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Wang Z, Wang Y, Yu Z, Tang L, Zhang J, Yang G, Huang T. Radiographic outcomes of lateral sinus floor elevation at sites without perforations and sites with perforations managed with a resorbable membrane: A retrospective study. J Clin Periodontol 2024; 51:1134-1146. [PMID: 38828551 DOI: 10.1111/jcpe.14026] [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: 02/26/2024] [Revised: 05/06/2024] [Accepted: 05/21/2024] [Indexed: 06/05/2024]
Abstract
AIM To evaluate the radiographic outcomes of lateral sinus floor elevation with simultaneous implant placement at sites without sinus membrane perforation (SMP) and sites with SMP managed with a resorbable membrane. MATERIALS AND METHODS One hundred and thirty-nine patients and 170 implants (56 perforation, 114 non-perforation) were included. Cone-beam computed tomography (CBCT) images were taken before surgery (T0), immediately after surgery (T1) and 6 months after surgery (T2). Post-operative augmentation parameters, including endo-sinus bone gain (ESBG) along the implant axis, mean new bone height (NBH) surrounding the implant and augmentation volume (AV), were measured at T1 and T2. RESULTS At T1, there were no significant differences in ESBG, NBH and AV between the two groups. At T2, although ESBG did not significantly differ between the two groups, NBH (8.50 ± 1.99 mm vs. 9.99 ± 2.52 mm, p = .039) and AV (519.37 ± 258.38 mm3 vs. 700.99 ± 346.53 mm3, p < .001) were significantly lower in the perforation group. The shrinkage of graft material from T1 to T2, including ΔESBG (p = .002), ΔNBH (p < .001) and ΔAV (p < .001), was higher in the perforation group. CONCLUSIONS SMP during LSFE with simultaneous implant placement is associated with greater resorption of the grafted area at a 6-month follow-up.
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Affiliation(s)
- Zhikang Wang
- 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
| | - Yuchen Wang
- 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
| | - Zhou Yu
- 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
| | - Like Tang
- 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
| | - Jing Zhang
- 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
| | - Tingben Huang
- 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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Biel P, Jurt A, Chappuis V, Suter VGA. Incidental findings in cone beam computed tomography (CBCT) scans for implant treatment planning: a retrospective study of 404 CBCT scans. Oral Radiol 2024; 40:207-218. [PMID: 38102453 DOI: 10.1007/s11282-023-00723-5] [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: 07/13/2023] [Accepted: 11/02/2023] [Indexed: 12/17/2023]
Abstract
OBJECTIVES To investigate the prevalence of incidental findings and need for further dental treatment and analyse the influence of size of field-of-view (FOV) and age in cone beam computed tomography (CBCT) for pre-implant planning. METHODS 404 CBCT scans were examined retrospectively for incidental findings and need for further dental treatment. Incidental finding-frequencies and need for further treatment were assessed for different age (< 40 years, 40-60 years, > 60 years) and FOV groups (small, medium, large). Intraexaminer and interexaminer agreements were evaluated. RESULTS In 82% of the scans at least one incidental finding was found, with a total of 766 overall. More incidental findings were found in scans with large FOV (98% vs. 72%, OR = 22.39 large vs. small FOV, p < 0.0001) and in scans of patients > 60 years (OR = 5.37 patient's age > 60 years vs. < 40 years, p = 0.0003). Further dental treatment due to incidental findings was needed in 31%. Scans with large FOV were more likely to entail further treatment (OR = 3.55 large vs. small FOV, p < 0.0001). Partial edentulism and large FOV were identified as risk factors for further treatment (p = 0.0003 and p < 0.0001). Further referral of the patient based on incidental findings was judged as indicated in 5%. Intra- and inter-examiner agreements were excellent (kappa = 0.944/0.805). CONCLUSIONS A considerable number of incidental findings with need for further dental treatment was found in partially edentulous patients and in patients > 60 years. In pre-implant planning of elderly patients, the selection of large FOV CBCT scans, including dentoalveolar regions not X-rayed recently, help to detect therapeutically relevant incidental findings.
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Affiliation(s)
- Philippe Biel
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland
| | - Alice Jurt
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland
| | - Vivianne Chappuis
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland
| | - Valerie G A Suter
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland.
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Wang Z, Zhang J, Li N, Pu R, Wang Y, Yang G. Survival analysis of implants placed simultaneously with lateral sinus floor elevation in severely atrophic maxilla: A 3- to 12-year retrospective cohort study. Clin Implant Dent Relat Res 2023; 25:1069-1079. [PMID: 37442813 DOI: 10.1111/cid.13249] [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: 04/11/2023] [Revised: 06/21/2023] [Accepted: 07/06/2023] [Indexed: 07/15/2023]
Abstract
OBJECTIVES To retrospectively evaluate whether implants placed simultaneously with lateral sinus floor elevation (LSFE) in severely atrophic maxilla (residual bone height [RBH] ≤3 mm) could achieve long-term survival and comprehensively analyze the factors influencing their survival rates. MATERIALS AND METHODS A total of 123 patients receiving LSFE and simultaneous implant placement from 2010 to 2019 and their 123 implants in sites with RBH ≤3 mm were included in this study. Basic characteristics of patients and implants were collected from the medical record system and cone-beam computed tomography (CBCT) images. Kaplan-Meier survival curves were applied to estimate cumulative survival rates (CSRs) and Cox proportional hazards regression models were used to detect factors influencing implant survival. RESULTS The 6-year and 12-year CSR of implants placed in sites with RBH ≤3 mm were 95.7% (95% confidence interval [CI]: 92.1%-99.5%) and 76.6% (95% CI: 58.1%-100%), respectively. Eight patients presented late implant failure. Univariate and multivariate Cox regression analyses demonstrated that RBH ≤2 mm (hazard ratio [HR]: 20.63, p = 0.000) and smoking habit (HR: 6.055, p = 0.024) were significantly associated with long-term implant survival. Specifically, the 10-year CSR of implants in sites with RBH ≤2 mm (53.3%, 95% CI: 27.5%-100%) was dramatically lower than those in sites with RBH >2 mm (92.9%, 95% CI: 81.7%-100%, p = 0.000). CONCLUSIONS Implants placed simultaneously with LSFE in sites with RBH ≤3 mm can achieve long-term survival. However, caution is required especially for implantation in sites with RBH ≤2 mm. Besides, the smoking habit is also considered a risk factor jeopardizing long-term implant survival.
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Affiliation(s)
- Zhikang Wang
- 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, People's Republic of China
| | - Jing Zhang
- 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, People's Republic of China
| | - Na Li
- 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, People's Republic of 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, People's Republic of China
| | - Ying Wang
- 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, People's Republic of 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, People's Republic of China
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Krennmair S, Postl L, Schwarze UY, Malek M, Stimmelmayr M, Krennmair G. Clinical, radiographic, and histological/histomorphometric analysis of maxillary sinus grafting with deproteinized porcine or bovine bone mineral: A randomized clinical trial. Clin Oral Implants Res 2023; 34:1230-1247. [PMID: 37610063 DOI: 10.1111/clr.14164] [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: 12/25/2022] [Revised: 07/18/2023] [Accepted: 07/25/2023] [Indexed: 08/24/2023]
Abstract
OBJECTIVE The present study aimed to compare histomorphometrically evaluated new bone formation, radiographically measured graft stability, and clinical implant outcome between maxillary sinus grafting with either deproteinized porcine bone mineral (DPBM) or deproteinized bovine bone mineral (DBBM). MATERIALS AND METHODS Thirty maxillary sinuses were initially included and randomly assigned to the test group (TG; DPBM, n = 15) or control group (CG; DBBM, n = 15). After a healing period (6 months), axially retrieved bone biopsies of the molar region were used for histological/histomorphometric analysis of new bone formations. Additionally, radiographically measured graft stability and clinical implant outcome were assessed. RESULTS Twenty-three sinus sites with 10 sinuses of the TG and 13 of the CG were ultimately available for data and statistical analysis. In the TG, a slightly, but yet significantly (p = .040) higher proportion of new bone formation (TG: 27.7 ± 5.6% vs. CG: 22.9 ± 5.1%) and a lesser (p = .019) amount of connective (non-mineralized) tissue (TG: 47.5 ± 9.5% vs. CG: 56.1 ± 9.5%) was found than in the CG. However, both xenografts showed comparable (n.s.) residual bone graft (TG: 23.7 ± 7.2% vs. CG: 21.1 ± 9.85.6%), bone-to-graft contacts (TG: 26.2 ± 9.8% vs. CG: 30.8 ± 13.8%), similar graft height reduction over time (TG: 12.9 ± 6.7% CG: 12.4 ± 5.8%) and implant survival/success rate (100%). At the 3-year post-loading evaluation, the peri-implant marginal bone loss (TG: 0.52 ± 0.19 mm; CG: 0.48 ± 0.15 mm) and the peri-implant health conditions (TG: 87.5%/CG: 81.2%) did not differ between implants inserted in both xenografts used. CONCLUSIONS The use of DPBM or DBBM for maxillary sinus augmentation is associated with comparable bone formation providing stable graft dimension combined with healthy peri-implant conditions.
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Affiliation(s)
- Stefan Krennmair
- Department of Oral and Maxillofacial Surgery, Keplerklinikum Linz, Johannes Kepler University (JKU) Linz, Linz, Austria
- NumBiolab Research Associate, Ludwig-Maximilian University (LMU), Munich, Germany
| | - Lukas Postl
- Department of Oral and Maxillofacial Surgery, Keplerklinikum Linz, Johannes Kepler University (JKU) Linz, Linz, Austria
- NumBiolab Research Associate, Ludwig-Maximilian University (LMU), Munich, Germany
| | - Uwe Yacine Schwarze
- Division of Oral Surgery and Orthodontics and Musculo-Skeletal Research Unit for Biomaterials, Medical University Graz, Graz, Austria
| | - Michael Malek
- Department of Oral and Maxillofacial Surgery, Keplerklinikum Linz, Johannes Kepler University (JKU) Linz, Linz, Austria
| | - Michael Stimmelmayr
- Department of Prosthodontics, Ludwig-Maximilian University (LMU), Munich, Germany
| | - Gerald Krennmair
- Department of Prosthodontics, Dental School, Sigmund Freud Medical University of Vienna, Vienna, Austria
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Kim JH, Min EJ, Ko Y, Kim DH, Park JB. Change in Maxillary Sinus Mucosal Thickness in Patients with Preoperative Maxillary Sinus Mucosal Thickening as Assessed by Otolaryngologists: A Retrospective Study. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1750. [PMID: 37893468 PMCID: PMC10608619 DOI: 10.3390/medicina59101750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 09/10/2023] [Accepted: 09/27/2023] [Indexed: 10/29/2023]
Abstract
Background and Objectives: Maxillary sinus pathologic conditions may increase the risk of complications during posterior maxillary sinus augmentation surgery. The purpose of this study was to evaluate the changes in participants with preoperative maxillary sinus mucosal thickening and to assess this factor as a preoperative risk indicator for sinusitis after maxillary dental implantation. Materials and Methods: We compared the preoperative and postoperative maxillary sinus mucosal thickness (MSMT), the distance between the maxillary sinus ostium and sinus floor (MOD), and the MSMT/MOD ratio. The participants were divided into three groups (sinus augmentation, bone grafting, and no grafting). Results: The mean preoperative MSMT was 4.3 ± 2.0 mm, and the mean MSMT/MOD ratio was 0.13 ± 0.05. No postoperative sinusitis was observed in these patients, including cases caused by anatomical variations. The mean postoperative MSMT was 4.5 ± 2.3 mm, and the mean postoperative MSMT/MOD ratio was 0.15 ± 0.06. There was no statistically significant difference between the groups at each time point (p > 0.05). Conclusions: The study found no significant change in MSMT at post-treatment evaluation, even when considering different subgroups. It underscores the importance of preoperative maxillary sinus radiographic assessments and collaboration between dentists and otolaryngologists for better outcomes in patients with preoperative maxillary sinus mucosal thickening.
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Affiliation(s)
- Jin-Hyeong Kim
- Department of Periodontics, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea; (J.-H.K.); (Y.K.)
| | - Eun Jeong Min
- Department of Medical Life Science, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea;
- Department of Biomedicine & Health Sciences, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Youngkyung Ko
- Department of Periodontics, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea; (J.-H.K.); (Y.K.)
- Dental Implantology, Graduate School of Clinical Dental Science, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Do Hyun Kim
- Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Jun-Beom Park
- Department of Periodontics, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea; (J.-H.K.); (Y.K.)
- Dental Implantology, Graduate School of Clinical Dental Science, The Catholic University of Korea, Seoul 06591, Republic of Korea
- Department of Medicine, Graduate School, The Catholic University of Korea, Seoul 06591, Republic of Korea
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Hwang IK, Kang SR, Yang S, Kim JM, Kim JE, Huh KH, Lee SS, Heo MS, Yi WJ, Kim TI. SinusC-Net for automatic classification of surgical plans for maxillary sinus augmentation using a 3D distance-guided network. Sci Rep 2023; 13:11653. [PMID: 37468515 DOI: 10.1038/s41598-023-38273-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 07/06/2023] [Indexed: 07/21/2023] Open
Abstract
The objective of this study was to automatically classify surgical plans for maxillary sinus floor augmentation in implant placement at the maxillary posterior edentulous region using a 3D distance-guided network on CBCT images. We applied a modified ABC classification method consisting of five surgical approaches for the deep learning model. The proposed deep learning model (SinusC-Net) consisted of two stages of detection and classification according to the modified classification method. In detection, five landmarks on CBCT images were automatically detected using a volumetric regression network; in classification, the CBCT images were automatically classified as to the five surgical approaches using a 3D distance-guided network. The mean MRE for landmark detection was 0.87 mm, and SDR for 2 mm or lower, 95.47%. The mean accuracy, sensitivity, specificity, and AUC for classification by the SinusC-Net were 0.97, 0.92, 0.98, and 0.95, respectively. The deep learning model using 3D distance-guidance demonstrated accurate detection of 3D anatomical landmarks, and automatic and accurate classification of surgical approaches for sinus floor augmentation in implant placement at the maxillary posterior edentulous region.
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Affiliation(s)
- In-Kyung Hwang
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, 03080, Republic of Korea
| | - Se-Ryong Kang
- Department of Biomedical Radiation Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, 08826, Republic of Korea
| | - Su Yang
- Department of Applied Bioengineering, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, 08826, Republic of Korea
| | - Jun-Min Kim
- Department of Electronics and Information Engineering, Hansung University, Seoul, 02876, Republic of Korea
| | - Jo-Eun Kim
- Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, 03080, Republic of Korea
| | - Kyung-Hoe Huh
- Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, 03080, Republic of Korea
| | - Sam-Sun Lee
- Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, 03080, Republic of Korea
| | - Min-Suk Heo
- Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, 03080, Republic of Korea
| | - Won-Jin Yi
- Department of Applied Bioengineering, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, 08826, Republic of Korea.
- Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, 03080, Republic of Korea.
| | - Tae-Il Kim
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, 03080, Republic of Korea.
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Cheng CD, Tsai YWC, Cheng WC, Lin FG, Weng PW, Chen YW, Huang RY, Chen WL, Shieh YS, Sung CE. The referral pattern and treatment modality for peri-implant disease between periodontists and non-periodontist dentists. BMC Oral Health 2023; 23:427. [PMID: 37370067 DOI: 10.1186/s12903-023-03135-3] [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: 03/09/2023] [Accepted: 06/14/2023] [Indexed: 06/29/2023] Open
Abstract
OBJECTIVES This study is to investigate the referral pattern and treatment modality of dentists in the management of peri-implant diseases between periodontists and non-periodontist dentists (NPDs). MATERIALS AND METHODS A total of 167 validated questionnaires were obtained from periodontists and NPDs, who had experience of placing implants for at least one year. Question I to IV asked how the dentist would respond if a patient came for treatment of their peri-implant diseases with four different scenarios according to resource of patient and disease severity. For each Scenario, dentists also replied which treatment procedures they would use if they decide to treat the patient. RESULTS Periodontal training, resource of patient, and disease severity were shown to significantly influence the referral pattern and treatment modality in the management of peri-implant disease (p < 0.05). Periodontists were more likely to use variable treatment procedures, including occlusal adjustment (OR = 2.283, p < 0.01), oral hygiene instruction (OR = 3.751, p < 0.001), topical antiseptic agent (OR = 2.491, p < 0.005), non-surgical mechanical therapy (OR = 2.689, p < 0.001), surgical therapy (OR = 2.009, p < 0.01), and remove implant (OR = 3.486, p < 0.001) to treat peri-implant diseases, compared to NPDs. CONCLUSION The periodontal specialty training, resource of patient, and disease severity significantly influenced the referral pattern and treatment modality of dentist treating an implant diagnosed with peri-implant disease. This study also highlighted the importance of educating basic periodontal and peri-implant disease-related knowledge to all dentists regularly performing dental implant treatments. CLINICAL RELEVANCE Peri-implant diseases are highly prevalent among patients with dental implants. Periodontal specialty training could enhance using variable treatment procedures to treat peri-implant diseases for dentists.
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Affiliation(s)
- Chia-Dan Cheng
- Department of Periodontology, School of Dentistry, Tri-Service General Hospital and National Defense Medical Center, Section 2, Chang-Gong Rd, Nei-Hu District, 114, No. 325, Taipei, Taiwan
| | - Yi-Wen Cathy Tsai
- Department of Periodontology, School of Dentistry, Tri-Service General Hospital and National Defense Medical Center, Section 2, Chang-Gong Rd, Nei-Hu District, 114, No. 325, Taipei, Taiwan
| | - Wan-Chien Cheng
- Department of Periodontology, School of Dentistry, Tri-Service General Hospital and National Defense Medical Center, Section 2, Chang-Gong Rd, Nei-Hu District, 114, No. 325, Taipei, Taiwan
| | - Fu-Gong Lin
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
- Department of Optometry, Asia University, Taichung City, Taiwan
| | - Pei-Wei Weng
- Department of Orthopaedics, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Department of Orthopaedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Ying-Wu Chen
- Department of Periodontology, School of Dentistry, Tri-Service General Hospital and National Defense Medical Center, Section 2, Chang-Gong Rd, Nei-Hu District, 114, No. 325, Taipei, Taiwan
| | - Ren-Yeong Huang
- Department of Periodontology, School of Dentistry, Tri-Service General Hospital and National Defense Medical Center, Section 2, Chang-Gong Rd, Nei-Hu District, 114, No. 325, Taipei, Taiwan
| | - Wei-Liang Chen
- Division of Geriatric Medicine, Department of Family Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yi-Shing Shieh
- Department of Operative Dentistry and Endodontics, School of Dentistry, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan
| | - Cheng-En Sung
- Department of Periodontology, School of Dentistry, Tri-Service General Hospital and National Defense Medical Center, Section 2, Chang-Gong Rd, Nei-Hu District, 114, No. 325, Taipei, Taiwan.
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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:diagnostics13101684. [PMID: 37238169 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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Park WB, Kim J, Kim YJ, Kang P, Lim HC, Han JY. Changes in sinus mucosal thickening in the course of tooth extraction and lateral sinus augmentation with surgical drainage: A cone-beam computed tomographic study. Clin Oral Implants Res 2023; 34:95-104. [PMID: 36336985 DOI: 10.1111/clr.14019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 10/08/2022] [Accepted: 11/03/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVES The objective of the study was to evaluate the radiographic changes in sinus mucosal thickness (SMT) in patients with mucosal thickening of odontogenic origin after maxillary molar extraction and lateral sinus augmentation with simultaneous surgical drainage and implant placement. MATERIALS AND METHODS Forty-six patients were included in this study. The changes in SMT were evaluated using cone-beam computed tomography images produced at four time points: before extraction (T0), before surgery (T1), immediately after surgery (T2), and after prosthesis delivery (T3), and statistical differences between time points were analyzed. The changes in SMT and augmented bone height (ABH) regarding the reason of extraction, smoking, ostial patency, and the presence of postoperative sinusitis were also evaluated. RESULTS Over time points, SMT gradually decreased (T0: 19.44 ± 9.22 mm, T1: 15.10 ± 8.89 mm, T2: 8.42 ± 6.01 mm, and T3: 4.16 ± 4.91 mm) (p < .05). Five out of 6 patients with ostial obstruction at T1 presented ostial patency at T3. Two patients developed postoperative sinusitis but recovered with medication. Ostial patency at T1, SMT at T1, and reason of extraction did not statistically significantly influence SMT at T3. SMT at T1 had no statistically significant impact on ABH change between T2 and T3. CONCLUSION Sinus mucosal thickness was gradually reduced by extraction of compromised teeth and drainage during lateral sinus augmentation. The drainage contributed more to the reduction in SMT.
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Affiliation(s)
- Won-Bae Park
- Department of Periodontology, Kyung Hee University, College of Dentistry, Private Practice in Periodontics and Implant Dentistry, Seoul, South Korea
| | - Jiyeong Kim
- Biostatistical Consulting and Research, Medical Research Collaborating Center, Industry-University Cooperation Foundation, Hanyang University, Seoul, South Korea
| | - Young-Jin Kim
- Nowon Eulji Medical Center, Eulji University, Private Practice in Otorhinolaryngology Clinic, Seoul, South Korea
| | - Philip Kang
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, Columbia University, College of Dental Medicine, New York, New York, USA
| | - Hyun-Chang Lim
- Department of Periodontology, Kyung Hee University, College of Dentistry, Kyung Hee University Medical Center, Periodontal Implant Clinical Research Institute, Seoul, South Korea
| | - Ji-Young Han
- Department of Periodontology, Division of Dentistry, Hanyang University, College of Medicine, Seoul, South Korea
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10
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Li N, Jiang Z, Pu R, Zhu D, Yang G. Implant failure and associated risk factors of transcrestal sinus floor elevation: A retrospective study. Clin Oral Implants Res 2023; 34:66-77. [PMID: 36346662 DOI: 10.1111/clr.14020] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 10/20/2022] [Accepted: 11/03/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVES This retrospective study aimed to evaluate early and late implant loss rates after transcrestal sinus floor elevation (TSFE) and to identify the risk factors related to these failures. MATERIAL AND METHODS All patients treated with TSFE and simultaneous implant placement during October 2015 to March 2019 were evaluated for inclusion. A total of 802 patients with 976 implants met the inclusion criteria. Clinical and radiographic information was collected from medical records and image software. Univariate and multivariate Cox proportional hazards frailty regression models were performed to identify potential risk factors associated with early and late implant loss after TSFE. RESULTS The 3-year cumulative implant survival rate was 96.9% (95% CI 95.8%-98.0%). Twelve implants in 12 patients were lost before or at the abutment connection, while 24 implants in 24 patients were lost after functional loading. The Cox frailty regression analyses indicated that two factors were correlated with early implant loss: TSFE with grafting materials, and operators with less clinical experience. As for late implant loss, RBH ≤6 mm, male sex, and certain implant brands were associated with a significantly increased failure rate. CONCLUSIONS Transcrestal sinus floor elevation with simultaneous implant placement is a predictable treatment option in the atrophic maxilla. The presence of grafting materials and the lack of clinical experience of the surgeon were possibly associated with early implant loss, while low RBH, male sex, and certain implant brands tended to increase late implant loss.
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Affiliation(s)
- Na Li
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang, China.,Zhejiang Provincial Clinical Research Center for Oral Diseases, Zhejiang, China.,Key Laboratory of Oral Biomedical Research of Zhejiang Province, Zhejiang, China.,Cancer Center of Zhejiang University, Hangzhou, China
| | - Zhiwei Jiang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang, China.,Zhejiang Provincial Clinical Research Center for Oral Diseases, Zhejiang, China.,Key Laboratory of Oral Biomedical Research of Zhejiang Province, Zhejiang, China.,Cancer Center of Zhejiang University, Hangzhou, China
| | - Rui Pu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang, China
| | - Danji Zhu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang, China.,Zhejiang Provincial Clinical Research Center for Oral Diseases, Zhejiang, China.,Key Laboratory of Oral Biomedical Research of Zhejiang Province, Zhejiang, China.,Cancer Center of Zhejiang University, Hangzhou, China
| | - Guoli Yang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang, China.,Zhejiang Provincial Clinical Research Center for Oral Diseases, Zhejiang, China.,Key Laboratory of Oral Biomedical Research of Zhejiang Province, Zhejiang, China.,Cancer Center of Zhejiang University, Hangzhou, China
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11
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Choi H, Jeon KJ, Kim YH, Ha EG, Lee C, Han SS. Deep learning-based fully automatic segmentation of the maxillary sinus on cone-beam computed tomographic images. Sci Rep 2022; 12:14009. [PMID: 35978086 PMCID: PMC9385721 DOI: 10.1038/s41598-022-18436-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 08/11/2022] [Indexed: 11/21/2022] Open
Abstract
The detection of maxillary sinus wall is important in dental fields such as implant surgery, tooth extraction, and odontogenic disease diagnosis. The accurate segmentation of the maxillary sinus is required as a cornerstone for diagnosis and treatment planning. This study proposes a deep learning-based method for fully automatic segmentation of the maxillary sinus, including clear or hazy states, on cone-beam computed tomographic (CBCT) images. A model for segmentation of the maxillary sinuses was developed using U-Net, a convolutional neural network, and a total of 19,350 CBCT images were used from 90 maxillary sinuses (34 clear sinuses, 56 hazy sinuses). Post-processing to eliminate prediction errors of the U-Net segmentation results increased the accuracy. The average prediction results of U-Net were a dice similarity coefficient (DSC) of 0.9090 ± 0.1921 and a Hausdorff distance (HD) of 2.7013 ± 4.6154. After post-processing, the average results improved to a DSC of 0.9099 ± 0.1914 and an HD of 2.1470 ± 2.2790. The proposed deep learning model with post-processing showed good performance for clear and hazy maxillary sinus segmentation. This model has the potential to help dental clinicians with maxillary sinus segmentation, yielding equivalent accuracy in a variety of cases.
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Affiliation(s)
- Hanseung Choi
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, Korea
| | - Kug Jin Jeon
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, Korea
| | - Young Hyun Kim
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, Korea
| | - Eun-Gyu Ha
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, Korea
| | - Chena Lee
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, Korea
| | - Sang-Sun Han
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, Korea.
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12
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Kang N, Liu C. Modified Osteotome Sinus Floor Elevation Technique for Multiple Edentulous Spaces: A Non-Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138019. [PMID: 35805687 PMCID: PMC9265290 DOI: 10.3390/ijerph19138019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 06/20/2022] [Accepted: 06/22/2022] [Indexed: 11/16/2022]
Abstract
Objectives: We aimed to demonstrate our modified osteotome sinus floor elevation (OSFE) technique for placing two implants in multiple maxillary posterior edentulous spaces with residual bone height (RBH) < 5 mm, to evaluate the clinical effect and explore the prognosis. Methods: We identified 18 appropriate patients with RBH < 5 mm and 12 patients with RBH ≥ 5 mm. After drill preparation, variously shaped curettes were applied to adequately release the tension of the membrane around the cavity and between two implants by blunt dissection. Then, an osteotome was used to elevate the membrane to the desired height. After filling bone graft into the elevated space, dental implants were inserted. Cone-Beam Computed Tomography (CBCT) was performed after surgery and 6 months later. Results: The implant survival rate was 100%, and after the 6-month resorption, the height of the graft apically between the two implants gradually stabilized at 8.92 mm. Compared with 12 patients with RBH ≥ 5 mm, their graft bone resorption demonstrated no significant difference. Conclusions: It can be suggested that the modified OSFE technique could yield predictable clinical results for placing adjacent implants in patients with RBH less than 5 mm after six months of follow-up. Clinical Significance: Our modified OSFE technique could be applied to place adjacent implants in patients with RBH less than 5 mm, especially for elderly patients or patients with bone crests and vessels on the lateral wall, owing to its advantages including less trauma and fewer complications, minimizing the risk of membrane perforation, shortening the treatment period, avoiding another surgery area or second-stage surgery, improving not only the bone around the implant apex but also between implants, etc.
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Affiliation(s)
- Ning Kang
- Department of Dental Implant, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- College of Biomedical Engineering, Sichuan University, Chengdu 610041, China
- Correspondence:
| | - Caojie Liu
- Department of Dental Implant, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
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13
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Automatic detection and segmentation of morphological changes of the maxillary sinus mucosa on cone-beam computed tomography images using a three-dimensional convolutional neural network. Clin Oral Investig 2022; 26:3987-3998. [DOI: 10.1007/s00784-021-04365-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 12/29/2021] [Indexed: 02/07/2023]
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14
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Cagna DR, Donovan TE, McKee JR, Eichmiller F, Metz JE, Albouy JP, Marzola R, Murphy KG, Troeltzsch M. Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry. J Prosthet Dent 2021; 126:276-359. [PMID: 34489050 DOI: 10.1016/j.prosdent.2021.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 06/22/2021] [Accepted: 06/22/2021] [Indexed: 11/26/2022]
Abstract
The Scientific Investigation Committee of the American Academy of Restorative Dentistry offers this review of the 2020 professional literature in restorative dentistry to inform busy dentists regarding noteworthy scientific and clinical progress over the past year. Each member of the committee brings discipline-specific expertise to this work to cover this broad topic. Specific subject areas addressed include prosthodontics; periodontics, alveolar bone, and peri-implant tissues; implant dentistry; dental materials and therapeutics; occlusion and temporomandibular disorders (TMDs); sleep-related breathing disorders; oral medicine and oral and maxillofacial surgery; and dental caries and cariology. The authors focused their efforts on reporting information likely to influence day-to-day dental treatment decisions with a keen eye on future trends in the profession. With the tremendous volume of dentistry and related literature being published today, this review cannot possibly be comprehensive. The purpose is to update interested readers and provide important resource material for those interested in pursuing greater detail. It remains our intent to assist colleagues in navigating the extensive volume of important information being published annually. It is our hope that readers find this work useful in successfully managing the dental patients they encounter.
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Affiliation(s)
- David R Cagna
- Professor, Associate Dean, Chair and Residency Director, Department of Prosthodontics, University of Tennessee Health Sciences Center College of Dentistry, Memphis, Tenn.
| | - Terence E Donovan
- Professor, Department of Comprehensive Oral Health, University of North Carolina School of Dentistry, Chapel Hill, NC
| | | | - Frederick Eichmiller
- Vice President and Science Officer, Delta Dental of Wisconsin, Stevens Point, Wis
| | | | - Jean-Pierre Albouy
- Assistant Professor of Prosthodontics, Department of Restorative Sciences, University of North Carolina School of Dentistry, Chapel Hill, NC
| | | | - Kevin G Murphy
- Associate Clinical Professor, Department of Periodontics, University of Maryland College of Dentistry, Baltimore, Md; Private practice, Baltimore, Md
| | - Matthias Troeltzsch
- Associate Professor, Department of Oral and Maxillofacial Surgery, Ludwig-Maximilians University of Munich, Munich, Germany; Private practice, Ansbach, Germany
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15
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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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