not permit a meaningful sinus classification. Clin Oral Implants Res 2018; 29:1220-1229. [PMID: 30430654 DOI: 10.1111/clr.13387] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 10/21/2018] [Accepted: 10/30/2018] [Indexed: 12/14/2022]
Abstract
OBJECTIVES The bucco-palatal sinus width (SW) appears as relevant factor for graft consolidation after maxillary sinus (MS) floor augmentation. The present study aimed to assess (a) SW at different height levels of posterior teeth, (b) possible factors influencing SW, and (c) whether a simple/meaningful sinus classification based on SW is possible. METHODS The following parameters were recorded on computed tomographies of 76 edentulous and 86 partially edentulous maxillary quadrants displaying 383 tooth sites in total: (a) alveolar ridge height, (b) -area, (c) -width 2 mm apical to the alveolar crest, (d) -width at the sinus floor, and (e) SW and sinus area at a level 2, 4, 6, 8, and 10 mm above the sinus floor. The possible influence of gender, tooth position [i.e., premolar (PM); molar (M)], tooth-gap extent, and residual alveolar ridge dimensions on SW was assessed. Further, based on percentiles of average values or on the frequency distribution of SW <10, 10-15, or >15 mm, it was attempted to classify the sinus at each given site into narrow, average, or wide. RESULTS Gender and tooth-gap extent presented no relevant impact on MS dimensions; however, significant differences were observed among the various tooth positions regarding all evaluated parameters. The lower the residual alveolar ridge, the wider the MS at 4-10 mm height, while the wider the residual alveolar ridge, the wider the MS. Large variation in SW classes among the different height levels within the same tooth position and among tooth positions within the same person was observed, irrespective of the threshold applied. Further, at a MS height of 10 mm at PM1, PM2, M1, and M2, SW was <10 mm in 68%, 33%, 0%, and 7% of the cases, respectively, while in 3%, 21%, 65%, and 57%, respectively, SW was >15 mm. CONCLUSIONS There is a large variation in SW depending on the height level within the sinus and on tooth position, which does not permit a simple/meaningful classification of each sinus as "narrow," "average," or "wide." Nevertheless, narrow sinuses (<10 mm) are rather prevalent in the premolar region, while wide sinuses (>15 mm) in the molar region; further, a wider and shorter residual alveolar ridge is associated with a wider SW.
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Affiliation(s)
- Kristina Bertl
- Department of Periodontology, Faculty of Odontology, University of Malmö, Malmö, Sweden.,Division of Oral Surgery, School of Dentistry, Medical University of Vienna, Vienna, Austria
| | - René-Bernard Mick
- Division of Oral Surgery, School of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Patrick Heimel
- Karl Donath Laboratory for Hard Tissue and Biomaterial Research, Division of Oral Surgery, Medical University of Vienna, Vienna, Austria.,Austrian Cluster for Tissue Regeneration, Vienna, Austria.,Ludwig Boltzmann Institute for Clinical and Experimental Traumatology, Vienna, Austria
| | - André Gahleitner
- Department of Diagnostic Radiology, Division of Osteoradiology, General Hospital, Medical University of Vienna, Vienna, Austria
| | - Andreas Stavropoulos
- Department of Periodontology, Faculty of Odontology, University of Malmö, Malmö, Sweden
| | - Christian Ulm
- Division of Oral Surgery, School of Dentistry, Medical University of Vienna, Vienna, Austria
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Stacchi C, Lombardi T, Ottonelli R, Berton F, Perinetti G, Traini T. New bone formation after transcrestal sinus floor elevation was influenced by sinus cavity dimensions: A prospective histologic and histomorphometric study. Clin Oral Implants Res 2018; 29:465-479. [PMID: 29569763 DOI: 10.1111/clr.13144] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The aim of this multicenter prospective study was to analyze clinically and histologically the influence of sinus cavity dimensions on new bone formation after transcrestal sinus floor elevation (tSFE). MATERIAL AND METHODS Patients needing maxillary sinus augmentation (residual crest height <5 mm) were treated with tSFE using xenogeneic granules. Six months later, bone-core biopsies were retrieved for histological analysis in implant insertion sites. Bucco-palatal sinus width (SW) and contact between graft and bone walls (WGC) were evaluated on cone beam computed tomography, and correlations between histomorphometric and anatomical parameters were quantified by means of forward multiple linear regression analysis. RESULTS Fifty consecutive patients were enrolled and underwent tSFE procedures, and forty-four were included in the final analysis. Mean percentage of newly formed bone (NFB) at 6 months was 21.2 ± 16.9%. Multivariate analysis showed a strong negative correlation between SW and NFB (R2 = .793) and a strong positive correlation between WGC and NFB (R2 = .781). Furthermore, when SW was stratified into three groups (<12 mm, 12 to 15 mm, and >15 mm), NFB percentages (36%, 13% and 3%, respectively) resulted significantly different. CONCLUSIONS This study represented the first confirmation based on histomorphometric data that NFB after tSFE was strongly influenced by sinus width and occurred consistently only in narrow sinus cavities (SW <12 mm, measured between buccal and palatal walls at 10-mm level, comprising the residual alveolar crest).
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Affiliation(s)
- Claudio Stacchi
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | | | | | - Federico Berton
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Giuseppe Perinetti
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Tonino Traini
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Chieti, Italy
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Abstract
OBJECTIVE To investigate the correlation between patient-dependent variables and dimensional variations of the maxillary sinus. METHODS In this cross-sectional study, a total of 394 individual cone-beam computed tomography scans were evaluated by one calibrated examiner to measure the total volume of the maxillary sinus, the distance between the medial and the lateral walls at 5, 10, and 15 mm vertically from the sinus floor, the height of septa (if present), and the height of the maxillary sinus cavity from both the alveolar crest and the sinus floor to the meatus. Recorded patient-dependent variables were age, gender, and edentulism status. RESULTS Total maxillary sinus volume was significantly smaller in completely and partially edentulous patients than in dentate subjects. This finding was influenced by age, as older patients exhibited less volume, regardless of gender and edentulism status. Age showed an indirect correlation with the distance to the meatus, the sinus volume, and the mediolateral dimensions. Additionally, the prevalence of accessory meatus in this population was 29.19%. CONCLUSIONS The dimensions of the maxillary sinus are influenced by age and edentulism status being reduced by aging and tooth loss.
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Influence of Maxillary Sinus Width on New Bone Formation After Transcrestal Sinus Floor Elevation: A Proof-of-Concept Prospective Cohort Study. IMPLANT DENT 2018; 26:209-216. [PMID: 28125520 DOI: 10.1097/id.0000000000000554] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Graft maturation in the maxillary sinus requires adequate angiogenesis and osteoprogenitor cells migration from the surrounding bony walls: the aim of this study was to analyze the correlation between sinus cavity dimensions and new bone formation after transcrestal sinus floor elevation (tSFE). METHODS Patients needing maxillary sinus augmentation (residual crest height ≤ 4 mm) were treated with tSFE using xenogeneic granules. Six months later, bone-core biopsies were retrieved for histological analysis in the implant insertion sites. Buccopalatal sinus width (SW) was evaluated on cone beam computed tomography, and correlations between histomorphometric and anatomical parameters were quantified by means of linear regression analysis. RESULTS Eight consecutive patients underwent tSFE procedures: at 6 months, average percentage of newly formed bone resulted 24.2% ± 7.9%. Statistical analysis showed a strong inverse correlation between SW and new bone formation (R = 0.88), and a strong direct correlation between the number of exposed bone walls and new bone formation (R = 0.82). CONCLUSION Within the limitations of this proof-of-concept study, in which a restricted number of patients were analyzed, tSFE showed more predictable results in narrow than in large sinuses, in terms of new bone formation.
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Dental Implants: The Last 100 Years. J Oral Maxillofac Surg 2018; 76:11-26. [DOI: 10.1016/j.joms.2017.08.045] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 08/21/2017] [Indexed: 01/30/2023]
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Chen Y, Yuan S, Zhou N, Man Y. Transcrestal sinus floor augmentation with immediate implant placement applied in three types of fresh extraction sockets: A clinical prospective study with 1-year follow-up. Clin Implant Dent Relat Res 2017; 19:1034-1043. [PMID: 28853203 DOI: 10.1111/cid.12529] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 07/03/2017] [Accepted: 07/31/2017] [Indexed: 02/05/2023]
Abstract
BACKGROUND Immediate implant insertion and transcrestal sinus augmentation both can provide a lot of advantages for patients and clinicians. OBJECTIVE This prospective study aims to verify the use of a modified technique for immediate implant insertion simultaneously with sinus augmentation in different types of sockets. MATERIALS AND METHODS Thirty-seven patients were recruited for the clinical study and were divided into 3 groups according to the relationship of their maxillary molar roots and sinus floor: group 1 with none of the teeth roots contacts sinus floor; group 2 as at least 1 teeth root contacting sinus floor, but no root is observed penetrating into sinus cavity; group 3 with at least 1 teeth root penetrating into sinus cavity. Implants were inserted after transcrestal sinus floor augmentation and immediately after tooth extraction. The change of mucosa thickness, diagnosis of rhinosinusitis, marginal bone loss (MBL), pocket depth (PD), and sulcus bleeding index were examined through radiographic measurement or clinical monitoring. RESULT During the study period, no implants failed. The relationship of the root of maxillary molars and sinus floor may have an effect on the bone height of the interradicular crest. Sinus mucosa was observed thicker after surgery. After healing period, sinus mucosa returned as thin as presurgery. At the time of 1-year follow-up, MBL was measured on X-ray (group 1: mesial: 0.63 ± 0.20 mm, distal: 0.70 ± 0.14 mm; group 2: mesial: 0.67 ± 0.21, distal: 0.65 ± 0.22 mm; group 3: mesial: 0.70 ± 0.15 mm, distal: 0.73 ± 0.19 mm). No statistical difference was found in MBL and PD as well as bleeding index among 3 groups. CONCLUSION In consideration of the advantages of sinus floor augmentation and immediate implant placement, our clinical result confirms that it is promising to combine the 2 techniques for replacing maxillary molars especially when using residual roots as implant orientation and taking full advantage of the interradicular crest bone.
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Affiliation(s)
- Yaqian Chen
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Shanshan Yuan
- Department of Implantology, School of Stomatology, Nanjing Medical University, Nanjing, China
| | - Nan Zhou
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yi Man
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Duan DH, Fu JH, Qi W, Du Y, Pan J, Wang HL. Graft-Free Maxillary Sinus Floor Elevation: A Systematic Review and Meta-Analysis. J Periodontol 2017; 88:550-564. [PMID: 28168901 DOI: 10.1902/jop.2017.160665] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND This systematic review and meta-analysis aims to investigate survival rates of dental implants placed simultaneously with graft-free maxillary sinus floor elevation (GFSFE). Factors influencing amount of vertical bone gain (VBG), protruded implant length (PIL) in sinus at follow-up (PILf), and peri-implant marginal bone loss (MBL) are also evaluated. METHODS Electronic and manual searches for human clinical studies on simultaneous implant placement and GFSFE using the lateral window or transcrestal approach, published in the English language from January 1976 to March 2016, were conducted. The random-effects model and mixed-effect meta-regression were used to analyze weighted mean values of clinical parameters and evaluate factors that influenced amount of VBG. RESULTS Of 740 studies, 22 clinical studies were included in this systematic review. A total of 864 implants were placed simultaneously with GFSFE at edentulous sites having mean residual bone height of 5.7 ± 1.7 mm. Mean implant survival rate (ISR) was 97.9% ± 0.02% (range: 93.5% to 100%). Weighted mean MBL was 0.91 ± 0.11 mm, and it was significantly associated with the postoperative follow-up period (r = 0.02; R2 = 43.75%). Weighted mean VBG was 3.8 ± 0.34 mm, and this parameter was affected significantly by surgical approach, implant length, and PIL immediately after surgery (PILi) (r = 2.82, 0.57, 0.80; R2 = 19.10%, 39.27%, 83.92%, respectively). Weighted mean PILf was 1.26 ± 0.33 mm (range: 0.3 to 2.1 mm). CONCLUSION Within limitations of the present systematic review, GFSFE with simultaneous implant placement can achieve satisfactory mean ISR of 97.9% ± 0.02%.
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Affiliation(s)
- Deng-Hui Duan
- Department of General Dentistry, School and Hospital of Stomatology, Peking University, Beijing, People's Republic of China
| | - Jia-Hui Fu
- Discipline of Periodontics, Faculty of Dentistry, National University of Singapore, Singapore, Republic of Singapore
| | - Wei Qi
- Department of Endodontics, Jinan Stomatology Hospital, Jinan, Shandong, People's Republic of China
| | - Yi Du
- Department of General Dentistry, School and Hospital of Stomatology, Peking University, Beijing, People's Republic of China
| | - Jie Pan
- Department of General Dentistry, School and Hospital of Stomatology, Peking University, Beijing, People's Republic of China
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI
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Stage Characterization and Marginal Bone Loss Evaluation Up to 96 Months of Crestal Sinus Augmentation With Sequential Drills: A Retrospective Study. IMPLANT DENT 2017; 24:642-9. [PMID: 26460742 DOI: 10.1097/id.0000000000000342] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The 2-stage crestal approach to augment the maxillary sinus is a little-used technique. The aim of this retrospective study was to assess events characterizing stages of this technique after implant placement in the posterior maxilla with residual bone height less than 4 mm and evaluate the marginal bone loss (MBL) changes over time. MATERIAL AND METHODS Thirty-three patients underwent unilateral sinus augmentations using the trancrestal technique with mineralized allograft. Six-months (6 m) after first surgery, if skeletal subsidence prevented insertion of a 10-mm-length implant, additional grafting was performed during implant (n = 33) insertion. Radiographs were taken before grafting (baseline), immediately after and at 6 months; immediately after and 6 months after implant placement; and at follow-up (24-96 m). RESULTS One implant was lost (ISR = 96.97%). Of the remaining 32 patients, 14 (A group) underwent standard implant placement, whereas 18 (B group) underwent additional grafting immediately before implant placement. Given that B-group patients initially obtained lower crestal bone height after first surgery, additional grafting procedures provided greater crestal height in the B group. A significant relationship between ending (eMBL) and 6mMBL was found in both groups, with greater values in the B group. However, in both groups, eMBL was always greater if 6mMBL was greater than 0.44 mm. DISCUSSION Results suggest a high and low skeletal-reactivity patient categorization. In both patient categories, MBL greatly depends upon 6-month values. Investigations are necessary to relate sinus size with results obtained by this 2-stage crestal approach. CONCLUSIONS The 2-stage crestal sinus lift procedure not only provides predictable results, but also allows low skeletal-reactivity patient recovery.
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Block MS. Improvements in the Crestal Osteotome Approach Have Decreased the Need for the Lateral Window Approach to Augment the Maxilla. J Oral Maxillofac Surg 2016; 74:2169-2181. [DOI: 10.1016/j.joms.2016.06.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 06/06/2016] [Accepted: 06/06/2016] [Indexed: 10/21/2022]
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Wainwright M, Torres-Lagares D, Pérez-Dorao B, Serrera-Figallo MA, Gutierrez-Perez JL, Troedhan A, Kurrek A. Histological and histomorphometric study using an ultrasonic crestal sinus grafting procedure. A multicenter case study. Med Oral Patol Oral Cir Bucal 2016; 21:e367-73. [PMID: 26946203 PMCID: PMC4867211 DOI: 10.4317/medoral.20994] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2015] [Accepted: 11/08/2015] [Indexed: 11/13/2022] Open
Abstract
Background The aim of this study was to evaluate the efficacy of a hydrodynamic ultrasonic driven transcrestal sinus grafting procedure (Intralift ®, Acteon Company, Bordeaux, France) and the use of a bovine high temperature sintered grafting material in sinus sites with less than 5 mm remaining bone height with no additional autogenous bone in order to create a sufficient recipient site for implants. Material and Methods 12 patients (16 sinus) in this multicenter case study were included. Using a crestal approach, bone under the sinus was prepared with ultrasonic tips until the Schneiderian membrane was reached. With a trumpet shaped instrument, the Schneiderian membrane was elevated. In the new created subantral space a high temperature sintered bovine grafting material was introduced (Bego Oss, BEGO Implant Systems GmbH & Co. KG, Bremen, Germany). After 6 months biopsies were taken with a trephine bur and histologies were generated following histomorphometric analysis. Results The results showed new vital bone in average of 33.4% ± 17.05%, and 43.6% ± 16.70 of bone substitute material. No signs of abnormal inflammation were observed. Conclusions This procedure (Intralift ®) allows, using a bovine material with no additional autogenous bone, new bone formation in the sinus in order to allow place implant subantraly. Key words:Bone regeneration, sinus, intralift ®, xenogenic bone graft
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Affiliation(s)
- M Wainwright
- Facultad de Odontología de Sevilla, C/Avicena s/n, 41009 Sevilla, Spain
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