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Tröltzsch M. Epidemiology of Odontogenic Sinusitis. Otolaryngol Clin North Am 2024:S0030-6665(24)00098-7. [PMID: 39142997 DOI: 10.1016/j.otc.2024.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/16/2024]
Abstract
Odontogenic sinusitis (ODS) is more common than historically thought, representing 25% to 40% of all maxillary sinusitis. Due to a lack of widely accepted diagnostic criteria and a specific international diagnostic code, a true overall prevalence is unknown. ODS may be caused by either a multitude of infectious dental pathologies or complications after dental procedures. The most common dental etiologies causing ODS are apical periodontitis (endodontic) and oroantral communication or fistula after dental extraction. Less commonly, ODS can evolve after dental implant or maxillary sinus bone grafting surgeries, infection of odontogenic cysts, or advanced periodontitis.
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Affiliation(s)
- Matthias Tröltzsch
- Center for Oral, Maxillofacial and Facial Reconstructive Surgery, Maximilianstraße 5, Ansbach 91522, Germany; Department of Oral, Maxillofacial and Facial Plastic Surgery, University Hospital LMU, Lindwurmstraße 2a, Munich 80336, Germany.
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2
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Munakata M, Kataoka Y, Yamaguchi K, Sanda M. Risk Factors for Early Implant Failure and Selection of Bone Grafting Materials for Various Bone Augmentation Procedures: A Narrative Review. Bioengineering (Basel) 2024; 11:192. [PMID: 38391678 PMCID: PMC10886188 DOI: 10.3390/bioengineering11020192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 02/13/2024] [Accepted: 02/15/2024] [Indexed: 02/24/2024] Open
Abstract
Implant therapy is now an established treatment with high long-term success and survival rates. However, early implant failure, which occurs within one year of superstructure placement, occurs at a higher rate than late failure, which is represented by peri-implantitis caused by bacterial infection. Furthermore, various risk factors for early failure have been reported, including patient-related factors, such as systemic diseases, smoking, and bone quality and quantity, as well as surgery-related factors, such as surgeons' skill, osteogenesis technique, and selection of graft material, and implant-related factors, such as initial implant fixation and implant length diameter. Due to the wide variety of relevant factors reported, it is difficult to identify the cause of the problem. The purpose of this review is to discuss the risk factors associated with various types of bone augmentation which have a close causal relationship with early implant failure, and to determine the optimal bone grafting material for bone augmentation procedures to avoid early implant failure.
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Affiliation(s)
- Motohiro Munakata
- Department of Implant Dentistry, Showa University School of Dentistry, 2-1-1, Kita-senzoku, Ota-ku, Tokyo 1458515, Japan
| | - Yu Kataoka
- Department of Dental Education, Showa University School of Dentistry, 1-8-5, Hatanodai, Shinagawa-ku, Tokyo 1428555, Japan
- Department of Biomaterials and Engineering, Showa University School of Dentistry, 1-8-5, Hatanodai, Shinagawa-ku, Tokyo 1428555, Japan
| | - Kikue Yamaguchi
- Department of Implant Dentistry, Showa University School of Dentistry, 2-1-1, Kita-senzoku, Ota-ku, Tokyo 1458515, Japan
| | - Minoru Sanda
- Department of Prosthodontics, Showa University School of Dentistry, 2-1-1, Kita-senzoku, Ota-ku, Tokyo 1458515, Japan
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3
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Iușan SAL, Costache C, Lucaciu OP, Petrescu BN, Mirică IC, Toc DA, Albu S. Correlations between Dental Implant Infectious Pathologies and Maxillary Sinusitis: A Review Article. J Clin Med 2023; 12:5059. [PMID: 37568461 PMCID: PMC10419797 DOI: 10.3390/jcm12155059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 07/23/2023] [Accepted: 07/30/2023] [Indexed: 08/13/2023] Open
Abstract
(1) Background: The demands of patients for aesthetic and functional rehabilitation of edentulous areas led to the use of dental implants as therapeutic means on an increasingly large scale. This aspect determined the appearance of some infectious pathologies with a peri-implant starting point that can be complicated by various sinus diseases. The purpose of this review article is to synthesize the existing information in the specialized literature regarding the existing correlations between peri-implant and maxillary sinusitis. (2) Methods: The articles published in five databases were researched using different combinations of search terms. We selected 12 articles from the 250 found, by applying the inclusion and exclusion criteria and removing duplicates. (3) Results: We analyzed the included studies and we found that all of them reported a positive correlation between maxillary sinusitis and peri-implant infectious diseases. There are also reported other pathologies with a peri-implant infectious disease as a starting point such as abscesses, oro-antral communications, or foreign body reactions due to implant or bone graft materials migration. (4) Conclusions: This scoping review highlighted the existence of correlations between peri-implant and sinus pathology and the importance of preventing peri-implant diseases of an infectious nature to avoid the occurrence of these complications.
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Affiliation(s)
| | - Carmen Costache
- Department of Microbiology, Iuliu Hatieganu University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania
| | - Ondine Patricia Lucaciu
- Department of Oral Health, Iuliu Hatieganu University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania
| | - Bianca-Nausica Petrescu
- Department of Oral Health, Iuliu Hatieganu University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania
| | - Ioana Codruța Mirică
- Department of Oral Health, Iuliu Hatieganu University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania
| | - Dan-Alexandru Toc
- Department of Microbiology, Iuliu Hatieganu University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania
| | - Silviu Albu
- II-nd Department of Otolaryngology, Iuliu Hatieganu University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania
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Comuzzi L, Tumedei M, Piattelli A, Tartaglia G, Del Fabbro M. Radiographic Analysis of Graft Dimensional Changes in Transcrestal Maxillary Sinus Augmentation: A Retrospective Study. MATERIALS 2022; 15:ma15092964. [PMID: 35591298 PMCID: PMC9102007 DOI: 10.3390/ma15092964] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/14/2022] [Accepted: 04/15/2022] [Indexed: 01/02/2023]
Abstract
Background. The maxillary sinus lift is a popular and predictable technique associated with implant-supported rehabilitation of the severely atrophic maxilla. The aim of the present retrospective study was to investigate the effectiveness of transcrestal maxillary sinus augmentation and the graft resorption pattern using different heterologous bone substitutes. Methods. A total of 75 sinus-grafting procedures were performed and 89 implants were placed in 66 patients, 24 males and 42 females, with mean age 67.9 ± 10.64 years (range 43−84 years). Nineteen subjects were smokers. The mean follow-up period was 93.33 ± 54.71 months (range 14−240 months). Clinical and radiographical evaluations were performed. Graft height and width were measured at baseline and at the latest follow-up. Results. Mesiodistal and vertical resorption averaged 9.3 ± 20.7% (standard deviation), and 5.04 ± 9.9% of the postoperative size, respectively, considering the graft as the unit. Linear regression analysis showed that graft resorption in both the vertical and the mesiodistal dimension is independent of the follow-up time. Conversely, there was a trend for greater resorption when increasing the postoperative graft size, in both vertical (p = 0.001) and horizontal (p = 0.007) dimensions. When grouping the dimensional changes by graft particle size (only small (<300 μm) particles, combination of small and medium (>500 μm)/large (>1000 μm) particles, and only medium/large particles), there was a trend for greater resorption associated with smaller particles, but it was not significant; neither in the mesiodistal nor in the vertical dimension (p = 0.17 and p = 0.25, respectively). No implant was lost during the observation period. In conclusion, the transcrestal technique for maxillary sinus augmentation documented a high level of predictability. The low clinical morbidity and the contextual dental implant positioning is clinically useful in relation to a significant reduction of the time required for implant restoration, a consistent decrease of the number of surgical phases, and a cost-effectiveness approach for the rehabilitation. The graft resorption pattern in all cases was compatible with persistent implant protection and support.
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Affiliation(s)
- Luca Comuzzi
- Independent Researcher, San Vendemmiano, 31020 Conegliano, Italy;
| | - Margherita Tumedei
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, 20122 Milan, Italy; (M.T.); (G.T.)
| | - Adriano Piattelli
- Dental School, Saint Camillus International University for Health Sciences (Unicamillus), 00131 Rome, Italy;
- Dental School, University of Belgrade, 11000 Belgrade, Serbia
- Casa di Cura Villa Serena, 65013 Città Sant’Angelo, Italy
- Fondazione Villaserena per la Ricerca, 65013 Città Sant’Angelo, Italy
| | - Gianluca Tartaglia
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, 20122 Milan, Italy; (M.T.); (G.T.)
- IRCCS Fondazione Ca’Granda IRCCS Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, 20122 Milan, Italy; (M.T.); (G.T.)
- IRCCS Orthopedic Institute Galeazzi, Via Riccardo Galeazzi 4, 20161 Milan, Italy
- Correspondence: ; Tel.: +39-02-50319950; Fax: +39-02-50319960
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Urban IA, Ravidà A, Saleh MHA, Galli M, Lozada J, Farkasdi S, Wang HL. Long-term crestal bone changes in implants placed in augmented sinuses with minimal or moderate remaining alveolar bone: A 10-year retrospective case-series study. Clin Oral Implants Res 2020; 32:60-74. [PMID: 33222302 DOI: 10.1111/clr.13680] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 09/13/2020] [Accepted: 10/20/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVES To evaluate long-term clinical and radiographic outcomes of dental implants placed after lateral window sinus augmentation utilizing the sagittal sandwich technique. MATERIALS AND METHODS Patients treated with sinus augmentation were included in this retrospective case-series study. The surgical procedure was performed with particulate autogenous bone- and anorganic bovine bone-derived mineral (3:7 ratio). Implants were grouped based on baseline residual alveolar ridge height: group S (residual alveolar ridge height of 0.1-3.5 mm), group M (height of 3.5-7mm), and group C (native bone). Radiographs were taken at baseline (abutment installation) and annually throughout the 10-year follow-up. RESULTS A total of 86 patients (92 sinus lifts) and 209 implants were included. Ten sinus membrane perforations were recorded (11% incidence), and graft infections occurred in 3 cases (3.2% incidence). During the 10-year follow-up, 3 implants (1.4%) failed. No significant differences in the mean implant marginal bone loss (MBL) between the three groups were found after 1-, 2-, and 5-year follow-up (p > .05). At 10 years, group C exhibited more MBL than group M with a mean difference of -0.53 mm (p = .01). After 10 years, MK III implants displayed significantly more bone loss in native bone than those in augmented bone with a mean difference of 0.48 mm (p = .02). Five patients and 7 implants developed peri-implantitis with no significant differences between the groups (p = .570). CONCLUSION Implant placement after two-stage sinus grafting utilizing the sagittal sandwich technique is a relatively safe and predictable procedure with minimal complications and MBL after 10-year follow-up.
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Affiliation(s)
- Istvan A Urban
- Graduate Implant Dentistry, Loma Linda University, Loma Linda, CA, USA.,Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA.,Department of Periodontics, University of Szeged, Szeged, Hungary.,Urban Regeneration Institute, Budapest, Hungary
| | - Andrea Ravidà
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Muhammad H A Saleh
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA.,Department of Periodontics, University of Louisville School of Dentistry, Louisville, KY, USA
| | - Matthew Galli
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Jaime Lozada
- Graduate Implant Dentistry, Loma Linda University, Loma Linda, CA, USA
| | - Sandor Farkasdi
- Department of Oral Biology, Faculty of Dentistry, Semmelweis University, Budapest, Hungary
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
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Park WB, Kim YJ, Herr Y, Lim HC. Functional Endoscopic Sinus Surgery for Paranasal Sinusitis Originating From a Peri-implantitis-Triggered Infection in the Augmented Maxilla: A Case Report. J ORAL IMPLANTOL 2020; 46:423-429. [PMID: 33031546 DOI: 10.1563/aaid-joi-d-19-00381] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The aim of this case report was to report the course of treatment for advanced paranasal sinus infection triggered by peri-implantitis, managed using functional endoscopic sinus surgery (FESS), with outcomes. A nonsmoking male patient received sinus augmentation with implant placement on his left posterior maxilla 15 years ago. Possibly due to noncompliance to maintenance, peri-implantitis developed and progressed into the augmented bone area in the maxilla. Eventually, maxillary sinusitis occurred concomitantly with a spread of the infection to the other paranasal sinuses. Implant removal and intraoral debridement of inflammatory tissue were performed, but there was no resolution. Subsequently, FESS was performed, with removal of nasal polyp and sequestrum. After FESS, the patient's sinusitis resolved. Histologically, the sequestrum was composed of bone substitute particles, necrotic bone, stromal fibrosis, and a very limited cellular component. Two implants were placed on the present site, and no adverse event occurred for up to 1 year after the insertion of the final prosthesis. Peri-implantitis in the posterior maxilla can trigger maxillary sinusitis with concomitant infection to the neighboring paranasal sinuses. FESS should be considered to treat this condition.
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Affiliation(s)
- Won-Bae Park
- Department of Periodontology, School of Dentistry, Kyung Hee University, Seoul, Republic of Korea.,Private practice in periodontics and implant dentistry, Seoul, Republic of Korea
| | - Young-Jin Kim
- Nowon Eulji Medical Center, Eulji University, Daejeon, Republic of South Korea.,Private practice, Seoul, Republic of Korea
| | - Yeek Herr
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, School of Dentistry, Kyung Hee University, Seoul, Republic of Korea
| | - Hyun-Chang Lim
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, School of Dentistry, Kyung Hee University, Seoul, Republic of Korea
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Emphysema after Sinus Grafting: Importance of Patient's Information, Early Diagnosis, and Management. Case Rep Dent 2020; 2020:1525673. [PMID: 32802524 PMCID: PMC7411474 DOI: 10.1155/2020/1525673] [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: 01/13/2020] [Revised: 03/27/2020] [Accepted: 07/07/2020] [Indexed: 11/24/2022] Open
Abstract
The sinus elevation procedure is a safe and predictable technique that allows the placement of implants in atrophic posterior maxillae. However, some recommendations have to be followed by the patient to ensure reliable healing. It is particularly important to avoid inducing trauma in the region concerned and through the sinuses. This report describes a rare complication that occurred after the grafting of a sinus, which was attributed to a violent sneeze a few hours after the intervention. The diagnosis of emphysema following air entry was confirmed by the suddenness of the swelling and associated crepitation, and by the radiographic observation of a delimited radiolucent zone in the grafted sinus. The immediate diagnosis and subsequent management prevented further adverse events. This case report supports the need for complete comprehensive instruction of patients after oral surgery, swift diagnosis, and management of emphysema.
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Kuchler U, Dos Santos GM, Heimel P, Stähli A, Strauss FJ, Tangl S, Gruber R. DBBM shows no signs of resorption under inflammatory conditions. An experimental study in the mouse calvaria. Clin Oral Implants Res 2019; 31:10-17. [PMID: 31529644 PMCID: PMC7003744 DOI: 10.1111/clr.13538] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 07/18/2019] [Accepted: 09/08/2019] [Indexed: 01/12/2023]
Abstract
OBJECTIVES Deproteinized bovine bone mineral (DBBM) is not resorbable. However, the behavior of DBBM under inflammatory conditions remains unclear. Aim of the study was therefore to evaluate the resorption of DBBM under local inflammatory conditions in vivo using the calvarial osteolysis model. METHODS In thirty adult BALB/c mice, DBBM was implanted into the space between the elevated soft tissue and the calvarial bone. Inflammation was induced either by lipopolysaccharides (LPS) injection or by polyethylene particles (Ceridust) mixed with DBBM. Three modalities were randomly applied (n = 10 each): (a) DBBM alone (control), (b) DBBM + LPS, and (c) DBBM + polyethylene particles (Ceridust). Mice were euthanized on day fourteen, and each calvarium was subjected to histological and µCT analysis. Primary outcome was the size distribution of the DBBM particles. Secondary outcome was the surface erosion of the calvarial bone. RESULTS Histological and µCT analysis revealed that the size distribution and the volume of DBBM particles in the augmented site were similar between DBBM alone and the combinations with LPS or polyethylene particles. Moreover, histological evaluation showed no signs of erosions of DBBM particles under inflammatory conditions. µCT analysis and histology further revealed that LPS and the polyethylene particles, but not the DBBM alone, caused severe erosions of the calvarial bone as indicated by large voids representing the massive compensatory new immature woven bone formation on the endosteal surface. CONCLUSIONS Local calvarial bone but not the DBBM particles undergo severe resorption and subsequent new bone formation under inflammatory conditions in a mouse model.
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Affiliation(s)
- Ulrike Kuchler
- Department of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Gabriel Mulinari Dos Santos
- Department of Oral Surgery and Integrated Clinic, Universidade Estadual Paulista "Júlio de Mesquita Filho", Araçatuba Dental School, Araçatuba, Brazil.,Core Facility Hard Tissue and Biomaterial Research, Karl Donath Laboratory, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria.,Department of Oral Biology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Patrick Heimel
- Core Facility Hard Tissue and Biomaterial Research, Karl Donath Laboratory, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria.,Ludwig Boltzmann Institute for Clinical and Experimental Traumatology, Vienna, Austria.,Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Alexandra Stähli
- Department of Oral Biology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria.,Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Franz Josef Strauss
- Department of Oral Biology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria.,Department of Conservative Dentistry, School of Dentistry, University of Chile, Santiago, Chile
| | - Stefan Tangl
- Core Facility Hard Tissue and Biomaterial Research, Karl Donath Laboratory, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria.,Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Reinhard Gruber
- Department of Oral Biology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria.,Austrian Cluster for Tissue Regeneration, Vienna, Austria.,Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
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Park WB, Kang KL, Han JY. Factors influencing long-term survival rates of implants placed simultaneously with lateral maxillary sinus floor augmentation: A 6- to 20-year retrospective study. Clin Oral Implants Res 2019; 30:977-988. [PMID: 31306519 DOI: 10.1111/clr.13505] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 07/04/2019] [Accepted: 07/08/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To evaluate the long-term influence of residual bone height (RBH), sinus membrane perforation and the presence of voids on the survival of implants placed simultaneously with lateral maxillary sinus floor augmentation (MSFA). MATERIALS AND METHODS A total of 207 patients (613 implants) who underwent MSFA from 1999 to 2003 and followed up until 2018 were included in this study. RBH and marginal bone loss were assessed using a series of panoramic and periapical radiographs. Cumulative survival rates (CSR) with log-rank tests and hazard ratios of implant failure according to RBH, membrane perforation, and the presence of voids were assessed. RESULTS The overall 10-year and 20-year CSRs were 95% (95% CI: 84.95%-85.05%) and 85% (95% CI: 84.95%-85.05%), respectively. CSR was significantly higher for implants with ≥3 mm RBH (n = 260, 92.4%) than those with <3 mm RBH (n = 353, 78.8%) (p = .002). CSR of non-smoking group (n = 312, 90.0%) was higher than that of smoking group (n = 301, 77.1%) (p = .009). There was no significant difference in the hazard ratio of implant failure between the perforated membrane group (n = 245) and the non-perforated group (n = 368). In two out of 11 patients with voids, the inflammation of peri-implantitis progressed into voids, resulting in severe bone resorption. CONCLUSIONS The survival of implants placed in <3 mm of RBH, even though it showed a lower CSR, could be considered acceptable. Neither sinus membrane perforation nor the presence of voids appeared to affect implant survival as long as supportive maintenance therapy with proper oral hygiene was provided.
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Affiliation(s)
- Won-Bae Park
- Department of Periodontology, School of Dentistry, Kyung Hee University, Seoul, Korea.,Private Practice in Periodontics and Implant Dentistry, Seoul, Korea
| | - Kyung Lhi Kang
- Department of Periodontology, School of Dentistry, Kyung Hee University, Seoul, Korea
| | - Ji-Young Han
- Department of Periodontology, Division of Dentistry, College of Medicine, Hanyang University, Seoul, Korea
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Scanning Electron Microscopy Analysis and Energy Dispersion X-ray Microanalysis to Evaluate the Effects of Decontamination Chemicals and Heat Sterilization on Implant Surgical Drills: Zirconia vs. Steel. APPLIED SCIENCES-BASEL 2019. [DOI: 10.3390/app9142837] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Background: Drills are an indispensable tool for dental implant surgery. Today, there are ceramic zirconium dioxide and metal alloy drills available. Osteotomy drills are critical instruments since they come in contact with blood and saliva. Furthermore, they are reusable and should be cleaned and sterilized between uses. Depending on the material, sterilizing agents and protocols can alter the surface and sharpness of implant drills. The hypothesis is that cleaning and sterilization procedures can affect the surface structure of the drills and consequently reduce their cutting efficiency. Methods: Eighteen zirconia ceramic drills and eighteen metal alloy drills were evaluated. Within the scope of this study, the drills were not used to prepare implant sites. They were immersed for 10 min in human blood taken from volunteer subjects and then separately exposed to 50 cycles of cleansing with 6% hydrogen peroxide, cold sterilization with glutaraldehyde 2%, and autoclave heat sterilization. Scanning Electron Microscopy (SEM) and energy dispersion X-ray (EDX) microanalysis were conducted before and after each cycle and was used to evaluate the drill surfaces for alterations. Results: After exposure to the cleansing agents used in this study, alterations were seen in the steel drills compared to zirconia. Conclusions: The chemical sterilization products used in this study cause corrosion of the metal drills and reduce their sharpness. It was observed that the cycles of steam sterilization did not affect any of the drills. Zirconia drill surfaces remained stable.
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11
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Lee K, Cha J, Sanz‐Martin I, Sanz M, Jung U. A retrospective case series evaluating the outcome of implants with low primary stability. Clin Oral Implants Res 2019; 30:861-871. [DOI: 10.1111/clr.13491] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 05/06/2019] [Accepted: 05/25/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Kwan‐Joo Lee
- Department of Periodontology, Research Institute for Periodontal Regeneration Yonsei University College of Dentistry Seoul Korea
| | - Jae‐Kook Cha
- Department of Periodontology, Research Institute for Periodontal Regeneration Yonsei University College of Dentistry Seoul Korea
| | - Ignacio Sanz‐Martin
- Section of Periodontology, Faculty of Odontology University Complutense of Madrid Madrid Spain
| | - Mariano Sanz
- Section of Periodontology, Faculty of Odontology University Complutense of Madrid Madrid Spain
| | - Ui‐Won Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration Yonsei University College of Dentistry Seoul Korea
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12
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Scarano A, de Oliveira PS, Traini T, Lorusso F. Sinus Membrane Elevation with Heterologous Cortical Lamina: A Randomized Study of a New Surgical Technique for Maxillary Sinus Floor Augmentation without Bone Graft. MATERIALS 2018; 11:ma11081457. [PMID: 30126102 PMCID: PMC6119994 DOI: 10.3390/ma11081457] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 08/08/2018] [Accepted: 08/14/2018] [Indexed: 12/13/2022]
Abstract
Background: The aim of this randomized controlled clinical trial was to compare the efficacy of two different techniques for maxillary sinus augmentation using a lateral window approach: Heterologous cortical lamina without any grafting material versus 100% collagenated granular collagen porcine bone. Methods: Twenty-three healthy patients with not relevant past medical history (14 women and 9 men, non-smokers, mean age 52 years, range 48–65 years) were included. In Group I, the sinus was filled with collagen porcine bone (Geno-os, OsteoBiol, Turin, Italy) and a collagen membrane (Evolution, OsteoBiol, Turin, Italy) was used to close the lateral window of the sinus. In Group II, the sinus was treated with heterologous cortical lamina only (Lamina, OsteoBiol, Turin, Italy). Results: There was a statistically significant difference in the surgical time required to complete the augmentation procedures: 18.3 ± 2.1 min for lamina treated sites versus 12.5 ± 3.1 min for porcine bone treated sites. In Group I, the mean volume of the graft was 3101 ± 321 mm3 in the immediate postoperative examination (5–7 days), while after a six-month healing period it was 2716.7 ± 432 mm3. Conclusion: This study demonstrates that the use of heterologous cortical lamina is a valid technique for the mechanical support of sinus membranes resulting in only bone tissue formation and not mixed with the graft. The graft material was biocompatible and not completely resorbed after six months, although the remains were integrated into the bone.
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Affiliation(s)
- Antonio Scarano
- Department of Medical, Oral and Biotechnological Sciences and CeSi-Met, 'G. D'Annunzio' University of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy.
| | - Pablo Santos de Oliveira
- Department of Oral Implantology, Dental Research Division, College Ingà, UNINGÁ, Cachoeiro de Itapemirim, 29312 Espirito Santo, Brazil.
| | - Tonino Traini
- Department of Medical, Oral and Biotechnological Sciences and CeSi-Met, 'G. D'Annunzio' University of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy.
| | - Felice Lorusso
- Department of Medical, Oral and Biotechnological Sciences University of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy.
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Scarano A, Lorusso F, Staiti G, Sinjari B, Tampieri A, Mortellaro C. Sinus Augmentation with Biomimetic Nanostructured Matrix: Tomographic, Radiological, Histological and Histomorphometrical Results after 6 Months in Humans. Front Physiol 2017; 8:565. [PMID: 28824459 PMCID: PMC5541018 DOI: 10.3389/fphys.2017.00565] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 07/20/2017] [Indexed: 12/31/2022] Open
Abstract
Background: Many bone substitutes have been applied for sinus regeneration procedures, such as autogenous bone, inorganic bovine bone, porous and resorbable hydroxyapatite, tricalcium phosphate, bioactive glass, and blood clots. The aim of the present study was a tomographic, histological and histomorphometrical evaluation in humans, of specimens retrieved from sinuses augmented with MgHA/collagen-based scaffolds, after a healing period of 6 months. Materials and Methods: Eleven healthy patients and a total of 15 sinuses were included in this study. The maxillary sinuses were filled with commercial MgHA/collagen-based scaffolds (RegenOss) with a porous three-dimensional (3D) structure (Fin-Ceramica Faenza S.p.A., Faenza, Italy). These grafts have a composite design, that replicate the organization of bone structure, obtained by a technique in which a specific hybrid organic–inorganic composite is spontaneously built by a biological mechanism. The CBCT scans were done before the procedure, after the surgical protocol (T1), and 6 months after sinus surgery (T2) for implantology. Bone specimens were stored in 10% formalin solution, embedded in a glycolmethacrylate resin and sectioned by a high-precision diamond disc. Histologic and histomorphometric analysis were carried out to evaluate the graft reabsorption and bone healing. Results: The mean volume after graft elevation, calculated for each of the 15 sinuses, was 2,906 mm3 in the immediate postoperative period (5–7 days), ranging from 2,148.8 to 3,146.4 mm3. In the late postoperative period (6 months) it was 2,806.7 mm3, ranging from 2,010.9 to 3,008.9 mm3. The sinuses were completely healed and no residual MgHA/collagen-based scaffolds were visible. Osteoblasts appeared actively secreting bone matrix and marrow spaces contained moderate numbers of stromal cells and vascular network. Osteoblasts were observed actively secreting osteoid matrix. The tissues present in the samples were composed of 1.9 ± 1.9% of lamellar bone, 36 ± 1% of woven bone and 58 ± 3.8% of marrow spaces. Conclusion: Mg-MgHA/collagen-based scaffolds can successfully be used for sinus augmentation procedures.
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Affiliation(s)
- Antonio Scarano
- Department of Medical, Oral and Biotechnological Sciences and CeSi-MeT, University of Chieti-PescaraChieti, Italy
| | - Felice Lorusso
- Department of Medical, Oral and Biotechnological Sciences and CeSi-MeT, University of Chieti-PescaraChieti, Italy
| | | | - Bruna Sinjari
- Department of Medical, Oral and Biotechnological Sciences and CeSi-MeT, University of Chieti-PescaraChieti, Italy
| | - Anna Tampieri
- Bioceramics and Bio-hybrid Composites Senior Affiliated Member Methodist Hospital Research InstituteHouston, TX, United States
| | - Carmen Mortellaro
- Department of Health Sciences Oral Surgery Unit, University of Eastern PiedmontNovara, Italy
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Unusual Etiology and Diagnosis of Oroantral Communication due to Late Implant Failure. Case Rep Dent 2017; 2017:2595036. [PMID: 29109871 PMCID: PMC5646311 DOI: 10.1155/2017/2595036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 08/19/2017] [Accepted: 08/24/2017] [Indexed: 11/17/2022] Open
Abstract
Oroantral communication (OAC) rarely occurs long after implant placement. The present report describes the rare etiology and the difficulty of the diagnosis of an uncommon OAC occurring 10 years after the implant placement in the posterior maxilla. The difficulty of the diagnosis lies in the absence of clinical symptoms of sinusitis and presence of multiunit prosthesis hiding implant failure. This case report supports the need for sinus check-up during a routine implant examination.
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