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Starch-Jensen T, Bruun NH, Spin-Neto R. Endo-sinus bone gain following sinus membrane elevation without graft compared with sinus floor augmentation and a composite graft: a one-year single-blind randomized controlled trial. Int J Oral Maxillofac Surg 2024; 53:319-332. [PMID: 37891069 DOI: 10.1016/j.ijom.2023.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 10/06/2023] [Accepted: 10/11/2023] [Indexed: 10/29/2023]
Abstract
The objective of this study was to assess endo-sinus bone gain (ESBG) and bone density (BD) following maxillary sinus membrane elevation without graft (test) compared with maxillary sinus floor augmentation and 1:1 ratio of autogenous bone from the buccal antrostomy and deproteinized porcine bone mineral (control) using two- and three-dimensional radiographic methods. Forty healthy patients were randomly allocated to the test and control groups. Cone beam computed tomography scans were obtained at enrolment (T0), immediately after surgery (T1), at delivery of the prosthetic rehabilitation (T2), and 1 year after functional implant loading (T3). Mean differences were expressed with the 95% confidence interval. Significance was set at ≤ 0.05. ESBG and BD were significantly higher in the control group than test group at T1, T2, and T3 (P < 0.001). A significant decrease in ESBG and increase in BD was observed from T1 to T3 with both treatments (P < 0.001). There was a non-significant positive correlation of ESBG with implant protrusion length and non-significant negative correlation with residual bone height. In conclusion, test was associated with significantly lower ESBG and BD compared with control. However, the lower ESBG and BD did not appear to negatively affect the implant stability quotient or implant treatment outcome after 1 year of functional implant loading.
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Affiliation(s)
- T Starch-Jensen
- Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, and Department of Clinical Medicine, The Faculty of Medicine, Aalborg University, Aalborg, Denmark.
| | - N H Bruun
- Unit of Clinical Biostatistics, Aalborg University Hospital, Aalborg, Denmark
| | - R Spin-Neto
- Department of Dentistry and Oral Health, Section for Oral Radiology, Faculty of Health, Aarhus University, Aarhus, Denmark
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2
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Takafuji K, Oyamada Y, Hatakeyama W, Kihara H, Shimazaki N, Fukutoku A, Satoh H, Kondo H. Quantitative analysis of change in bone volume 5 years after sinus floor elevation using plate-shaped bone substitutes: a prospective observational study. Int J Implant Dent 2024; 10:9. [PMID: 38372934 PMCID: PMC10876503 DOI: 10.1186/s40729-023-00501-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 09/09/2023] [Indexed: 02/20/2024] Open
Abstract
PURPOSE Tricalcium phosphate (TCP) has osteoconductive ability and reportedly offers similar clinical results as autogenous bone grafts in dental implant treatment. However, few reports quantify temporal changes in augmented bone volume after sinus augmentation. We aimed to establish a three-dimensional (3D) quantification method to assess bone volume after sinus augmentation and to evaluate biocompatibility of the TCP plate. METHODS Maxillary sinus floor augmentation was performed employing the lateral window technique, and plate-shaped β-TCP (TCP plate) was used instead of granular bone grafting materials. After lifting the sinus membrane, the TCP plate was inserted and supported by dental implants or micro-screws. The changes in bone volumes in the maxillary sinus before and after surgery were recorded using cone-beam computed tomography, saved as Digital Imaging and Communications in Medicine-formatted files, and transformed to Standard Triangle Language (STL)-formatted files. Pre- and post-operative STL data of bone volume were superimposed, and the augmented bone volume was calculated. Moreover, changes in bone volumes, TCP plate resorption rates, and bone heights surrounding the implants were three dimensionally quantified. RESULTS Fifteen implants in nine subjects were included in this study. TCP plates secured long-term space making, with results similar to those of granular bone substitutes. Newly formed bone was identified around the implant without bone graft material. TCP plate was absorbed and gradually disappeared. CONCLUSIONS A novel 3D quantification method was established to evaluate changes in bone volume. Clinical application of TCP plate in sinus augmentation could be a better procedure in terms of prognosis and safety.
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Affiliation(s)
- Kyoko Takafuji
- Department of Prosthodontics and Oral Implantology School of Dentistry, Iwate Medical University, 19-1 Uchimaru, Morioka, 020-8505, Japan
- Department of Fixed Prosthodontics and Oral Implantology, Aichi Gakuin University, Nagoya, Japan
| | - Yutaro Oyamada
- Department of Prosthodontics and Oral Implantology School of Dentistry, Iwate Medical University, 19-1 Uchimaru, Morioka, 020-8505, Japan
| | - Wataru Hatakeyama
- Department of Prosthodontics and Oral Implantology School of Dentistry, Iwate Medical University, 19-1 Uchimaru, Morioka, 020-8505, Japan
| | - Hidemichi Kihara
- Department of Prosthodontics and Oral Implantology School of Dentistry, Iwate Medical University, 19-1 Uchimaru, Morioka, 020-8505, Japan
| | - Nobuko Shimazaki
- Department of Prosthodontics and Oral Implantology School of Dentistry, Iwate Medical University, 19-1 Uchimaru, Morioka, 020-8505, Japan
| | - Akihiro Fukutoku
- Department of Prosthodontics and Oral Implantology School of Dentistry, Iwate Medical University, 19-1 Uchimaru, Morioka, 020-8505, Japan
| | - Hiroaki Satoh
- Department of Prosthodontics and Oral Implantology School of Dentistry, Iwate Medical University, 19-1 Uchimaru, Morioka, 020-8505, Japan
| | - Hisatomo Kondo
- Department of Prosthodontics and Oral Implantology School of Dentistry, Iwate Medical University, 19-1 Uchimaru, Morioka, 020-8505, Japan.
- Department of Fixed Prosthodontics and Oral Implantology, Aichi Gakuin University, Nagoya, Japan.
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Guruprasad M, Kulloli A, Mehta V, Fiorillo L, Cicciu M. Maxillary Sinus Floor Augmentation With Allograft Alone Compared With Alternate Grafting Materials: A Systematic Review and Meta-Analysis. J Craniofac Surg 2023:00001665-990000000-01243. [PMID: 37991404 DOI: 10.1097/scs.0000000000009913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 10/29/2023] [Indexed: 11/23/2023] Open
Abstract
A meta-analysis of scientific literature was conducted to ascertain the superiority between allografts and other regenerative grafts for maxillary sinus floor augmentation (MSFA). Review was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines and registered in PROSPERO-CRD42023392766. Electronic databases like PubMed, Google scholar and Ebsco Host were searched from 2000 to December 2022 for studies reporting MSFA using allografts or other regenerative grafts. Quality assessment of included studies was evaluated using the Cochrane risk of bias (ROB)-2 tool for randomized controlled trials through its domains. Risk of bias summary graph and ROB summary applicability concern were plotted using RevMan software version 5.3. The standardized mean difference was used as a summary statistic measure with random effect model and P value <0.05 as statistically significant. Four studies fulfilled the eligibility criteria and were included in qualitative synthesis, of which all 4 studies were suitable for meta-analysis. Pooled estimate through standardized mean difference signifies that new bone formation was more or less similar for both graft materials, whereas regenerative grafts showed more residual bone grafts (P>0.05). Publication bias through funnel plot showed symmetric distribution with the absence of systematic heterogeneity. Both allografts and other regenerative grafts are equally effective in the MSFA in terms of new bone formation, whereras regenerative grafts showed more residual bone grafts. Furthermore, randomized controlled trials are required to establish evidence in outcomes involving sinus floor augmentation and different graft materials.
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Affiliation(s)
| | | | - Vini Mehta
- Department of Dental Research Cell, Dr. D. Y. Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Pimpri, Pune, India
| | - Luca Fiorillo
- Department of Dental Research Cell, Dr. D. Y. Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Pimpri, Pune, India
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, Messina
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania "Luigi Vanvitelli", Naples
| | - Marco Cicciu
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Catania, Italy
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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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5
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Starch-Jensen T, Spin-Neto R, Veiss-Pedersen P, Dahlin C, Bruun NH, Fink T. Radiographic outcome after maxillary sinus floor augmentation with allogeneic adipose tissue-derived stem cells seeded on deproteinized bovine bone mineral. A randomized controlled experimental study. J Craniomaxillofac Surg 2023; 51:321-331. [PMID: 37355369 DOI: 10.1016/j.jcms.2023.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 05/01/2023] [Accepted: 05/21/2023] [Indexed: 06/26/2023] Open
Abstract
The objective was to test the hypothesis of no difference in radiographic outcome after maxillary sinus floor augmentation (MSFA) with allogeneic adipose tissue-derived stem cells (ASCs) seeded on deproteinized bovine bone mineral (DBBM) (test) compared with excipient on DBBM (control). Eighteen minipigs were assigned into three groups of six animals and euthanised after one month (T1), two months (T2), and four months (T3), respectively. Each maxillary sinus was randomly allocated to either test or control with an equal volume of graft. Computed tomography scans (CTs) after MSFA (T0) were compared with CTs after euthanasia to evaluate graft volume (GV) changes and bone density (BD) using three-dimensional measurements and Hounsfield units. GV was larger in test compared with control at T1 (P = 0.046), whereas GV was larger in control compared with test at T3 (P = 0.01). BD increased from T0 to T1-T3 (P < 0.001) with both treatments. Higher BD was observed in control compared with test at T3 (P = 0.01), while no significant difference was observed at T1 and T2. Conclusively, the present study demonstrate that allogeneic ASCs seeded on DBBM in conjunction with MSFA seemed not to improve the radiographic outcome compared with excipient on DBBM. However, radiological outcomes need to be supplemented by bone histomorphometry before definitive conclusions can be provided about the beneficial use of allogeneic ASCs seeded on DBBM in conjunction with MSFA compared with DBBM alone.
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Affiliation(s)
- Thomas Starch-Jensen
- Department of Oral and Maxillofacial Surgery, Aalborg University Hospital and Department of Clinical Medicine, The Faculty of Medicine, Aalborg University, Aalborg, Denmark.
| | - Rubens Spin-Neto
- Department of Dentistry and Oral Health, Section of Oral Radiology, Faculty of Health, Aarhus University, Aarhus, Denmark
| | | | - Christer Dahlin
- Department of Biomaterials, BIOMATCELL VINN Excellence Center, Institute for Surgical Science, The Sahlgrenska Academy, University of Gothenburg, and Department of Oral and Maxillofacial Surgery, NU-Hospital, Organization Trollhättan, Gothenburg, Sweden
| | - Niels Henrik Bruun
- Unit of Clinical Biostatistics, Aalborg University Hospital, Aalborg, Denmark
| | - Trine Fink
- Regenerative Medicine Group, Department of Health Science and Technology, The Faculty of Medicine, Aalborg University, Aalborg, Denmark
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Schulz MC, Holtzhausen S, Nies B, Heinemann S, Muallah D, Kroschwald L, Paetzold-Byhain K, Lauer G, Sembdner P. Three-Dimensional Plotted Calcium Phosphate Scaffolds for Bone Defect Augmentation—A New Method for Regeneration. J Pers Med 2023; 13:jpm13030464. [PMID: 36983646 PMCID: PMC10058839 DOI: 10.3390/jpm13030464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/19/2023] [Accepted: 02/24/2023] [Indexed: 03/06/2023] Open
Abstract
For sinus grafting, different methods and materials are available. One possible shortcoming of particulate bone grafts is either overfilling or augmenting the planned implant area insufficiently. To overcome this risk and to determine the implant position prior augmentation, we present an approach using three-dimensional printed scaffolds. A patient with a remaining anterior dentition and bilateral severely atrophied posterior maxilla was seeking oral rehabilitation. The cone beam computed tomography (CBCT) showed residual bone heights between one and two millimeters. Following the three-dimensional reconstruction of the CBCT data, the positions of the implants were determined in areas 16 and 26. Three-dimensional scaffolds adapted to the topography of the sinus were virtually designed and printed using a calcium phosphate cement paste. Bilateral sinus floor augmentation applying the printed scaffolds with an interconnecting porosity followed. After nine months, a satisfying integration of the scaffolds was obvious. At the re-entry, vital bone with sufficient blood supply was found. One implant could be placed in positions 16 and 26, respectively. After five months, the implants could be uncovered and were provided with a temporary denture. The application of three-dimensionally printed scaffolds from calcium phosphate cement paste seems to be a promising technique to graft the severely atrophied posterior maxilla for the placement of dental implants.
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Affiliation(s)
- Matthias C. Schulz
- Department of Oral and Maxillofacial Surgery, University Hospital Tübingen, Eberhard Karls Universität Tübingen, Osianderstraße 2-8, 72076 Tübingen, Germany
- Department of Oral and Maxillofacial Surgery, University Hospital “Carl Gustav Carus”, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany
- Correspondence: ; Tel.: +49-7071-2986-174
| | - Stefan Holtzhausen
- Institute of Machine Elements and Machine Design, Chair of Virtual Product Development, Technische Universität Dresden, 01062 Dresden, Germany
| | - Berthold Nies
- INNOTERE GmbH, Meissner Str. 191, 01445 Radebeul, Germany
| | | | - David Muallah
- Department of Oral and Maxillofacial Surgery, University Hospital “Carl Gustav Carus”, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany
| | - Lysann Kroschwald
- Department of Oral and Maxillofacial Surgery, University Hospital “Carl Gustav Carus”, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany
| | - Kristin Paetzold-Byhain
- Institute of Machine Elements and Machine Design, Chair of Virtual Product Development, Technische Universität Dresden, 01062 Dresden, Germany
| | - Günter Lauer
- Department of Oral and Maxillofacial Surgery, University Hospital “Carl Gustav Carus”, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany
| | - Philipp Sembdner
- Institute of Machine Elements and Machine Design, Chair of Virtual Product Development, Technische Universität Dresden, 01062 Dresden, Germany
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7
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15-Year Retrospective Study on the Success Rate of Maxillary Sinus Augmentation and Implants: Influence of Bone Substitute Type, Presurgical Bone Height, and Membrane Perforation during Sinus Lift. BIOMED RESEARCH INTERNATIONAL 2023; 2023:9144661. [PMID: 36860810 PMCID: PMC9970713 DOI: 10.1155/2023/9144661] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 01/24/2023] [Accepted: 01/31/2023] [Indexed: 02/22/2023]
Abstract
Objectives To evaluate the success rate of bone grafts and implants carried out at the Latin American Institute for Research and Dental Education (ILAPEO), considering the following: (i) the different pure bone substitutes (autogenous, xenogeneic, and alloplastic), (ii) the presurgical bone height, and (iii) how the treatment is compromised when membrane perforation occurs during sinus lift in maxillary sinus surgeries. Material and Methods. The initial sample comprised 1040 records of maxillary sinus lifting surgeries. After evaluation, the final sample retained 472 grafts performed using the lateral window technique with a total of 757 implants. The grafts were divided into 3 groups: (i) autogenous bone (n = 197), (ii) xenogenous bovine bone (n = 182), and (iii) alloplastic material (n = 93). One calibrated examiner classified the sample into two groups based on the residual bone height (<4 mm and ≥4 mm) of the area of interest measured on parasagittal sections of tomographic images. Data on membrane perforation occurrences in each group were collected; qualitative variables were described using frequency, expressed as percentages. The Chi-square test was used to analyze the success of the graft types and the survival rate of the implants as a function of the grafted material and the residual bone height. The Kaplan-Meier survival analysis was used to calculate the survival rate of bone grafts and implants according to the classifications adopted in this retrospective study. Results The success rate of grafts and implants was 98.3% and 97.2%, respectively. There was no statistically significant difference in the success rate among the different bone substitutes (p = 0.140). Only 8 grafts (1.7%) and 21 implants (2.8%) failed. There was a greater success rate for both grafts (96.5%) and implants (97.4%) when the bone height was ≥4 mm. The success rate in the 49 sinuses in which the membrane was perforated was 97.96% for the grafts and 96.2% for the implants. The follow-up periods after rehabilitation ranged from 3 months to 13 years. Conclusions Within the limitations of the data analyzed in this retrospective study, maxillary sinus lift was a viable surgical technique that enabled implant placement with a predictable long-term success rate, regardless of the type of material used. The presence of membrane perforation did not interfere with the success rate obtained for grafts and implants.
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8
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Li Q, Wang Z, Wang C, Wang HL. Characterizing the respiratory-induced mechanical stimulation at the maxillary sinus floor following sinus augmentation by computational fluid dynamics. Front Bioeng Biotechnol 2022; 10:885130. [PMID: 35957638 PMCID: PMC9360545 DOI: 10.3389/fbioe.2022.885130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 06/28/2022] [Indexed: 11/14/2022] Open
Abstract
Background: The relationship between maxillary sinus pneumatization and respiratory-induced fluid mechanics remains unclear. The purpose of this study was to simulate and measure the respiratory-induced mechanical stimulation at the sinus floor under different respiratory conditions and to investigate its potential effect on the elevated sinus following sinus-lifting procedures. Methods: The nasal airway together with the bilateral maxillary sinuses of the selected patient was segmented and digitally modeled from a computed tomographic image. The sinus floors of the models were elevated by simulated sinus augmentations using computer-aided design. The numerical simulations of sinus fluid motion under different respiratory conditions were performed using a computational fluid dynamics (CFD) algorithm. Sinus wall shear stress and static pressure on the pre-surgical and altered sinus floors were examined and quantitatively compared. Results: Streamlines with minimum airflow velocity were visualized in the sinus. The sinus floor pressure and the wall shear stress increased with the elevated inlet flow rate, but the magnitude of these mechanical stimulations remained at a negligible level. The surgical technique and elevated height had no significant influence on the wall pressure and the fluid mechanics. Conclusion: This study shows that respiratory-induced mechanical stimulation in the sinus floor is negligible before and after sinus augmentation.
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Affiliation(s)
- Qing Li
- Center of Digital Dentistry, Second Clinical Division, Peking University School and Hospital of Stomatology and National Center of Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| | - Zhongyu Wang
- Center of Digital Dentistry, Second Clinical Division, Peking University School and Hospital of Stomatology and National Center of Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| | - Chao Wang
- Key Laboratory of Biomechanics and Mechanobiology, Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, School of Engineering Medicine, Beihang University, Beijing, China
- *Correspondence: Chao Wang, ; Hom-Lay Wang,
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, United States
- *Correspondence: Chao Wang, ; Hom-Lay Wang,
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Three-Dimensional Analysis of Bone Volume Change at Donor Sites in Mandibular Body Bone Block Grafts by a Computer-Assisted Automatic Registration Method: A Retrospective Study. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12147261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
This study aimed to evaluate the bone volume change at donor sites in patients who received mandibular body bone block grafts using intensity-based automatic image registration. A retrospective study was conducted with 32 patients who received mandibular bone block grafts between 2017 and 2019 at the Pusan National University Dental Hospital. Cone-beam computed tomography (CBCT) images were obtained before surgery (T0), 1 day after surgery (T1), and 4 months after surgery (T2). Scattered artefacts were removed by manual segmentation. The T0 image was used as the reference image for registration of T1 and T2 images using intensity-based registration. A total of 32 donor sites were analyzed three-dimensionally. The volume and pixel value of the bones were measured and analyzed. The mean regenerated bone volume rate on follow-up images (T2) was 34.87% ± 17.11%. However, no statistically significant differences of regenerated bone volume were noted among the four areas of the donor site (upper anterior, upper posterior, lower anterior, and lower posterior). The mean pixel value rate of the follow-up images (T2) was 78.99% ± 16.9% compared with that of T1, which was statistically significant (p < 0.05). Intensity-based registration with histogram matching showed that newly generated bone is generally qualitatively and quantitatively poorer than the original bone, thus revealing the feasibility of pixel value to evaluate bone quality in CBCT images. Considering the bone mass recovered in this study, 4 months may not be sufficient for a second harvesting, and a longer period of follow-up is required.
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Miura K, Sasaki M, Ohba S, Noda S, Sumi M, Kamakura S, Takahashi T, Asahina I. Long‐term clinical and radiographic evaluation after maxillary sinus floor augmentation with octacalcium phosphate–collagen composite: A retrospective case series study. J Tissue Eng Regen Med 2022; 16:621-633. [DOI: 10.1002/term.3301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 03/14/2022] [Accepted: 03/16/2022] [Indexed: 11/11/2022]
Affiliation(s)
- Kei‐ichiro Miura
- Division of Oral and Maxillofacial Surgery Tohoku University Graduate School of Dentistry Sendai Miyagi Japan
| | - Miho Sasaki
- Radiology and Biomedical Informatics Nagasaki University Graduate School of Biomedical Sciences Nagasaki Japan
| | - Seigo Ohba
- Department of Regenerative Oral Surgery Nagasaki University Graduate School of Biomedical Sciences Nagasaki Japan
| | - Sawako Noda
- Department of Regenerative Oral Surgery Nagasaki University Graduate School of Biomedical Sciences Nagasaki Japan
| | - Misa Sumi
- Radiology and Biomedical Informatics Nagasaki University Graduate School of Biomedical Sciences Nagasaki Japan
| | - Shinji Kamakura
- Division of Bone Regenerative Engineering Tohoku University Graduate School of Biomedical Engineering Sendai Japan
| | - Tetsu Takahashi
- Division of Oral and Maxillofacial Surgery Tohoku University Graduate School of Dentistry Sendai Miyagi Japan
| | - Izumi Asahina
- Department of Regenerative Oral Surgery Nagasaki University Graduate School of Biomedical Sciences Nagasaki Japan
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11
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Wang Z, Jia Q, Jiang HB, Han J, Zou L, Niu G. The Relation between Morphology of Maxillary Sinus after Augmentation in Three Classification Methods and Residual Bone Height: A Retrospective Study. Int J Clin Pract 2022; 2022:1850012. [PMID: 36249910 PMCID: PMC9536978 DOI: 10.1155/2022/1850012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 09/13/2022] [Accepted: 09/16/2022] [Indexed: 11/18/2022] Open
Abstract
Maxillary sinus augmentation is critical to oral implantology, particularly in some cases. The morphology of the sinus floor reflects the lifting effect to a certain extent; however, there has been limited research on the morphology after sinus augmentation. The present study aims to investigate the relationship between residual bone height (RBH) and the morphology of the sinus floor and determine whether a correlation exists between the different evaluation classifications. Maxillary sinus floor augmentation procedures were performed in 56 patients and 68 teeth using the sinus crest approach (SCA). Imaging results obtained after one year of sinus augmentation were analyzed and simultaneously classified along the coronal plane, the sagittal plane, and the biplane (coronal-sagittal). The higher the RBH, the closer the result tends to be to A, A', or type 1 (more satisfactory). There was a significant correlation between the three different evaluation classifications (p < 0.05). The morphology of perforation cases was involved in types C, D, C', and D'. A more satisfactory post-lifting morphology (tent type and flat type) is probably related to an optimal preoperative bone height, and an unsatisfactory post-lifting morphology is related to a low preoperative sinus floor height. The sagittal plane evaluation correlates with the coronal plane and biplane evaluation and is thus more recommended.
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Affiliation(s)
- Zhi Wang
- Second Clinical Division, School and Hospital of Stomatology, Peking University, Beijing 100101, China
| | - Qi Jia
- Department of Dental Materials, Peking University School and Hospital of Stomatology, Beijing 100081, China
- The Conversationalist Club, School of Stomatology, Shandong First Medical University, Jinan, Shandong 250117, China
| | - Heng Bo Jiang
- Department of Dental Materials, Peking University School and Hospital of Stomatology, Beijing 100081, China
- The Conversationalist Club, School of Stomatology, Shandong First Medical University, Jinan, Shandong 250117, China
| | - Jianmin Han
- Department of Dental Materials, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Lidong Zou
- Second Clinical Division, School and Hospital of Stomatology, Peking University, Beijing 100101, China
| | - Guangliang Niu
- Department of Oral Prosthodontics, The First Affiliated Hospital of Nanchang University, Nanchang 330006, China
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12
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Raymond Y, Pastorino D, Ginebreda I, Maazouz Y, Ortiz M, Manzanares MC, Ginebra MP. Computed tomography and histological evaluation of xenogenic and biomimetic bone grafts in three-wall alveolar defects in minipigs. Clin Oral Investig 2021; 25:6695-6706. [PMID: 33931811 DOI: 10.1007/s00784-021-03956-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 04/19/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVES This study aimed to compare the performance of a xenograft (XG) and a biomimetic synthetic graft (SG) in three-wall alveolar defects in minipigs by means of 3D computerised tomography and histology. MATERIALS AND METHODS Eight minipigs were used. A total of eight defects were created in the jaw of each animal, three of which were grafted with XGs, three with SGs, and two were left empty as a negative control. The allocation of the different grafts was randomised. Four animals were euthanised at 6 weeks and four at 12 weeks. The grafted volume was then measured by spiral computed tomography to assess volume preservation. Additionally, a histological analysis was performed in undecalcified samples by backscattered scanning electron microscopy and optical microscopy after Masson's trichrome staining. RESULTS A linear mixed-effects model was applied considering four fixed factors (bone graft type, regeneration time, anatomic position, and maxilla/mandible) and one random factor (animal). The SG exhibited significantly larger grafted volume (19%) than the XG. The anterior sites preserved better the grafted volume than the posterior ones. Finally, regeneration time had a positive effect on the grafted volume. Histological observations revealed excellent osseointegration and osteoconductive properties for both biomaterials. Some concavities found in the spheroidal morphologies of SGs were associated with osteoclastic resorption. CONCLUSIONS Both biomaterials met the requirements for bone grafting, i.e. biocompatibility, osseointegration, and osteoconduction. Granule morphology was identified as an important factor to ensure a good volume preservation. CLINICAL RELEVANCE Whereas both biomaterials showed excellent osteoconduction, SGs resulted in better volume preservation.
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Affiliation(s)
- Yago Raymond
- Mimetis Biomaterials S.L., Carrer de Cartagena, 245, 3F, 08025, Barcelona, Spain
- Biomaterials, Biomechanics and Tissue Engineering Group, Department of Materials Science and Engineering, Universitat Politècnica de Catalunya (UPC), EEBE, Av. Eduard Maristany, 10-14, 08019, Barcelona, Spain
| | - David Pastorino
- Mimetis Biomaterials S.L., Carrer de Cartagena, 245, 3F, 08025, Barcelona, Spain
| | - Ignacio Ginebreda
- Department of Restorative and Esthetic Dentistry, Universitat Internacional de Catalunya, Carrer de Josep Trueta, 08195 Sant Cugat del Vallès, Barcelona, Spain
| | - Yassine Maazouz
- Mimetis Biomaterials S.L., Carrer de Cartagena, 245, 3F, 08025, Barcelona, Spain
| | - Mònica Ortiz
- Biomaterials, Biomechanics and Tissue Engineering Group, Department of Materials Science and Engineering, Universitat Politècnica de Catalunya (UPC), EEBE, Av. Eduard Maristany, 10-14, 08019, Barcelona, Spain
| | - Maria-Cristina Manzanares
- Human Anatomy and Embryology Unit, Department of Pathology and Experimental Therapeutics, Universitat de Barcelona, 08907 L'Hospitalet de Llobregat, Barcelona, Spain
| | - Maria-Pau Ginebra
- Mimetis Biomaterials S.L., Carrer de Cartagena, 245, 3F, 08025, Barcelona, Spain.
- Biomaterials, Biomechanics and Tissue Engineering Group, Department of Materials Science and Engineering, Universitat Politècnica de Catalunya (UPC), EEBE, Av. Eduard Maristany, 10-14, 08019, Barcelona, Spain.
- Institute for Bioengineering of Catalonia (IBEC), Barcelona Institute of Science and Technology, C/ Baldiri Reixac 10-12, 08028, Barcelona, Spain.
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13
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Starch-Jensen T, Deluiz D, Vitenson J, Bruun NH, Tinoco EMB. Maxillary Sinus Floor Augmentation with Autogenous Bone Graft Compared with a Composite Grafting Material or Bone Substitute Alone: a Systematic Review and Meta-Analysis Assessing Volumetric Stability of the Grafting Material. EJOURNAL OF ORAL MAXILLOFACIAL RESEARCH 2021; 12:e1. [PMID: 33959236 PMCID: PMC8085675 DOI: 10.5037/jomr.2021.12101] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 03/23/2021] [Indexed: 11/16/2022]
Abstract
Objectives Test the hypothesis of no difference in the volumetric stability of the grafting material following maxillary sinus floor augmentation with autogenous bone graft compared with composite grafting material or bone substitute alone applying the lateral window technique. Material and Methods MEDLINE (PubMed), Embase, Cochrane library and hand-search of relevant journals were conducted. Human studies published in English until the 9th of October 2020 were included. Outcome measures included three-dimensional volumetric changes of the grafting material and potential predictive parameters. Volumetric changes were evaluated by descriptive statistics and meta-analysis including 95% confidence interval. Results Electronic search and hand-searching resulted in 102 entries. Four randomized controlled trials with unclear risk of bias fulfilled the inclusion criteria. The volumetric stability of the grafting material was significantly improved by mixing autogenous bone graft with a non-resorbable xenograft compared with autogenous bone graft. Meta-analyses assessing absolute and relative volumetric changes demonstrated no significant differences between autogenous bone graft compared with allogeneic bone graft, synthetic biomaterials combined with autogenous bone graft or used alone. Association between volumetric changes of the grafting material and potential predictive parameters were not assessed in the included studies. Conclusions Volumetric reduction of the augmented area seems inevitable following maxillary sinus floor augmentation regardless of the grafting material. The volumetric stability of autogenous bone graft is improved with addition of xenograft compared with autogenous bone graft. However, conclusions drawn from this systematic review should be interpreted with caution since only four studies using three-dimensional radiographic measurements were included.
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Affiliation(s)
- Thomas Starch-Jensen
- Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, AalborgDenmark
| | - Daniel Deluiz
- Department of Periodontology, Rio de Janeiro State University, Rio de JaneiroBrazil
| | - Julie Vitenson
- Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, AalborgDenmark
| | - Niels Henrik Bruun
- Unit of Clinical Biostatistics, Aalborg University Hospital, AalborgDenmark
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14
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Nagata K, Fuchigami K, Kitami R, Okuhama Y, Wakamori K, Sumitomo H, Kim H, Okubo M, Kawana H. Comparison of the performances of low-crystalline carbonate apatite and Bio-Oss in sinus augmentation using three-dimensional image analysis. Int J Implant Dent 2021; 7:24. [PMID: 33754242 PMCID: PMC7985233 DOI: 10.1186/s40729-021-00303-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 02/12/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In locations where the alveolar bone height is low, such as at the maxillary molars, implant placement can be difficult, or even impossible, without procedures aimed at generating new bone, such as sinus lifts. Various types of bone graft materials are used after a sinus lift. In our study, a three-dimensional image analysis using a volume analyzer was performed to measure and compare the volume of demineralized bovine bone mineral (Bio-Oss®) and carbonate apatite (Cytrans®) after a sinus lift, as well as the amount of bone graft material resorption. Patient data were collected from cone-beam computed tomography images taken before, immediately following, and 6 months after the sinus lift. Using these images, both the volume and amount of resorption of each bone graft material were measured using a three-dimensional image analysis system. RESULTS The amount of bone resorption in the Bio-Oss®-treated group was 25.2%, whereas that of the Cytrans®-treated group was 14.2%. A significant difference was found between the two groups (P < 0.001). CONCLUSIONS Our findings indicate that the volume of bone resorption was smaller in the Cytrans®-treated group than in the Bio-Oss®-treated group, suggesting that Cytrans® is more promising for successful implant treatments requiring a sinus lift.
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Affiliation(s)
- Koudai Nagata
- Department of Oral and Maxillofacial Implantology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka, 238-8580, Japan
| | - Kei Fuchigami
- Department of Oral and Maxillofacial Implantology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka, 238-8580, Japan
| | - Ryoji Kitami
- Department of Oral and Maxillofacial Implantology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka, 238-8580, Japan
| | - Yurie Okuhama
- Department of Oral and Maxillofacial Implantology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka, 238-8580, Japan
| | - Kana Wakamori
- Department of Oral and Maxillofacial Implantology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka, 238-8580, Japan
| | - Hirokazu Sumitomo
- Department of Oral and Maxillofacial Implantology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka, 238-8580, Japan
| | - Hyunjin Kim
- Department of Oral and Maxillofacial Implantology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka, 238-8580, Japan
| | - Manabu Okubo
- Department of Oral and Maxillofacial Implantology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka, 238-8580, Japan
| | - Hiromasa Kawana
- Department of Oral and Maxillofacial Implantology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka, 238-8580, Japan.
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15
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Andrés-García R, Ríos-Santos JV, Herrero-Climent M, Bullón P, Fernández-Farhall J, Gómez-Menchero A, Fernández-Palacín A, Ríos-Carrasco B. Sinus Floor Elevation via an Osteotome Technique without Biomaterials. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031103. [PMID: 33513756 PMCID: PMC7908564 DOI: 10.3390/ijerph18031103] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 01/20/2021] [Accepted: 01/24/2021] [Indexed: 11/16/2022]
Abstract
According to classic Hirschfeld studies, the first teeth to be lost are the first and second maxillary molars. After the teeth are extracted and the alveolar process is developed, the maxillary sinus is reabsorbed and pneumatized with a decrease in bone availability in the posterior sector of the maxilla. This process often creates the need to perform regeneration techniques for the placement of implants in this area due to the low availability of bone. The most frequently used and documented technique for the elevation of the sinus maxillary floor is elevation by the side window, as proposed by Tatum. In 1994, Summers proposed a technique that allowed the elevation of the sinus floor from a crestal access using an instrument called an osteotome, as well as the placement of the implant in the same surgical act. The aimed of the study was to evaluate the survival of 32 implants placed in posterior maxilla with bone availability less than 5 mm performing a sinus lift augmentation technique with osteotome without biomaterials. The results of this study show a survival rate of 100% for 32 implants placed in situations with an initial bone availability of 2 to 5 mm without the use of graft material. The infra-drilling technique used offers an increase in the primary stability of implants that allows adequate osteointegration Implants placed were charged at 12 weeks. In all cases, spontaneous bone formation was observed, even in cases where a positive Valsalva maneuver was observed. This proposed technique reduces treatment time and the need for more invasive maxillary sinus augmentation techniques.
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Affiliation(s)
- Rodrigo Andrés-García
- Department of Surgery, Faculty of Medicine, University of Salamanca, 37007 Salamanca, Spain;
| | - José Vicente Ríos-Santos
- Department of Periodontology, School of Dentistry, Universidad de Sevilla, 41009 Sevilla, Spain; (P.B.); (A.G.-M.); (B.R.-C.)
- Correspondence: ; Tel.: +34-954-481-121; Fax: +34-954-481-157
| | | | - Pedro Bullón
- Department of Periodontology, School of Dentistry, Universidad de Sevilla, 41009 Sevilla, Spain; (P.B.); (A.G.-M.); (B.R.-C.)
| | | | - Alberto Gómez-Menchero
- Department of Periodontology, School of Dentistry, Universidad de Sevilla, 41009 Sevilla, Spain; (P.B.); (A.G.-M.); (B.R.-C.)
| | - Ana Fernández-Palacín
- Department of Social and Health Sciences, Universidad de Sevilla, 41009 Sevilla, Spain;
| | - Blanca Ríos-Carrasco
- Department of Periodontology, School of Dentistry, Universidad de Sevilla, 41009 Sevilla, Spain; (P.B.); (A.G.-M.); (B.R.-C.)
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16
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Ying Y, Li B, Liu C, Xiong Z, Bai W, Li J, Ma P. A biodegradable gelatin-based nanostructured sponge with space maintenance to enhance long-term osteogenesis in maxillary sinus augmentation. J Biomater Appl 2020; 35:681-695. [PMID: 33059516 DOI: 10.1177/0885328220964446] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The search for bone substitutes that are biodegradable, ensure space maintenance, and have osteogenic predictability, is ongoing in the field of sinus augmentation. We thus compared the bone regeneration potential of nanostructured sponges (NS-Sponge) with that of collagen-stabilized inorganic bovine bones (BO-Collagen), gelatin sponges (Gelatin), and blood clots (Cont) in sinus augmentation of rabbits. NS-Sponge was prepared by thermally induced phase separation with porogen leaching techniques. All the materials were non-hemolytic and cytocompatible. The porous and nanofibrous NS-Sponge showed better dimensional stability to support cell growth and osteogenic differentiation. In vivo, the sinus membrane collapsed in Cont and Gelatin, while BO-Collagen and NS-Sponge maintained the elevated height as assessed by come-beam computed tomography. Limited bone regeneration was observed in Cont and Gelatin. In the entire implanted area, histological analysis revealed a higher percentage of new bone area at 4 weeks of BO-Collagen treatment; however, a significantly greater increase in new bone area was observed after 12 weeks of NS-Sponge treatment. The 12-week remnant NS-Sponge material was significantly lower than the 4-week remnant material. Overall, NS-Sponge may be highly recommended for sinus augmentation, as it exhibits numerous advantages, including excellent operability, clear imaging characteristics, space maintenance, biodegradability, and superior osteogenic potential.
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Affiliation(s)
- Yiqian Ying
- Department of Dental Implant Center, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, China
| | - Beibei Li
- Department of Dental Implant Center, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, China
| | - Changying Liu
- Department of Dental Implant Center, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, China
| | - Zuochun Xiong
- Chengdu Institute of Organic Chemistry, Chinese Academy of Sciences, Chengdu, China
| | - Wei Bai
- Chengdu Institute of Organic Chemistry, Chinese Academy of Sciences, Chengdu, China
| | - Jun Li
- Department of Dental Implant Center, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, School of Stomatology, Capital Medical University, Beijing, China
| | - Pan Ma
- Department of Dental Implant Center, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, China
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17
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Mendes LD, Bustamante RPC, Vidigal BCL, Favato MN, Manzi FR, Cosso MG, Zenóbio EG. Effect of amount of biomaterial used for maxillary sinus lift on volume maintenance of grafts. J Clin Exp Dent 2020; 12:e830-e837. [PMID: 32994871 PMCID: PMC7511044 DOI: 10.4317/jced.56315] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 05/14/2020] [Indexed: 11/11/2022] Open
Abstract
Background Regardless of the kind of biomaterial used for the graft, it is clear that, over time, the graft undergoes dimensional changes that could influence the final bone volume obtained, which could alter the stability of the installed implants. The aim of the present study was to compared and correlated the graft behavior with the amount (in grams) of xenogeneic and alloplastic biomaterials used in grafts for maxillary sinus lift.
Material and Methods This retrospective cohort study used 148 CBCT images of 74 grafts from 68 maxillary sinuses lift patients in a university, post-graduate clinic. The weights of biomaterials, categorized in intervals according to amount used, were correlated with the graft volumes at V1 (10 days) and V2 (180 days). Kruskal-Wallis test was used to evaluate the possible bias effect of weight on graft maintenance.
Results Mean weights of biomaterials used were: Bio-Oss Small® (1.58g); Bio-Oss Large® (1.35g); Endobon® (0.72g); BoneCeramic®+Emdogaim® (0.96g); Cerasorb® (1.13g) and Osteogen® (2.70g). No significant differences (p>0.05). Were found for the influence of these mean amounts in graft maintenance: Bio-Oss Small® (18); Bio-Oss Large® (10); Endobon® (17); BoneCeramic®+Emdogaim® (10); Cerasorb® (11); and Osteogen® (08) at V1 and V2. However, when biomaterials were categorized by intervals, all Cerasorb® interval groups showed statistically significant differences (p<0.001) in graft volume at V2.
Conclusions The amounts of the biomaterials used could influence the final volume; depending on the biomaterial characteristics. Implant installation was possible with all studied grafts, although graft volume shrinkage should be considered when selecting biomaterial for sinus lift. Key words:Biocompatible materials; cone beam computed tomography; maxillary sinus; hydroxyapatites.
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Affiliation(s)
- Luciene-Dornas Mendes
- Post-graduate, Dentistry Department Program Pontifical Catholic University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Roberta-Paula-Colen Bustamante
- Post-graduate, Implant Master's Program Pontifical Catholic University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Bruno-César-Ladeira Vidigal
- Post-graduate, Dentistry Department Program Pontifical Catholic University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Mario-Nazareno Favato
- Post-graduate, Dentistry Department Program Pontifical Catholic University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Flávio-Ricardo Manzi
- Associated Professor, Dentistry Department, Implant Master's Program Pontifical Catholic University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Mauricio-Greco Cosso
- Associated Professor, Dentistry Department, Implant Master's Program Pontifical Catholic University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Elton-Gonçalves Zenóbio
- Associated Professor, Dentistry Department, Implant Master's Program Pontifical Catholic University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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18
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Shi JY, Li Y, Zhuang LF, Zhang X, Fan LF, Lai HC. Accuracy assessment of a novel semiautomatic method evaluating bone grafts around the dental implant: an in vitro and ex vivo study. Sci Rep 2020; 10:14902. [PMID: 32913190 PMCID: PMC7483504 DOI: 10.1038/s41598-020-71651-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 08/18/2020] [Indexed: 12/03/2022] Open
Abstract
The present study aimed to evaluate the accuracy and repeatability of morphological contour interpolation (MCI)-based semiautomatic segmentation method for volumetric measurements of bone grafts around dental implants. Three in vitro (one with a cylinder and two with a geometrically complex form) and four ex vivo models (peri-implant cylinder-shaped bone defect) were created for imitating implant placement with simultaneous guided bone regeneration (GBR) procedure. Cone beam computerized tomography (CBCT) scans of all models were obtained with the same parameters. For volumetric measurements, the actual volumes of bone grafts in models were assessed by computer-aided calculation and both manual and MCI-based methods were utilized as test methods. The accuracy of the methods was evaluated by comparing the measured value and the actual volume. The repeatability was assessed by calculating the coefficients of variation of repeated measurements. For the accuracy of three dimensional (3D) reconstructions, the computer-designed corresponding models were set as the reference and the morphological deviation of 3D surface renderings created by two methods were evaluated by comparing with reference. Besides, measurement time was recorded and a comparison between the two methods was performed. High accuracy of the MCI-based segmentation method was found with a discrepancy between the measured value and actual value never exceeding − 7.5%. The excellent repeatability was shown with coefficients of variation never exceeding 1.2%. The MCI-based method showed less measurement time than the manual method and its 3D surface rendering showed a lower deviation from the reference.
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Affiliation(s)
- Jun-Yu Shi
- Department of Oral and Maxillofacial Implantology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, China.,National Clinical Research Center for Oral Diseases, Shanghai, China.,Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Yuan Li
- Department of Oral and Maxillofacial Implantology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, China.,National Clinical Research Center for Oral Diseases, Shanghai, China.,Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | | | - Xiao Zhang
- Department of Oral and Maxillofacial Implantology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, China.,National Clinical Research Center for Oral Diseases, Shanghai, China.,Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Ling-Feng Fan
- Department of Radiology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
| | - Hong-Chang Lai
- Department of Oral and Maxillofacial Implantology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, China. .,National Clinical Research Center for Oral Diseases, Shanghai, China. .,Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China.
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19
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Liu Y, Wang J, Chen F, Feng Y, Xie C, Li D. A reduced healing protocol for sinus floor elevation in a staged approach with deproteinized bovine bone mineral alone: A randomized controlled clinical trial of a 5-month healing in comparison to the 8-month healing. Clin Implant Dent Relat Res 2020; 22:281-291. [PMID: 32267601 DOI: 10.1111/cid.12906] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 03/16/2020] [Accepted: 03/18/2020] [Indexed: 12/17/2022]
Abstract
PURPOSE To investigate the feasibility of reducing the healing time of maxillary sinus floor elevation (MSFE) by a two-stage approach using deproteinized bovine bone mineral (DBBM) alone, based on clinical, histomorphometric, and microradiographic evaluations. MATERIALS AND METHODS Twenty consecutive cases with an atrophic posterior edentulous maxilla were randomly assigned to two groups at a ratio of 1:1. The lateral window approach to MSFE with DBBM alone was followed by an 8-month bone-healing period in the control group compared to 5 months in the test group. During implant placement, bone biopsies were harvested from implant osteotomy sites for micro-computed tomography (CT), histological, and histomorphometric evaluations. Cone beam CT (CBCT) scans were performed before and immediately after MSFE and after the bone-healing periods. The implant stability quotient (ISQ) was measured sequentially at implant placement and 1, 3, and 6 months thereafter. RESULTS The histomorphometric and microradiographic results showed no significant differences in new bone formation on the augmented sinus floor between the two groups (all Ps > .05), except that trabecular thickness was significantly reduced and trabecular separation significantly increased in the test group (both Ps < .05). The ISQs of both groups increased continuously after implant placement, but the difference was not significant between the groups at each time point. CBCT analyses showed that the extent of volumetric loss was comparable after bone healing for 5 and 8 months (P > .05). CONCLUSIONS Within the limitations of this study, the bone-healing time of MSFE with DBBM alone for staged implant placement could be reduced to 5 months instead of 8 or 9 months, based on the histomorphometric, microradiographic, and clinical outcomes; however, impact on long-term implant survival remains unknown and needs further investigation with long-term follow-ups.
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Affiliation(s)
- Yi Liu
- Department of Oral Implants, School of Stomatology, State Key Laboratory of Military Stomatology, The Fourth Military Medical University, Xi'an, China
| | - Jin Wang
- Department of Oral Implants, School of Stomatology, State Key Laboratory of Military Stomatology, The Fourth Military Medical University, Xi'an, China
| | - Fei Chen
- Department of Oral Implants, School of Stomatology, State Key Laboratory of Military Stomatology, The Fourth Military Medical University, Xi'an, China
| | - Yuan Feng
- Department of Oral Implants, School of Stomatology, State Key Laboratory of Military Stomatology, The Fourth Military Medical University, Xi'an, China
| | - Chao Xie
- Department of Oral Implants, School of Stomatology, State Key Laboratory of Military Stomatology, The Fourth Military Medical University, Xi'an, China
| | - Dehua Li
- Department of Oral Implants, School of Stomatology, State Key Laboratory of Military Stomatology, The Fourth Military Medical University, Xi'an, China
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20
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Cinar IC, Gultekin BA, Saglanmak A, Yalcin S, Olgac V, Mijiritsky E. Histologic, Histomorphometric, and Clinical Analysis of the Effects of Growth Factors in a Fibrin Network Used in Maxillary Sinus Augmentation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17061918. [PMID: 32183498 PMCID: PMC7142822 DOI: 10.3390/ijerph17061918] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 03/03/2020] [Accepted: 03/04/2020] [Indexed: 12/15/2022]
Abstract
This randomized controlled clinical trial evaluated the effect of mineralized plasmatic matrix (MPM), comprised of synthetic graft and platelet concentrates, on new bone formation and volume stability over time in maxillary sinus lifting (MSL). Unilateral MSL was performed in 20 patients with either beta-tricalcium phosphate (β-TCP) or MPM grafts (10 sinuses each). Six months postsurgery, specimens were obtained with a trephine bur prior to implant placement in 39 cases. Volumetric changes in sinus augmentation were analyzed between 1 week (T-I) and 6 months (T-II) postsurgery. Histomorphometric and histological analyses of biopsy samples revealed mean new bone percentages of 35.40% ± 9.09% and 26.92% ± 7.26% and residual graft particle areas of 23.13% ± 6.16% and 32.25% ± 8.48% in the MPM and β-TCP groups, respectively (p < 0.05). The mean soft-tissue areas in the MPM and β-TCP groups were 41.48% ± 8.41% and 40.83% ± 8.86%, respectively (p > 0.05). Graft reductions between baseline and 6-months postprocedure in the β-TCP and MPM groups were 17.12% ± 13.55% and 14.41% ± 12.87%, respectively, with significant graft volume reduction observed in both groups (p < 0.05) while there is no significant difference between MPM and β-TCP groups (p > 0.05). Thus, MPM, representing growth factors in a fibrin network, increases new bone formation and has acceptable volume stability in MSL procedures
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Affiliation(s)
- Ihsan Caglar Cinar
- Department of Oral Implantology, Istanbul University Faculty of Dentistry, Istanbul, 34093 Fatih, Turkey; (I.C.C.); (A.S.); (S.Y.)
| | - Bahattin Alper Gultekin
- Department of Oral Implantology, Istanbul University Faculty of Dentistry, Istanbul, 34093 Fatih, Turkey; (I.C.C.); (A.S.); (S.Y.)
- Correspondence: ; Tel.: +90-5326757236; Fax: +90-212-5323254
| | - Alper Saglanmak
- Department of Oral Implantology, Istanbul University Faculty of Dentistry, Istanbul, 34093 Fatih, Turkey; (I.C.C.); (A.S.); (S.Y.)
| | - Serdar Yalcin
- Department of Oral Implantology, Istanbul University Faculty of Dentistry, Istanbul, 34093 Fatih, Turkey; (I.C.C.); (A.S.); (S.Y.)
| | - Vakur Olgac
- Pathology and Oncology Cytology Department of Institute of Oncology, Istanbul University, 34093 Fatih, Turkey;
| | - Eitan Mijiritsky
- Department of Otolaryngology, Head and Neck and Maxilllofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, 5219100 Ramat Aviv, Israel;
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21
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Kwon JJ, Hwang J, Kim YD, Shin SH, Cho BH, Lee JY. Automatic three-dimensional analysis of bone volume and quality change after maxillary sinus augmentation. Clin Implant Dent Relat Res 2019; 21:1148-1155. [PMID: 31651078 DOI: 10.1111/cid.12853] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 09/08/2019] [Accepted: 09/19/2019] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Maxillary sinus augmentation is a widely used surgical procedure to increase the bone volume before implant placement. In order to predict the stability of the implant, analysis of the change in bone volume and quality after a sinus graft procedure is necessary. The purpose of this study was to analyze the change in volume and quality of bone graft material after maxillary sinus augmentation using cone beam computed tomography (CBCT). METHODS AND MATERIALS Maxillary sinus lift procedures using bovine bone materials (Bio-Oss, Geistrich, Swiss) without immediate implantation were performed at the Pusan National University Dental Hospital in 22 patients, from 2014 to 2017. CBCT images were captured before surgery (T1), a day after surgery (T2), and after 4 to 7 months at follow-up (T3). The T2 and T3 images were registered to the T1 image using histogram matching and intensity-based registration. A total of 30 sinuses were analyzed three-dimensionally (3-D), using self-made software MATLAB 2018a (MathWorks, Natick, Massachusetts). The volume and structural indices of the bone graft material were measured and analyzed. RESULTS The average volume of graft material showed a decrease, while the average gray value showed an increase during the follow-up period, but these changes were not statistically significant. The structural indices of the graft material after histogram matching showed a significant difference in homogeneity, connectivity, thickness, and roughness at the postoperative follow-up. CONCLUSIONS The volume and gray value showed no statistically significant changes after the maxillary sinus lift procedures. The results of this study show that structural analysis using histogram matching can be used as a promising tool to analyze the quality of graft materials.
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Affiliation(s)
- Jin-Ju Kwon
- Department of Oral and Maxillofacial Surgery, Pusan National University, Dental Research Institute, Yangsan, Korea
| | - JaeJoon Hwang
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Pusan National University, Dental Research Institute, Yangsan, Korea
| | - Yong-Deok Kim
- Department of Oral and Maxillofacial Surgery, Pusan National University, Dental Research Institute, Yangsan, Korea
| | - Sang-Hun Shin
- Department of Oral and Maxillofacial Surgery, Pusan National University, Dental Research Institute, Yangsan, Korea
| | - Bong-Hae Cho
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Pusan National University, Dental Research Institute, Yangsan, Korea
| | - Jae-Yeol Lee
- Department of Oral and Maxillofacial Surgery, Pusan National University, Dental Research Institute, Yangsan, Korea
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22
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Evaluation of three-dimensional contraction of the volume of grafts after staged augmentation of the sinus floor, and an analysis of influential factors. Br J Oral Maxillofac Surg 2019; 57:323-329. [PMID: 30940406 DOI: 10.1016/j.bjoms.2019.03.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Accepted: 03/07/2019] [Indexed: 11/21/2022]
Abstract
Our aim was to evaluate the volume by which grafts contract after augmentation of the sinuses by three-dimensional analysis on cone-beam computed tomographs (CT), and to investigate the factors that influence the outcomes. The sinus floor was augmented with deproteinised bovine bone mineral in 58 patients with 123 edentulous sites related to 67 sinuses. The outcomes of augmentation were analysed by both linear and volumetric measurements on cone-beam CT images taken immediately after operation and six months later. Mathematical models were established to investigate the influence of anatomical characteristics of the sinuses and patient-related factors on contraction of the volume of the grafts. The mean reduction in the height of the grafts on site-based analysis was 17.8% after six months, and the contraction in volume on sinus-based analysis was 22.7 %. Of the edentulous sites 20/123 (16%) could not have implants 10 mm long inserted at the second stage operation because of insufficient bony height. Linear regression indicated that the type of edentulism (single or multiple teeth lost) was significantly associated with contraction in the volume of the grafts (p=0.006). Mixed model regression showed that the reduction in the height of the grafts was significantly influenced by the width of the sinus floor and the angle between the lateral and the medial wall of sinus (p=0.001, p=0.000). The reduction in height of the grafts and contraction in volume on linear and volumetric measurements six months after augmentation were roughly 18% and 22%, respectively. A wide sinus, large lateromedial angle, and loss of multiple teeth under the same sinus strongly predict that large amount of grafts will resorb. The anatomy of the sinus and patients' characteristics should be taken into consideration before treatment.
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23
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Li Y, Qiao SC, Gu YX, Zhang XM, Shi JY, Lai HC. A novel semiautomatic segmentation protocol to evaluate guided bone regeneration outcomes: A pilot randomized, controlled clinical trial. Clin Oral Implants Res 2019; 30:344-352. [PMID: 30854705 DOI: 10.1111/clr.13420] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 02/28/2019] [Accepted: 03/05/2019] [Indexed: 12/27/2022]
Abstract
OBJECTIVES The aims of this study were to (a) present a novel morphological contour interpolation (MCI) algorithm based method to evaluate grafted bone alterations following guided bone regeneration (GBR), (b) compare clinical and radiological outcomes of GBR with two different collagen membranes. MATERIALS AND METHODS The data were retrieved from an ongoing randomized controlled trial. Patients were randomly allocated into two groups: (a) control group (CG): Bio-Gide (b) test group (TG): bovine dermis-derived collagen membrane. Cone beam computed tomography examinations were performed 1 week (T0) and 6 months after surgery (T1). PES/WES at T1, grafted bone volume and density changes from T0 to T1 were recorded. RESULTS Thirty-six patients (16/20 in test/control group, respectively) were enrolled in the present study. Excellent inter-observer reliability (ICC ≥ 0.97) was revealed for repeated measurements using this method. Significant volumetric reduction of grafted bone were found in both groups (test group: from 0.60 to 0.39 cm3 , p < 0.01; control group: from 0.54 to 0.31 cm3 , p < 0.01). Mean bone density (gray-scale values) significantly increased from 305.12 to 456.69 in CG (p < 0.01). In TG, it slightly increased from 304.75 to 393.27 (p = 0.25). The mean PES/WES values were 13.84 (6.62/7.22) and 13.90 (6.70/7.20) for TG and CG, respectively. As for inter-group comparison, no significant differences of grafted bone volume change, density change and PES/WES were found between two groups. CONCLUSION Within the limitations of this study, the novel MCI-based method is a reproducible tool to segment and visualize changes of grafted bone in 3D. Furthermore, both collagen membranes could be used as a barrier membrane for GBR in humans.
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Affiliation(s)
- Yuan Li
- Department of Oral and Maxillo-facial Implantology, Shanghai Key Laboratory of Stomatology, National Clinical Research Center for Stomatology, School of Medicine, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Shi-Chong Qiao
- Department of Oral and Maxillo-facial Implantology, Shanghai Key Laboratory of Stomatology, National Clinical Research Center for Stomatology, School of Medicine, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Ying-Xin Gu
- Department of Oral and Maxillo-facial Implantology, Shanghai Key Laboratory of Stomatology, National Clinical Research Center for Stomatology, School of Medicine, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Xiao-Meng Zhang
- Department of Oral and Maxillo-facial Implantology, Shanghai Key Laboratory of Stomatology, National Clinical Research Center for Stomatology, School of Medicine, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Jun-Yu Shi
- Department of Oral and Maxillo-facial Implantology, Shanghai Key Laboratory of Stomatology, National Clinical Research Center for Stomatology, School of Medicine, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Hong-Chang Lai
- Department of Oral and Maxillo-facial Implantology, Shanghai Key Laboratory of Stomatology, National Clinical Research Center for Stomatology, School of Medicine, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, Shanghai, China
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Cha JK, Kim C, Pae HC, Lee JS, Jung UW, Choi SH. Maxillary sinus augmentation using biphasic calcium phosphate: dimensional stability results after 3-6 years. J Periodontal Implant Sci 2019; 49:47-57. [PMID: 30847256 PMCID: PMC6399091 DOI: 10.5051/jpis.2019.49.1.47] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 02/18/2019] [Indexed: 11/10/2022] Open
Abstract
Purpose This study was designed to observe the resorption pattern of biphasic calcium phosphate (BCP) used for maxillary sinus augmentation over a 3- to 6-year healing period, and to investigate factors affecting the resorption of BCP. Methods A total of 47 implants placed in 27 sinuses of 22 patients were investigated. All patients had residual bone height less than 5 mm at baseline. The modified Caldwell-Luc approach was used to elevate the maxillary sinus membrane, and the sinus cavity was filled with BCP (70% hydroxyapatite and 30% β-tricalcium phosphate). Implant placement was done simultaneously or in a staged manner. Serial radiographic analysis was performed up to 6 years postoperatively. Results During the follow-up period, no implant loss was reported. The mean reduced height of the augmented sinus (RHO) was 0.27±1.08 mm at 36 months, and 0.89±1.39 mm at 72 months postoperatively. Large amounts of graft material (P=0.021) and a long healing period (P=0.035) significantly influenced the amount of RHO. In particular, there was a significant relationship between a healing period longer than 40 months and RHO. Conclusions BCP can achieve proper dimensional stability with minimal reduction of the graft height in a 3- to 6-year healing period after maxillary sinus augmentation. The healing period and the amount of graft material influenced the resorption of BCP.
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Affiliation(s)
- Jae-Kook Cha
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Chingu Kim
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Hyung-Chul Pae
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Jung-Seok Lee
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Ui-Won Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Seong-Ho Choi
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
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Younes F, Cosyn J, De Bruyckere T, Cleymaet R, Eghbali A. A 2-year prospective case series on volumetric changes, PROMs, and clinical outcomes following sinus floor elevation using deproteinized bovine bone mineral as filling material. Clin Implant Dent Relat Res 2019; 21:301-309. [PMID: 30740863 DOI: 10.1111/cid.12730] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 01/12/2019] [Accepted: 01/16/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND A sinus floor augmentation may be indicated when a lack of hard tissue impedes implant placement. Although clinically successful, evidence supporting the long-term three-dimensional stability of the grafted volume is scarce. Second, evidence on the patient's acceptance of this type of treatment is limited. PURPOSE First is to evaluate the changes in graft volume after lateral wall sinus lifting based on superimposed cone beam computed tomography (CBCT) images and then to assess patient-reported outcome measures (PROMs) and clinical outcomes. MATERIALS AND METHODS Partially edentulous patients in need of a sinus lift and fixed reconstruction on at least two neighboring implants were selected for a prospective case series. Lateral wall sinus augmentation was performed using deproteinized bovine bone mineral (DBBM) as the only filling material. Volumetric changes were quantified on the basis of a preoperative CBCT and three postoperative CBCTs (at 2 weeks, 3 months, and 2 years). PROMs and clinical parameters were registered. RESULTS Twenty-two patients (7 males, 15 females; mean age 59 years) participated of which three patients dropped out during the follow up. Graft volumes amounted to 1418.26 mm3 at 2 weeks, 1201.21 mm3 at 3 months, and 1130.13 mm3 at 2 years postoperative pointing to a relative graft volume stability of 79.7%. Swelling was the leading symptom during the first week. A peak in visual analogue scale scores was observed for pain, swelling, and hematoma the day of surgery and 1 day postoperation with a statistically significant decline between days 3 and 7. Hemorrhage and nose bleeding occurred in 18.2% and 27.3% of the subjects, respectively. About 95.5% of the subjects would undergo the treatment again. All implants integrated successfully and demonstrated healthy clinical conditions. CONCLUSION Lateral wall sinus augmentation using DBBM as the only filling material is a viable treatment concept given limited graft resorption, good patients' tolerance, and clinical outcomes.
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Affiliation(s)
- Faris Younes
- Faculty of Medicine and Pharmacy, Oral Health Research Group (ORHE), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Jan Cosyn
- Faculty of Medicine and Pharmacy, Oral Health Research Group (ORHE), Vrije Universiteit Brussel (VUB), Brussels, Belgium.,Faculty of Medicine and Health Sciences, Department of Periodontology and Oral Implantology, Dental School, Ghent University, Ghent, Belgium
| | - Thomas De Bruyckere
- Faculty of Medicine and Pharmacy, Oral Health Research Group (ORHE), Vrije Universiteit Brussel (VUB), Brussels, Belgium.,Faculty of Medicine and Health Sciences, Department of Periodontology and Oral Implantology, Dental School, Ghent University, Ghent, Belgium
| | - Robbert Cleymaet
- Faculty of Medicine and Pharmacy, Oral Health Research Group (ORHE), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Aryan Eghbali
- Faculty of Medicine and Pharmacy, Oral Health Research Group (ORHE), Vrije Universiteit Brussel (VUB), Brussels, Belgium.,Faculty of Medicine and Health Sciences, Department of Periodontology and Oral Implantology, Dental School, Ghent University, Ghent, Belgium
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Pichotano EC, de Molon RS, de Souza RV, Austin RS, Marcantonio E, Zandim-Barcelos DL. Evaluation of L-PRF combined with deproteinized bovine bone mineral for early implant placement after maxillary sinus augmentation: A randomized clinical trial. Clin Implant Dent Relat Res 2019; 21:253-262. [PMID: 30690860 DOI: 10.1111/cid.12713] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 11/14/2018] [Accepted: 12/10/2018] [Indexed: 02/06/2023]
Abstract
PURPOSE To investigate the effectiveness of adding leukocyte and platelet-rich fibrin (L-PRF) to deproteinized bovine bone mineral (DBBM) for early implant placement after maxillary sinus augmentation. MATERIALS AND METHODS Twelve patients requiring two-stage bilateral maxillary sinus augmentation were enrolled to the study. The elevated sinus cavities were randomly grafted with DBBM + L-PRF (test) or DBBM alone (control) in a split-mouth design. Implants were placed in the augmented sites after 4 months in the test group and 8 months in the control group. Bone biopsies were collected during implant placement for histomorphometric evaluation. Resonance frequency analysis was performed immediately after implant placement and at implant loading in both groups. Cone-beam computed tomography was obtained preoperatively and postoperatively for evaluation of graft volume changes. RESULTS Both procedures were effective for maxillary sinus augmentation. Cone-beam computed tomography analysis did not reveal differences in graft volume between test and control group at any of the evaluated time points (P > .05). Histological evaluation demonstrated increased percentage of newly formed bone for the test group (44.58% ± 13.9%) compared to the control group (30.02% ± 8.42%; P = .0087). The amount of residual graft in the control group was significantly higher (13.75% ± 9.99%) than in the test group (3.59 ± 4.22; P = .0111). Implant stability quotient (ISQ) immediately after implant placement was significantly higher in the control group (75.13 ± 5.69) compared to the test group (60.9 ± 9.35; P = .0003). The ISQ values at loading did not differ between the groups (P = .8587). Implant survival rate was 100% for both groups. CONCLUSION The addition of L-PRF to the DBBM into the maxillary sinus allowed early implant placement (4 months) with increased new bone formation than DBBM alone after 8 months of healing.
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Affiliation(s)
- Elton Carlos Pichotano
- Department of Diagnosis and Surgery, São Paulo State University (Unesp), School of Dentistry, Araraquara, São Paulo, Brazil
| | - Rafael Scaf de Molon
- Department of Diagnosis and Surgery, São Paulo State University (Unesp), School of Dentistry, Araraquara, São Paulo, Brazil
| | | | - Rupert S Austin
- Tissue Engineering and Biophotonics, King's College London Dental Institute, Guy's Hospital, London, United Kingdom
| | - Elcio Marcantonio
- Department of Diagnosis and Surgery, São Paulo State University (Unesp), School of Dentistry, Araraquara, São Paulo, Brazil
| | - Daniela Leal Zandim-Barcelos
- Department of Diagnosis and Surgery, São Paulo State University (Unesp), School of Dentistry, Araraquara, São Paulo, Brazil
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Cruz AD, Peixoto GA, Aguiar MF, Camargo GACG, Homs N. Surgeons' Performance Determining the Amount of Graft Material for Sinus Floor Augmentation Using Tomography. Braz Dent J 2018; 28:385-390. [PMID: 29297561 DOI: 10.1590/0103-6440201601442] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 03/14/2017] [Indexed: 11/22/2022] Open
Abstract
This study aimed to assess the performance of surgeons in determining the amount of graft material required for maxillary sinus floor augmentation in a preoperative analysis using cone-beam computed tomography images. A convenience sample of 10 retrospective CBCT exams (i-CAT®) was selected. Scans of the posterior maxilla area with an absence of at least one tooth and residual alveolar bone with an up to 5 mm height were used. Templates (n=20) contained images of representative cross-sections in multiplanar view. Ten expert surgeons voluntarily participated as appraisers of the templates for grafting surgical planning of a 10 mm long implant. Appraisers could choose a better amount of graft material using scores: 0) when considered grafting unnecessary, 1) for 0.25 g in graft material, 2) for 0.50 g, 3) for 1.00 g and 4) for 1.50 g or more. Reliability of the response pattern was analyzed using Cronbach's a. Wilcoxon and Mann-Whitney tests were performed to compare scores. Regression analysis was performed to evaluate whether the volume of sinuses (mm3) influenced the choose of scores. In the reliability analysis, all values were low and the score distribution was independent of the volume of the maxillary sinuses (p>0.05), which did not influence choosing the amount of graft material. Surgeons were unreliable to determine the best amount of graft material for the maxillary sinus floor augmentation using only CBCT images. Surgeons require auxiliary diagnostic tools to measure the volume associated to CBCT exams in order to perform better.
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Affiliation(s)
- Adriana Dibo Cruz
- Specific Formation Dept., Dental School, UFF - Universidade Federal Fluminense, Nova Friburgo, RJ, Brazil
| | - Guilherme Alvares Peixoto
- Postgraduate Program, Dental School, UFF - Universidade Federal Fluminense, Nova Friburgo, RJ, Brazil
| | - Marcelo Freitas Aguiar
- Specific Formation Dept., Dental School, UFF - Universidade Federal Fluminense, Nova Friburgo, RJ, Brazil
| | | | - Nicolas Homs
- Specific Formation Dept., Dental School, UFF - Universidade Federal Fluminense, Nova Friburgo, RJ, Brazil
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Maddalone M, Mirabelli L, Venino PM, Karanxha L, Porcaro G, Del Fabbro M. Long-term stability of autologous bone graft of intraoral origin after lateral sinus floor elevation with simultaneous implant placement. Clin Implant Dent Relat Res 2018; 20:713-721. [DOI: 10.1111/cid.12649] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 05/02/2018] [Accepted: 06/09/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Marcello Maddalone
- Department of Surgery and Medicine; University of Milano-Bicocca; Monza Italy
| | - Luca Mirabelli
- Department of Surgery and Medicine; University of Milano-Bicocca; Monza Italy
| | - Pier Matteo Venino
- Department of Surgery and Medicine; University of Milano-Bicocca; Monza Italy
| | - Lorena Karanxha
- Department of Biomedical, Surgical and Dental Sciences; Università degli Studi di Milano; Milan Italy
| | - Gianluca Porcaro
- Department of Surgery and Medicine; University of Milano-Bicocca; Monza Italy
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences; Università degli Studi di Milano; Milan Italy
- Dental Clinic; IRCCS Istituto Ortopedico Galeazzi; Milan Italy
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29
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Barbato L, Baldi N, Gonnelli A, Duvina M, Nieri M, Tonelli P. Association of Smoking Habits and Height of Residual Bone on Implant Survival and Success Rate in Lateral Sinus Lift: A Retrospective Study. J ORAL IMPLANTOL 2018; 44:432-438. [PMID: 30011240 DOI: 10.1563/aaid-joi-d-17-00192] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The primary aim was to evaluate the association of patient-related factors, biomaterials, and implant characteristics on complications' rate of sinus graft surgery and on implant survival rate in grafted sinus. Secondary aims were to measure bone remodeling around implants and patient satisfaction. A retrospective cohort study was designed. Patients who had computerized tomography (CT) before sinus surgery (T0), orthopantomography after implant surgery (T1) and at follow-up (T2), were included. Specific forms were used to collect clinical data. Radiographic measures were: height of residual bone before sinus surgery measured on CT (T0) and apical and marginal bone levels around implants measured on orthopantomography at T1 and T2. Forty-three lateral sinus lifts were performed. Three grafts failed before implant insertion. Out of 83 implants inserted in 29 patients, a total of 19 failed. Mean follow-up (T2) was 6 ± 1.8 years [4; 11.2 years]. The multilevel models analysis showed no association between complications rate and patient-related factors, biomaterials, and implant characteristics. Smoking (odds ratio [OR]: 8.3; 95% CI 1.46-48.05, P = .0173) and height of residual bone (OR: 0.32 for each mm; 95% CI 0.15-0.68, P = .0034) were associated with implant failure. Bone remodeling between T1 and T2 was -0.8 ± 0.2 mm for apical bone and -0.6 ± 0.3 mm for marginal bone. General therapy satisfaction measured in a visual analogue scale was 8.4 ±1.4. In conclusion, lower height of residual bone before sinus surgery and smoking habits had a negative prognostic effect on survival rate of dental implants placed in grafted sinuses.
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Affiliation(s)
- Luigi Barbato
- Department of Oral Surgery, University of Florence, Florence, Italy
| | - Niccolò Baldi
- Department of Oral Surgery, University of Florence, Florence, Italy
| | - Alessio Gonnelli
- Department of Oral Surgery, University of Florence, Florence, Italy
| | - Marco Duvina
- Department of Oral Surgery, University of Florence, Florence, Italy
| | - Michele Nieri
- Department of Oral Surgery, University of Florence, Florence, Italy
| | - Paolo Tonelli
- Department of Oral Surgery, University of Florence, Florence, Italy
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30
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Pichotano EC, de Molon RS, Freitas de Paula LG, de Souza RV, Marcantonio E, Zandim-Barcelos DL. Early Placement of Dental Implants in Maxillary Sinus Grafted With Leukocyte and Platelet-Rich Fibrin and Deproteinized Bovine Bone Mineral. J ORAL IMPLANTOL 2018; 44:199-206. [PMID: 29457934 DOI: 10.1563/aaid-joi-d-17-00220] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This case report aimed to describe the effects of leukocyte and platelet-rich fibrin (L-PRF) associated with demineralized bovine bone mineral (DBBM) and absorbable collagen membrane (CM) on bone regeneration in maxillary sinus augmentation. A 59-year-old male patient was referred to the Department of Periodontology for implant rehabilitation of his edentulous upper jaw. The treatment plan involved maxillary sinus augmentation followed by implant installations. A split-mouth design was employed in which the right maxillary sinus was filled using L-PRF, DBBM, and CM; the left side was filled with DBBM and CM. After 4 and 8 months postoperatively, 2 dental implants were installed in each of the right and left maxillary sinuses. Cone-beam computerized tomography (CBCT) was taken before and after sinus augmentation for evaluation of tridimensional bone volume alterations. Bone biopsies were harvested from the implant sites for histomorphometric evaluation. Resonance frequency analysis was employed immediately after implant placement and before prosthetic rehabilitation for evaluation of implant stability. Implants were loaded 10 months after sinus augmentation. CBCT analysis showed a higher resorption rate in the right side of the maxillary sinus (L-PRF + DBBM) compared to the left side (22.25% and 8.95%, respectively). Implant stability quotients were above 68 in all time-points for both groups. Histomorphometric analysis showed a high amount of newly formed bone when L-PRF was used compared with DBBM alone (2 118 102 and 975 535 mm3, respectively). Taken together, both techniques were effective for maxillary sinus augmentation, however the addition of L-PRF to the graft allowed early implant placement and accelerated bone healing in the conditions studied.
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Affiliation(s)
- Elton Carlos Pichotano
- 1 Department of Diagnosis and Surgery, School of Dentistry at Araraquara, Sao Paulo State University - UNESP, Araraquara, SP, Brazil
| | - Rafael Scaf de Molon
- 1 Department of Diagnosis and Surgery, School of Dentistry at Araraquara, Sao Paulo State University - UNESP, Araraquara, SP, Brazil
| | | | | | - Elcio Marcantonio
- 1 Department of Diagnosis and Surgery, School of Dentistry at Araraquara, Sao Paulo State University - UNESP, Araraquara, SP, Brazil
| | - Daniela Leal Zandim-Barcelos
- 1 Department of Diagnosis and Surgery, School of Dentistry at Araraquara, Sao Paulo State University - UNESP, Araraquara, SP, Brazil
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Subantral Augmentation With Mineralized Cortical Bone Allograft Material: Clinical, Histological, and Histomorphometric Analyses and Graft Volume Assessments. IMPLANT DENT 2017; 25:353-60. [PMID: 26866847 DOI: 10.1097/id.0000000000000391] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of this study was to clinically and histologically evaluate the effect of using mineralized cortical bone allograft in sinus lift augmentation and to 3-dimensionally quantify volumetric changes in maxillary sinuses augmented over a 2-year period. MATERIALS AND METHODS Eleven patients affected with less than 3 mm of residual ridge were enrolled in the study. After sinus grafting with a mineralized bone allograft, the site was covered with a collagen wound dressing. During implant placement 4 months later, a biopsy was obtained for histological and histomorphometry evaluations. Bone volume changes were also evaluated. RESULTS Biopsies showed mature cancellous bone with a predominantly lamellar structure. The well-vascularized intertrabecular spaces were filled with connective tissue and bone marrow. Histomorphometry evaluations revealed a mean 43.76 ± 1.47% of bone marrow, 40.16 ± 1.35% of mineralized bone and 16.59 ± 0.55% of woven bone. The mean of residual particles was 0.47 ± 0.01%. Volumetric measurements showed a mean volume of grafted material 16.24 ± 1.55 cm at T0, 14.48 ± 1.48 cm at T1, and 13.06 ± 1.39 cm at T2. The mean volume retraction was 10.83% of the initial total volume at (T0-T1) and 9.8% at (T1-T2). CONCLUSIONS The clinical and histological results indicated that mineralized cortical bone allograft promoted de novo bone formation and can be used for sinus lift procedure.
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Temmerman A, Van Dessel J, Cortellini S, Jacobs R, Teughels W, Quirynen M. Volumetric changes of grafted volumes and the Schneiderian membrane after transcrestal and lateral sinus floor elevation procedures: A clinical, pilot study. J Clin Periodontol 2017; 44:660-671. [PMID: 28382627 DOI: 10.1111/jcpe.12728] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2017] [Indexed: 11/29/2022]
Abstract
AIM To investigate the influence of various surgical techniques for sinus augmentation on the volumetric changes of graft, membrane and the post-operative discomfort. MATERIALS AND METHODS Eighteen patients in need of bilateral sinus floor elevation (SFE) were assigned to lateral SFE, transcrestal SFE and intralift procedures. CBCT images taken at baseline, 1 week and 6 weeks were analysed for volumetric changes in graft and Schneiderian membrane. Questionnaires were used to analyse post-op discomfort. RESULTS The overall average graft volume obtained after 1 week was 1.87 cm3 (range 0.12-4.72 cm3 ). Volumes decreased after 6 weeks to an overall mean volume of 1.33 cm3 (range 0.10-4.29 cm3 - average decrease of 27.6%). After 6 weeks, the amount of graft volume decreased in every treatment option, ranging from -23.13% for the tSFE, over -24.55% for the lSFE, to -33.71% for the IL. Although all treatment options correspond in an increase in Schneiderian membrane volume, no statistically significant correlation between this increase and loss of graft volume could be obtained for all treatments (p = 0.97). CONCLUSION All SFE techniques provided sufficient graft volume for implant treatment. All techniques provoke a partially transient swelling of the Schneiderian membrane. All techniques resulted in a decrease in graft volume after 6 weeks; however, no significant differences were obtained between treatments. Furthermore, no statistical significant correlation between the post-operative swelling of the Schneiderian membrane and reduction in graft volume at 6 weeks could be obtained.
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Affiliation(s)
- Andy Temmerman
- Section of Periodontology, Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals, Leuven, Belgium
| | - Jeroen Van Dessel
- Department of Maxillofacial Surgery, OMFS-Impath Research Group, Leuven, Belgium
| | - Simone Cortellini
- Section of Periodontology, Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals, Leuven, Belgium
| | - Reinhilde Jacobs
- Department of Maxillofacial Surgery, OMFS-Impath Research Group, Leuven, Belgium
| | - Wim Teughels
- Section of Periodontology, Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals, Leuven, Belgium
| | - Marc Quirynen
- Section of Periodontology, Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals, Leuven, Belgium
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Evaluation of Volumetric Changes of Augmented Maxillary Sinus With Different Bone Grafting Biomaterials. J Craniofac Surg 2016; 27:e144-8. [PMID: 26890457 DOI: 10.1097/scs.0000000000002393] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Extensive alveolar bone resorption because of pneumatized maxillary sinus is a common problem that limits dental implant placement. Maxillary sinus floor augmentation (MSFA) is an accepted treatment protocol that provides sufficient bone volume. The aim of this study was to evaluate the percentage of graft volume reduction following MSFA using cone beam computed tomography. In this retrospective study, cone beam computed tomography scans of MSFA were measured to evaluate the volume of the grafted sinus with deproteinized bovine bone (DBB), mineralized allograft (MA), or a mixture of MA and demineralized allograft as a composite. The volumetric changes in sinus augmentation between 2 weeks (T-I) and 6 months (T-II) after operation were analyzed. Thirty-nine patients were included in this study. The average percent volume reduction was 8.14 ± 3.76%, 19.38 ± 9.22%, and 24.66 ± 4.68% for DBB, MA, and composite graft, respectively. A significant graft volume reduction was found between T-I and T-II for all groups (P < 0.01). The DBB group showed the least volume reduction (P < 0.01). Biomaterials can influence the bone graft volume change before implant placement. Deproteinized bovine bone may offer greater volume stability during healing than mineralized and composite allografts.
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Deluiz D, Santos Oliveira L, Ramôa Pires F, Reiner T, Armada L, Nunes MA, Muniz Barretto Tinoco E. Incorporation and Remodeling of Bone Block Allografts in the Maxillary Reconstruction: A Randomized Clinical Trial. Clin Implant Dent Relat Res 2016; 19:180-194. [DOI: 10.1111/cid.12441] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 06/30/2016] [Accepted: 07/11/2016] [Indexed: 11/27/2022]
Affiliation(s)
- Daniel Deluiz
- Postdoctoral researcher, Department of Periodontology; State University of Rio de Janeiro; RJ, Rio de Janeiro Brazil
| | - Luciano Santos Oliveira
- Professor, Department of Implantology; Pontifical Catholic University of Rio de Janeiro; Rio de Janeiro RJ Brazil
| | - Fábio Ramôa Pires
- Professor, Department of Stomatology, Estácio de Sá University; Rio de Janeiro RJ Brazil
| | - Teresita Reiner
- Investigator, Geriatric Research, Education and Clinical Center - Bruce W. Carter Veterans Affairs Medical Center; Miami FL USA
| | - Luciana Armada
- Professor, Department of Endodontics, Estácio de Sá University; Rio de Janeiro RJ Brazil
| | - Marcus A. Nunes
- Professor, Department of Statistics, Federal University of Rio Grande do Norte; Natal RN Brazil
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Younes F, Eghbali A, De Troyer S, De Bruyckere T, Cleymaet R, Cosyn J. Marginal and apical bone stability after staged sinus floor augmentation using bone condensing implants with variable-thread design: a two-dimensional analysis. Int J Oral Maxillofac Surg 2016; 45:1135-41. [PMID: 27156066 DOI: 10.1016/j.ijom.2016.04.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 01/20/2016] [Accepted: 04/19/2016] [Indexed: 11/18/2022]
Abstract
Studies on the vertical stability of augmented bone after sinus lifting differ substantially. In addition, long healing periods are usually advocated prior to implant installation. The purpose of this case series study was to evaluate the changes in bone height after sinus lifting with a bovine-derived xenograft and to evaluate the clinical outcome of bone condensing implants installed after a short healing period. Patients treated during the years 2010-2013 were re-examined using peri-apical radiographs to evaluate the changes in augmented bone height (BH) and marginal bone loss (BL). Fifty-seven of 70 eligible subjects (28 male and 29 female, mean age 56 years) attended for reassessment. Data were available for 53 sinus lifts and 105 implants installed after a mean healing period of 4.6±1.5 months. Implant survival was 99% after a mean time in function of 19±9 months. Baseline BH, BH at implant placement, and final BH were on average 3.87±1.74mm, 13.75±2.12mm, and 13.11±2.12mm, respectively (P<0.001). Mean BL was 0.51±0.65mm. Only limited resorption is to be expected after sinus lifting in the short term. A bone condensing implant can be used in the early healing phase with successful outcomes in terms of implant survival and bone adaptation.
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Affiliation(s)
- F Younes
- Department of Periodontology and Oral Implantology, Vrije Universiteit Brussel (VUB), Brussels, Belgium.
| | - A Eghbali
- Department of Periodontology and Oral Implantology, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - S De Troyer
- Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
| | - T De Bruyckere
- Department of Periodontology and Oral Implantology, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - R Cleymaet
- Department of Restorative Dentistry, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - J Cosyn
- Department of Periodontology and Oral Implantology, Vrije Universiteit Brussel (VUB), Brussels, Belgium; Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
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Lim HC, Hong JY, Lee JS, Jung UW, Choi SH. Late-term healing in an augmented sinus with different ratios of biphasic calcium phosphate: a pilot study using a rabbit sinus model. J Periodontal Implant Sci 2016; 46:57-69. [PMID: 26937294 PMCID: PMC4771838 DOI: 10.5051/jpis.2016.46.1.57] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Accepted: 01/28/2016] [Indexed: 11/08/2022] Open
Abstract
PURPOSE The aim of this pilot study was to determine the osteoconductivity and dimensional stability of augmented sinuses using different ratios of biphasic calcium phosphate (BCP) in a rabbit sinus model. METHODS Each sinus of New Zealand white rabbits (2.5-3.5 kg) was assigned to one of two groups: BCP with a hydroxyapatite to β-tricalcium phosphate (HA:β-TCP) ratio of 70:30 (group TCP30) and BCP with an HA:β-TCP ratio of 30:70 (group TCP70). After preparing a window in the antral wall of a sinus, the Schneiderian membrane was elevated, and the applicable material was grafted. A fluorochrome calcein green was injected five days before euthanizing the animals at four months post-surgery. The specimens were analyzed histologically, histomorphometrically, and by using micro-computed tomography (micro-CT). RESULTS Micro-CT analysis revealed that the total augmented volume and the new bone volume did not differ significantly between the two groups whereas the resorption of materials was greater in the TCP70 group. The trabecular thickness, number, and separation also did not differ significantly between the two groups. Histomorphometrically, the areas of total augmentation, new bone, and residual material, as well as the ratio of new-bone-material contact did not differ significantly between the groups. Histologically, the residual particles were more scattered in the TCP70 group than in the TCP30 group. The fluorescence of the calcein green did not differ notably between the two groups. CONCLUSIONS The osteoconductivity and dimensional stability of the two BCPs with different ratios tested in this study were comparable after four months of healing. Therefore, we conclude that both BCPs show promise as a bone substitute for sinus augmentation.
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Affiliation(s)
- Hyun-Chang Lim
- Department of Periodontology, Kyung Hee University School of Dentistry, Seoul, Korea
| | - Ji-Youn Hong
- Department of Periodontology, Kyung Hee University School of Dentistry, Seoul, Korea
| | - Jung-Seok Lee
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Ui-Won Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Seong-Ho Choi
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
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Barbeck M, Najman S, Stojanović S, Mitić Ž, Živković JM, Choukroun J, Kovačević P, Sader R, James Kirkpatrick C, Ghanaati S. Addition of blood to a phycogenic bone substitute leads to increased
in vivo
vascularization. Biomed Mater 2015; 10:055007. [DOI: 10.1088/1748-6041/10/5/055007] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Berberi A, Bouserhal L, Nader N, Assaf RB, Nassif NB, Bouserhal J, Salameh Z. Evaluation of Three-Dimensional Volumetric Changes After Sinus Floor Augmentation with Mineralized Cortical Bone Allograft. J Maxillofac Oral Surg 2015; 14:624-9. [PMID: 26225054 PMCID: PMC4511887 DOI: 10.1007/s12663-014-0736-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Accepted: 12/04/2014] [Indexed: 11/24/2022] Open
Abstract
AIM The aim of this retrospective study was to quantify three-dimensional (3D) volumetric bone changes over a two-year period in maxillary sinuses augmented with a mineralized cortical bone allograft material (MCBA) material. PATIENTS AND METHODS Eleven patients (6 males and 5 females) with mean of age of 51.6 (range: 46-61) years were treated to increase the vertical dimension of the alveolar crest by maxillary sinus floor augmentation procedure. Study data were collected from patient records and by analyzing preoperative radiographs and cone beam computed tomography (CBCT) scans taken within the first two weeks after maxillary sinus lift (T0), immediately before implant placement four months after grafting (T1), and after one year of implant loading (T2). All DICOM-formatted images were rendered into volumetric images using software that automatically calculated the volume of the grafted material in cubic centimeters. RESULTS Mean graft volume was 16.24 ± 1.54 cm(3) at T0, 14.48 ± 1.48 cm(3) at T1 and 13.06 ± 1.39 cm(3) at T2. Mean volume retraction resulted in 1.76 ± 0.34 cm(3) ΔV1 (T0-T1) and 1.42 ± 0.4 cm(3) ΔV2 (T1-T2) and was 10.83 % of the initial total volume at (T0-T1) and 9.8 % of the total volume (T1-T2). CONCLUSION The present retrospective investigation demonstrated a 20.63 % decrease in graft volume. Volumetric 3D assessment of CBCT scans with the selected software appeared to be a promising approach to quantifying long-term changes in the grafted area.
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Affiliation(s)
- Antoine Berberi
- />Oral and Maxillofacial Surgery Department, School of Dentistry, Lebanese University, P.O. Box 5208-116, Beirut, Lebanon
- />Oral Surgery Section, ENT Department, Sacre-Coeur Hospital, Lebanese University, Beirut, Lebanon
| | - Lea Bouserhal
- />Department of Orthodontics, Case Western Reserve University, Cleveland, OH USA
| | - Nabih Nader
- />Oral and Maxillofacial Surgery Department, School of Dentistry, Lebanese University, P.O. Box 5208-116, Beirut, Lebanon
| | - Rita Bou Assaf
- />Oral and Maxillofacial Surgery Department, School of Dentistry, Lebanese University, P.O. Box 5208-116, Beirut, Lebanon
| | - Nayla Bassil Nassif
- />Orthodontics Department, Faculty of Dental Medicine, Saint-Joseph University, Beirut, Lebanon
| | - Joseph Bouserhal
- />Orthodontics Department, Faculty of Dental Medicine, Saint-Joseph University, Beirut, Lebanon
| | - Ziad Salameh
- />Oral and Maxillofacial Surgery Department, School of Dentistry, Lebanese University, P.O. Box 5208-116, Beirut, Lebanon
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Treatment outcomes of implants performed after regenerative treatment of absorbed alveolar bone due to the severe periodontal disease and endoscopic surgery for maxillary sinus lift without bone grafts. J Craniofac Surg 2015; 24:1599-602. [PMID: 24036734 DOI: 10.1097/scs.0b013e3182a20fd5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE We have developed a regenerative medicine therapy for the alveolar bone and endoscopic surgery for maxillary sinus lift without bone grafts, in patients experiencing severe periodontal disease with significant absorption of the maxillary alveolar bone, in which more than 10 mm of bone thickness in the maxillary bone was attained, with satisfactory results. The objective of this study was to examine the treatment outcomes of implants that were performed after these therapies. PARTICIPANTS AND METHODS The participants were 36 patients with severe periodontal disease, who cannot be cured with any other treatments except the extirpation of all teeth. The 36 patients are all patients who underwent regenerative treatment of the alveolar bone through tooth replantation and transplantation of the iliac cancellous bone (the bone marrow) as well as endoscopic surgery for maxillary sinus lift from May 2003 to July 2007 in our clinic. A total of 120 implants were placed in these patients when the replanted teeth fell out because of root resorption, and the success rate was examined. RESULTS The success rates of the implants were 16 of 33 (48%) in the group when surveyed less than 2 years after the surgery and 84 of 87 (96.5%) in the group when surveyed more than 2 years after the surgery. A statistically significant difference was found between the 2 groups (Chi-squared test, P < 0.001). CONCLUSIONS AND CONSIDERATIONS It was believed that it takes approximately 2 years for the bones in the maxillary sinus floor, augmented through endoscopic surgery for maxillary sinus lift, to attain the thickness and hardness required for implant placement. Therefore, although the implant treatment should be performed later than 2 years after surgery, chewing is possible during this period, with the replanted teeth that were used for regenerative treatment of the alveolar bone. It is believed that this is an extremely effective treatment method to improve the patients' quality of life.
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In vivo comparison of hard tissue regeneration with ovine mesenchymal stem cells processed with either the FICOLL method or the BMAC method. J Craniomaxillofac Surg 2015; 43:1177-83. [PMID: 26138380 DOI: 10.1016/j.jcms.2015.05.020] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Revised: 05/21/2015] [Accepted: 05/26/2015] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION The aim of this work was to analyse the suitability of mesenchymal stem cell isolation by FICOLL density centrifugation and the closed bone marrow aspirate concentrate (BMAC) system for sinus augmentation with bovine bone mineral (BBM) in the sheep model. METHODS 16 sheep underwent sinus augmentation with BBM and MSCs; they were divided between two groups with survival points of 8 and 16 weeks. For the FICOLL control arm three, and for the BMAC test arm, five augmentations were performed for each time point. The derived cell numbers were counted; a colony forming unit (CFU) assay was performed; the pluripotency of the MSCs was proved; histological and histomorphometrical analysis were performed. RESULTS The approach of using BBM and MSCs in combination with fibrin adhesive was sufficient for new bone formation as the FICOLL experiment indicated. However, due to significantly lower cell numbers isolated using the BMAC in sheep, less new bone was formed in the test arm. CONCLUSIONS The BMAC system is well suited for human MSC isolation but it needs to be optimized to fit sheep cell characteristics if it is to be used in this animal model.
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Pommer B, Unger E, Busenlechner D, Haas R, Mailath-Pokorny G, Fürhauser R, Watzek G. Graft Remodeling following Transcrestal Sinus Floor Elevation via the Gel-Pressure Technique (GPT) and Pasteous Nano-Crystalline Hydroxyapatite Bone Substitute. MATERIALS 2015; 8:3210-3220. [PMCID: PMC5455727 DOI: 10.3390/ma8063210] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Accepted: 05/28/2015] [Indexed: 06/12/2024]
Abstract
Bone grafting of the maxillary sinus is attempted to compensate for sinus pneumatization and permit reliable insertion of endosseous dental implants for prosthetic rehabilitation. The aim of the present clinical investigation was to study bone regeneration four months after transcrestal sinus floor elevation via the Gel-Pressure Technique (GPT) and application of pasteous nano-crystalline hydroxyapatite bone substitute. A total of 25 patients with deficient alveolar ridges in the posterior maxilla (mean residual bone height: 4.7 ± 1.8 mm) were subjected to 32 flapless transcrestal sinus floor augmentations and simultaneous insertion of 40 implants. Sinus membrane elevation height averaged 11.2 ± 2.7 mm and minimal vertical graft resorption of 0.1 mm was observed after four months. Radiographic bone density averaged 460 Hounsfield units in regions adjacent to the native jawbone (1 to 7 mm distance), while reduction of bone density by −7.2%, −11.3%, −14.8%, −19.6% and −22.7% was recorded in more apical regions of 8, 9, 10, 11, and ≥12 mm distance to the original sinus floor, respectively. The results suggest that graft remodeling is completed up to a distance of 7 mm within a healing period of four months after sinus augmentation using nano-crystalline hydroxyapatite bone substitute material.
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Affiliation(s)
- Bernhard Pommer
- Academy for Oral Implantology, Lazarettgasse 19/DG, Vienna 1090, Austria; E-Mails: (D.B.); (R.H.); (G.M.-P.); (R.F.); (G.W.)
| | - Ewald Unger
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Währinger Gürtel 18-20, AKH-4L, Vienna 1090, Austria; E-Mail:
| | - Dieter Busenlechner
- Academy for Oral Implantology, Lazarettgasse 19/DG, Vienna 1090, Austria; E-Mails: (D.B.); (R.H.); (G.M.-P.); (R.F.); (G.W.)
| | - Robert Haas
- Academy for Oral Implantology, Lazarettgasse 19/DG, Vienna 1090, Austria; E-Mails: (D.B.); (R.H.); (G.M.-P.); (R.F.); (G.W.)
| | - Georg Mailath-Pokorny
- Academy for Oral Implantology, Lazarettgasse 19/DG, Vienna 1090, Austria; E-Mails: (D.B.); (R.H.); (G.M.-P.); (R.F.); (G.W.)
| | - Rudolf Fürhauser
- Academy for Oral Implantology, Lazarettgasse 19/DG, Vienna 1090, Austria; E-Mails: (D.B.); (R.H.); (G.M.-P.); (R.F.); (G.W.)
| | - Georg Watzek
- Academy for Oral Implantology, Lazarettgasse 19/DG, Vienna 1090, Austria; E-Mails: (D.B.); (R.H.); (G.M.-P.); (R.F.); (G.W.)
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Ohe JY, Kim GT, Lee JW, Al Nawas B, Jung J, Kwon YD. Volume stability of hydroxyapatite and β-tricalcium phosphate biphasic bone graft material in maxillary sinus floor elevation: a radiographic study using 3D cone beam computed tomography. Clin Oral Implants Res 2015; 27:348-53. [DOI: 10.1111/clr.12551] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/26/2014] [Indexed: 11/27/2022]
Affiliation(s)
- Joo-Young Ohe
- Department of Oral & Maxillofacial Surgery; School of Dentistry; Kyung Hee University; Seoul Korea
| | - Gyu-Tae Kim
- Department of Oral & Maxillofacial Radiology; School of Dentistry; Kyung Hee University; Seoul Korea
| | - Jung-Woo Lee
- Department of Oral & Maxillofacial Surgery; School of Dentistry; Kyung Hee University; Seoul Korea
| | - Bilal Al Nawas
- Department of Oral & Maxillofacial Surgery; University Medical Center of Mainz; Mainz Germany
| | - Junho Jung
- Department of Oral & Maxillofacial Surgery; University Medical Center of Mainz; Mainz Germany
| | - Yong-Dae Kwon
- Department of Oral & Maxillofacial Surgery; School of Dentistry; Kyung Hee University; Seoul Korea
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Favato MN, Vidigal BCL, Cosso MG, Manzi FR, Shibli JA, Zenóbio EG. Impact of human maxillary sinus volume on grafts dimensional changes used in maxillary sinus augmentation: a multislice tomographic study. Clin Oral Implants Res 2014; 26:1450-5. [PMID: 25283800 DOI: 10.1111/clr.12488] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2014] [Indexed: 11/28/2022]
Abstract
PURPOSE To assess the influence of complete maxillary sinus volume on the dimensional changes of different grafts used in maxillary sinus lift. MATERIALS AND METHODS Analysis of 50 surgical procedures of maxillary sinus lift performed on 43 subjects using different grafting materials: fresh frozen allogenic particulated bone (11), hydroxyapatite (Endobon(®)) (17), 60% hydroxyapatite + 40% beta-tricalcium phosphate (Bone Ceramic(®)) (12) and Bone Ceramic(®) + Emdogain(®) (10). One hundred and fifty multislice tomographic images of the maxillary sinus were obtained using the software Syngo CT 2011 A VOLUME, measuring complete maxillary sinus volume (T0) and dimensional changes of different graft materials during periods of 15 days (T1) and 180 days (T2). The factor studied was the influence of maxillary sinus volume on the dimensional changes of different graft materials used in maxillary sinus lift in patients with posterior edentulism. Data obtained were assessed using the Student's t-test and Pearson's correlation coefficient. RESULTS No correlation (r 0.112) between the total maxillary sinus volume and the dimensional changes of the different graft materials used in this study was observed (P > 0.05). CONCLUSION This study demonstrated that there is no sufficient evidence to support the thesis that the volume of the maxillary sinus influences the contraction of the grafts, at least on sample or the biomaterials evaluated in this cohort study.
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Affiliation(s)
- Mário N Favato
- Department of Dentistry, Implant Master Program, PUCMINAS, Belo Horizonte, Brazil
| | - Bruno C L Vidigal
- Department of Dentistry, Radiology Master Program, PUCMINAS, Belo Horizonte, Brazil
| | - Maurício G Cosso
- Department of Dentistry, Implant Master Program, PUCMINAS, Belo Horizonte, Brazil
| | - Flávio R Manzi
- Department of Dentistry, Radiology Master Program, PUCMINAS, Belo Horizonte, Brazil
| | - Jamil A Shibli
- Department of Periodontology and Oral Implantology, UNG, Guarulhos, Brazil
| | - Elton G Zenóbio
- Department of Dentistry, Implant Master Program, PUCMINAS, Belo Horizonte, Brazil
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Sehn FP, Dias RR, de Santana Santos T, Silva ER, Salata LA, Chaushu G, Xavier SP. Fresh-frozen allografts combined with bovine bone mineral enhance bone formation in sinus augmentation. J Biomater Appl 2014; 29:1003-13. [PMID: 25245781 DOI: 10.1177/0885328214552709] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We evaluated histologically, histomorphometrically, and tomographically the effects of the association of fresh-frozen bone allograft (FFB) with bovine bone mineral (BBM) in maxillary sinus floor augmentation. In total, 34 maxillary sinuses from 29 patients, with a mean age of 51.32 (±6.44) years, underwent sinus augmentation. Patients were divided into control and test groups (17 sinuses each). The controls were grafted with allograft bone, and the test group received a combination of FFB and BBM at a 2:1 ratio. After 6 months, bone samples were collected for histological and histomorphometric examinations. The implant survival rates were 93.02% (control group) and 100% (test group) at 6 months after functional loading. Median volumetric reductions of 28.32% (17.05-44.05) and 12.62% (5.65-16.87) were observed for the control and test groups, respectively. Statistically significant histomorphometric differences were found between the control and test groups regarding newly formed bone 12.54% (10.50-13.33) vs. 24.42% (17.62-35.92), p < 0.001, total bone 48.34% (39.03-54.42) vs. 61.32% (50.61-64.96), p = 0.007, and connective tissue 51.66% (45.57-60.97) vs. 39.30% (35.03-49.37), p = 0.007. The addition of BBM to allograft bone in maxillary sinus augmentation resulted in higher percentages of new bone formation and total bone, and permitted implant placement with a low rate of osseointegration failure at the 6-month follow-up.
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Affiliation(s)
- Felipe Perraro Sehn
- Department of Oral and Maxillofacial Surgery and Periodontology. Ribeirão Preto Dental School, University of São Paulo, São Paulo, Brazil
| | - Rafael Rodrigues Dias
- Department of Oral and Maxillofacial Surgery and Periodontology. Ribeirão Preto Dental School, University of São Paulo, São Paulo, Brazil
| | - Thiago de Santana Santos
- Department of Oral and Maxillofacial Surgery and Periodontology. Ribeirão Preto Dental School, University of São Paulo, São Paulo, Brazil
| | - Erick Ricardo Silva
- Department of Oral and Maxillofacial Surgery and Periodontology. Ribeirão Preto Dental School, University of São Paulo, São Paulo, Brazil
| | - Luiz Antonio Salata
- Department of Oral and Maxillofacial Surgery and Periodontology. Ribeirão Preto Dental School, University of São Paulo, São Paulo, Brazil
| | - Gavriel Chaushu
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Tel Aviv University, Israel
| | - Samuel Porfírio Xavier
- Department of Oral and Maxillofacial Surgery and Periodontology. Ribeirão Preto Dental School, University of São Paulo, São Paulo, Brazil
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Martuscelli R, Toti P, Sbordone L, Guidetti F, Ramaglia L, Sbordone C. Five-year outcome of bone remodelling around implants in the maxillary sinus: assessment of differences between implants placed in autogenous inlay bone blocks and in ungrafted maxilla. Int J Oral Maxillofac Surg 2014; 43:1117-26. [PMID: 24774722 DOI: 10.1016/j.ijom.2014.03.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2013] [Revised: 03/19/2014] [Accepted: 03/25/2014] [Indexed: 10/25/2022]
Abstract
The placement of implants in the posterior maxillary area is considered a reliable procedure, offering recognized rehabilitative advantages. The aim of this study was to evaluate the performance of dental implants placed in the sinus floor augmented with a block autograft by comparing the outcomes over 5 years with those of dental implants positioned in non-augmented bone. This retrospective cohort study included 16 patients who had undergone prosthetic rehabilitation supported by dental implants between 2000 and 2006. One implant per patient was included and assigned to one of two predictor groups: grafted versus ungrafted maxillary sinus. Changes in marginal bone level (MBL) and apical bone level (ABL) over time, at 1, 3, and 5 years, were the primary outcome variables. Appropriate pair-wise comparison tests were performed. No significant differences were seen with regard to ABLs and among times between the grafted group (nine implants) and the ungrafted group (seven implants). Significant marginal bone resorption was found over time, primarily at the buccal aspect, in both study groups. The bone surrounding the apex of dental implants appeared stable after sinus augmentation in the grafted area. The behaviour of the two groups with regard to loss of MBLs over time was very similar.
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Affiliation(s)
- R Martuscelli
- Clinical Department of Head and Neck, School of Medicine, University of Naples "Federico II", Naples, Italy
| | - P Toti
- Private Practice and Department of Surgical, Medical, Molecular, and Critical Area Pathology, University of Pisa, Camaiore, Pisa, Italy
| | - L Sbordone
- Department of Medicine and Surgery, School of Medicine, University of Salerno, Baronissi, Salerno, Italy.
| | - F Guidetti
- Complex Operating Unit of Maxillofacial Surgery, Azienda Ospedaliero - Universitaria Pisana, Pisa, Italy
| | - L Ramaglia
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, School of Medicine, University of Naples "Federico II", Naples, Italy
| | - C Sbordone
- Maxillo-Facial Surgery, School of Medicine, University of Naples "Federico II", Naples, Italy
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Kim ES, Moon SY, Kim SG, Park HC, Oh JS. Three-dimensional volumetric analysis after sinus grafts. IMPLANT DENT 2014; 22:170-4. [PMID: 23399787 DOI: 10.1097/id.0b013e31827f3576] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE The purpose of this study was to evaluate the augmentation volume of a sinus graft according to the time and graft materials based on cone-beam computed tomography (CBCT) scans and to assess efficacy of a bioabsorbable membrane. METHODS Fourteen patients were investigated, and volumetric analysis was performed using OnDemand 3DTM software (Cybermed, Seoul, Korea). CBCT scans were performed on patients before surgery, immediately after surgery, 6 months after surgery, and 1 year after surgery. Following this analysis, the volumetric data were compared with the actual grafted volumes. Bioabsorbable membranes were used in all patients to promote the protection of sinus membranes and to guide bone regeneration. RESULTS Overall, the average percent volume of graft material that remained 6 months after implantation was 82.0%, and the average percent volume of graft material that remained 1 year after surgery was 60.4%. These reductions in the volume of graft material from immediately after surgery until 6 months or 1 year after surgery were shown to be statistically significant (P = 0.002 and P < 0.001, respectively). CONCLUSION The slight differences observed among the data indicate that volumetric analysis performed using CBCT can provide highly accurate data. A significant difference was observed in volumetric change over time, but no significant differences were observed between materials. No significant relationship was observed between the resorption of grafted bone and the success rate.
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Affiliation(s)
- Eun-Sik Kim
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University, Gwangju, Republic of Korea
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Oshima T, Duttenhoefer F, Xavier S, Nelson K, Sauerbier S. Can mesenchymal stem cells and novel gabapentin-lactam enhance maxillary bone formation? J Oral Maxillofac Surg 2013; 72:485-95. [PMID: 24528562 DOI: 10.1016/j.joms.2013.10.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Revised: 10/30/2013] [Accepted: 10/31/2013] [Indexed: 12/26/2022]
Abstract
PURPOSE Novel gabapentin-lactam (GBP-L) has shown its potency in enhancing new bone formation (NBF) in vitro. The objective of the present preclinical trial was to investigate the in vivo performance of GBP-L. MATERIALS AND METHODS Bilateral sinus floor augmentations in 10 adult sheep were conducted. Bovine bone mineral (BBM) and mesenchymal stem cells (MSCs) combined with novel GBP-L were placed into the test sinus of each sheep. The BBM and MSCs alone served as the control on the contralateral side. Simultaneously, 3 dental implants were inserted in each maxillary sinus. The animals were sacrificed after 8 and 16 weeks, and the amount of NBF was analyzed using histomorphometry. The osteogenic potency of the MSCs was demonstrated using the colony-forming unit and differentiation assay. Statistical evaluation was performed using the Wilcoxon signed rank test and 3-factorial nonparametric analysis of variance. RESULTS The histologic examination showed NBF in tight contact with the original bone in the control and test groups. The NBF was not significantly different between the test and control sites (P > .05). However, a highly significant difference in NBF between the apical and coronal sites in the specimens from the control and test groups was detected (P < .05). GBP-L did not alter the multipotency of the MSCs or impair NBF. CONCLUSIONS Bone formation is initiated from the residual alveolar crest and along the implant. The elected mode of GBP-L application did not induce faster NBF. Alternate forms of application (eg, slow release or systemic administration) might clarify the controversial in vitro findings.
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Affiliation(s)
- Toshiyuki Oshima
- Assistant Professor, Department of Oral and Craniomaxillofacial Surgery, University Medical Center Freiburg, Freiburg, Germany.
| | - Fabian Duttenhoefer
- Resident, Department of Oral and Craniomaxillofacial Surgery, University Medical Center Freiburg, Freiburg, Germany
| | - Samuel Xavier
- Professor, Department of Oral and Craniomaxillofacial Surgery, University Medical Center Freiburg, Freiburg, Germany; and Department of Oral and Maxillofacial Surgery, University of São Paulo Faculty of Dentistry, Ribeirão Preto, São Paulo, Brazil
| | - Katja Nelson
- Professor, Department of Oral and Craniomaxillofacial Surgery, University Medical Center Freiburg, Freiburg, Germany
| | - Sebastian Sauerbier
- Associate Professor, Department of Oral and Craniomaxillofacial Surgery, University Medical Center Freiburg, Freiburg, Germany
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Short-Term Evaluation of Bioactive Glass Using the Modified Osteotome Sinus Elevation Technique. IMPLANT DENT 2013; 22:491-8. [DOI: 10.1097/id.0b013e31829d1a0b] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Wildburger A, Payer M, Jakse N, Strunk D, Etchard-Liechtenstein N, Sauerbier S. Impact of autogenous concentrated bone marrow aspirate on bone regeneration after sinus floor augmentation with a bovine bone substitute--a split-mouth pilot study. Clin Oral Implants Res 2013; 25:1175-81. [PMID: 23875876 DOI: 10.1111/clr.12228] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2013] [Indexed: 12/22/2022]
Abstract
PURPOSE Mesenchymal stem cells (MSC) with biomaterials have osteoinductive potential. The aim of this study was to evaluate early bone formation in xenogenic sinus grafts in a direct comparison with and without MSCs after 3 and 6 months. Literature on bone formation in pure xenogenic graft materials after 3 months in a human model is still lacking. MATERIALS AND METHODS In a split-mouth design, seven patients with a bilateral highly atrophic posterior maxilla were included. The test side was grafted with MSCs from concentrated bone marrow aspirate admixed to the bone graft material. On the control side, pure bovine bone material was applied. Biopsies were taken navigated after 3 and 6 months. RESULTS After 3 months, new bone formation in the control group was 11.8% (SD 6.2%) and in the test group 7.4% (SD 4.1%). After 6 months, the control group showed 13.9% (SD 8.5%) of new bone and the test group 13.5% NB (SD 5.4%). The fraction of bovine bone material after 3 months was 42.6% (SD 3.5%) in the test group and 34.9% (SD 11.8%) in the control group. After 6 months, the biomaterial content was comparable at both sides (test 36.2%, SD 7.8%; control 39.5%, SD 9.3%). CONCLUSIONS There was no significant difference in new bone formation between the test and control group with n = 7. The results may be dominated by the high mineral content of the biomaterial but could nevertheless be valuable for meta-analysis in the future.
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Affiliation(s)
- Angelika Wildburger
- Department of Oral Surgery and Radiology, Medical University of Graz, Graz, Austria
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Sbordone C, Toti P, Ramaglia L, Guidetti F, Sbordone L, Martuscelli R. A 5-year clinical and computerized tomographic implant follow-up in sinus-lifted maxillae and native bone. Clin Oral Implants Res 2013; 25:1056-64. [PMID: 23822163 DOI: 10.1111/clr.12222] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The present study analysed apical and marginal bone remodelling around dental implants placed in both maxillary (sinus elevated with particulated autogenous osseous graft) and corresponding native bone areas, with a follow-up of 5 years. The clinical survival of implants was also observed. MATERIALS AND METHODS In this retrospective chart review, 27 patients were enrolled, with 55 dental implants inserted from 2000 to 2006, 26 of which were followed (one implant per patient); if required, patients were treated via sinus lift with autogenous bone and particulate technique. The internal controls were implants positioned in native areas beneath the sinus. Radiologic survey was assessed via computerized tomographic analysis measuring apical bone level (ABL) and marginal bone level (MBL), at 1- (T1 ), 3- (T2 ) and 5 years (T3 ), around implants (buccal, b; palatal, p; mesial, m; and distal sides, d). Clinical probing depth (CPD) and clinical attachment level (CAL) for all the four peri-implant aspects were measured. Cumulative survival rate (CSR) and survival rate (SR) of implants were calculated. Significances for paired and unpaired comparisons were searched for. RESULTS A significant degree of apical resorption was recorded between T1 and T3 for the mesial particulate group; again, a significant difference was discovered between the native and particulate procedures for mABL. A further feature was discovered for the particulate procedure, for which ABLs resulted negative at least for three of the aspects. Regarding MBL measurements, similar behaviours were revealed using time-comparison analysis for the two procedures at the buccal aspect. Comparisons among diameters, irrespective of the procedure, showed that resorption times for the bMBL were shorter as the diameter of the implant became wider. The implant CSR was 92% in native areas (two failures/25 implants) and 93.3% in sinuses lifted with particulate bone (two failures/30 implants). CONCLUSIONS The results suggest that a protrusion of the implant apices into augmented sinus lift occurred, whereas the bone remodelling of the coronal areas was not influenced by the events in the maxillary sinus. A diameter ranging from 4 to 5 mm might better guarantee a conservation of marginal peri-implant bone level compared with implants with smaller diameters.
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Affiliation(s)
- Carolina Sbordone
- Maxillo-Facial Surgery, School of Medicine, University of Naples "Federico II", Napoli, Italy
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