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Liu Y, Lan D, Gao J, Deng C, Man Y. Guided bone regeneration for peri-implant augmentation: A retrospective study comparing two surgical techniques with a mean follow-up of 26 months. Clin Oral Implants Res 2024; 35:573-584. [PMID: 38467593 DOI: 10.1111/clr.14254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 01/31/2024] [Accepted: 02/24/2024] [Indexed: 03/13/2024]
Abstract
OBJECTIVES To introduce a modified guided bone regeneration (GBR) technique using intact periosteum and deproteinized bovine bone mineral (DBBM) for peri-implant augmentation and compare the clinical outcomes with those of conventional GBR. MATERIALS AND METHODS Patients who received peri-implant augmentation in posterior sites between 2015 and 2021 were reviewed in this study. Group A was treated with a modified GBR technique, and Group B was treated with conventional GBR. For group comparison, propensity score matching was performed with a sensitivity analysis. The implant survival rate, dimensional changes in hard tissue, marginal bone loss (MBL), and peri-implant parameters were evaluated. RESULTS In total, 114 implants from 98 patients were included. The implant survival rates were 95.74% in Group A and 95.00% in Group B during the follow-up period. At 6 months, the median horizontal thickness was recorded at 0.87 mm (IQ1-IQ3 = 0.00-1.75 mm) in Group A, exhibiting a relatively lower value compared to the corresponding measurement of 0.98 mm (IQ1-IQ3 = 0.00-1.89 mm) in Group B (p = .937). Vertical height displayed no statistically significant intergroup difference between the two groups (p = .758). The mean follow-up period was 25.83 ± 12.93 months after loading in Group A and 27.47 ± 21.29 months in Group B (p = .761). MBL and peri-implant parameters were comparable between the two groups. CONCLUSIONS Within the limitations of this study, the modified GBR technique using intact periosteum and DBBM grafting might be a viable alternative to correct bone defects around implants in molar and premolar sites.
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Affiliation(s)
- Yeyu Liu
- Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
- Department of Oral Implantology, The Affiliated Stomatological Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Dongping Lan
- Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Jiayu Gao
- Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Chen Deng
- Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Yi Man
- Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
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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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Yano M, Yasui K, Jo JI, Nishiura A, Hashimoto Y, Matsumoto N. Carbonate apatite versus β-tricalcium phosphate for rat vertical bone augmentation: A comparison of bioresorbable bone substitutes using polytetrafluoroethylene tubes. Dent Mater J 2023; 42:851-859. [PMID: 37853644 DOI: 10.4012/dmj.2023-112] [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] [Indexed: 10/20/2023]
Abstract
This study radiologically and histologically compared two bioresorbable bone substitutes with different compositions carbonate apatite (Cytrans® Granules; CGs) and β-tricalcium phosphate (β-TCP) for vertical bone augmentation on a rat skull using a polytetrafluoroethylene (PTFE) tubes. This PTFE tube was placed at the center of the skull, fixed with Super Bond, and augmented with CGs or β-TCP granules. Specimens with surrounding tissue were harvested at 4, 8, and 12 weeks postoperatively, and radiological and histological evaluations were performed. The bone volume to total volume ratio (BV/TV) of the β-TCP-implanted group was markedly higher than that of the CG-implanted group at 4 and 12 weeks postoperatively. Compared to CGs, β-TCP exhibited the ability to form blood vessels into the graft material for a short period after transplantation, as well as an elevated production of collagen into β-TCP granules during the bone formation process.
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Affiliation(s)
- Makiko Yano
- Department of Orthodontics, Osaka Dental University
| | | | | | - Aki Nishiura
- Department of Orthodontics, Osaka Dental University
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Zhou Y, Jiang R, Zeng J, Chen Y, Ren J, Chen S, Nie E. Transcriptome analysis of osteogenic differentiation of human maxillary sinus mesenchymal stem cells using RNA-Seq. Heliyon 2023; 9:e20305. [PMID: 37800070 PMCID: PMC10550513 DOI: 10.1016/j.heliyon.2023.e20305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 09/09/2023] [Accepted: 09/18/2023] [Indexed: 10/07/2023] Open
Abstract
Recent studies have demonstrated that human maxillary sinus mesenchymal stem cells (hMSMSCs) have osteogenic potential and can be osteogenically induced. Here, we investigated pivotal molecular functions and candidates that contribute to the osteogenic differentiation of hMSMSCs. Human maxillary sinus membranes were harvested from 3 patients with jaw deformities. hMSMSCs from human maxillary sinus membranes were osteogenically induced for 0 or 21 days. Subsequently, their functional profiles were analysed by RNA sequencing and validated by quantitative PCR. Compared with control hMSMSCs, osteogenically induced hMSMSCs showed (1) osteogenic differentiation phenotype, as evidenced by the cell nodes, alizarin red staining, osteogenesis-related protein, and RNA expression; (2) accelerated osteogenic process of ossification and calcium signalling, as demonstrated by Gene Ontology (GO) terms and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway; (3) enriched osteogenesis gene expression of SMOC2, OMD, IGF1, JUNB, BMP5, ADRA1A, and IGF2, which was validated by quantitative PCR. Based on by these results, we demonstrated that accelerated ossification process, calcium signalling, and upregulation of SMOC2, OMD, IGF1, JUNB, BMP5, ADRA1A and IGF2, may contribute to the osteogenic differentiation of hMSMSCs.
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Affiliation(s)
- Yutao Zhou
- Department of Stomatology, Panyu Central Hospital, Guangzhou, China
| | - Rui Jiang
- Department of Stomatology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jindi Zeng
- Department of Stomatology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yu Chen
- Department of Stomatology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jing Ren
- Department of Stomatology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Songling Chen
- Department of Stomatology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Ermin Nie
- Department of Stomatology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
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Hu YK, Qian WT, Xu GZ, Zou DH, Yang C. A Study of Two Novel Techniques for One-stage Closure of Chronic Oroantral Fistula and Sinus Floor Lift. J Craniofac Surg 2023; 34:1799-1803. [PMID: 37253250 PMCID: PMC10445622 DOI: 10.1097/scs.0000000000009362] [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: 12/11/2022] [Accepted: 01/17/2023] [Indexed: 06/01/2023] Open
Abstract
PURPOSE This study aimed to compare two novel techniques for chronic oroantral fistula (OAF) closure combined with maxillary sinus floor elevation. MATERIALS AND METHODS Ten patients who had implant installation needs but suffered from a chronic OAF were enrolled in the study from January 2016 to June 2021. The technique applied involved OAF closure and simultaneous sinus floor elevation by either a transalveolar or lateral window approach. Bone graft material evaluation results, postoperative clinical symptoms and complications were compared between the two groups. Student's t -test and χ 2 test were used to analyze the results. RESULTS In this study, 5 patients with a chronic OAF were treated with the transalveolar approach (group I), and 5 were treated with the lateral window approach (group II). The alveolar bone height was significantly higher in group II than in group I ( P <0.001). The pain at 1 day ( P =0.018) and 3 days ( P =0.029) postoperatively and facial swelling at 7 days ( P =0.016) postoperatively were obviously greater in group II than in group I. There were no severe complications in either group. CONCLUSIONS The techniques combined OAF closure with sinus lifting to reduce surgical frequency and risks. The transalveolar approach resulted in milder postoperative reactions, but the lateral approach could provide more bone volume.
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Khijmatgar S, Del Fabbro M, Tumedei M, Testori T, Cenzato N, Tartaglia GM. Residual Bone Height and New Bone Formation after Maxillary Sinus Augmentation Procedure Using Biomaterials: A Network Meta-Analysis of Clinical Trials. MATERIALS (BASEL, SWITZERLAND) 2023; 16:1376. [PMID: 36837005 PMCID: PMC9962504 DOI: 10.3390/ma16041376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 01/26/2023] [Accepted: 02/02/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Different factors may affect new bone formation following maxillary sinus floor augmentation for the rehabilitation of posterior edentulous maxilla. The purpose of this study was to determine the influence of residual bone height (RBH) on new bone formation after lateral sinus augmentation utilizing different biomaterials, through a network meta-analysis (NMA). METHODS PUBMED, Scopus, and Web of Science electronic databases were searched until 31 December 2022 to obtain relevant articles. A hand search was also conducted. Randomised controlled studies on maxillary sinus augmentation comparing different grafting materials in patients with atrophic posterior maxilla, in need of prosthetic rehabilitation, were included. The risk of bias was assessed following the guidelines of the Cochrane Collaboration. The primary outcome was new bone formation (NBF), assessed histomorphometrically. The statistical analysis was performed by splitting the data according to RBH (<4 mm and ≥4 mm). RESULTS A total of 67 studies were eligible for conducting NMA. Overall, in the included studies, 1955 patients were treated and 2405 sinus augmentation procedures were performed. The biomaterials used were grouped into: autogenous bone (Auto), xenografts (XG), allografts (AG), alloplasts (AP), bioactive agents (Bio), hyaluronic acid (HA), and combinations of these. An inconsistency factor (IF) seen in the entire loop of the XG, AP, and Bio+AP was found to be statistically significant. The highest-ranked biomaterials for the <4 mm RBH outcome were XG+AG, XG+AP, and Auto. Similarly, the surface under the cumulative ranking curve (SUCRA) of biomaterials for ≥4 mm RBH was Auto, Bio+XG, and XG+Auto. CONCLUSION There is no grafting biomaterial that is consistently performing better than others. The performance of the materials in terms of NBF may depend on the RBH. While choosing a biomaterial, practitioners should consider both patient-specific aspects and sinus clinical characteristics.
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Affiliation(s)
- Shahnavaz Khijmatgar
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
- Department of Oral Biology and Genomic Studies, AB Shetty Memorial Institute of Dental Sciences, Nitte (Deemed to be University), Mangalore 575018, Karnataka, India
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Margherita Tumedei
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Tiziano Testori
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
- Department of Implantology and Oral Rehabilitation, Dental Clinic, IRCCS Ospedale Galeazzi-Sant’Ambrogio, 20157 Milan, Italy
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI 48109, USA
| | - Niccolò Cenzato
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Gianluca Martino Tartaglia
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
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7
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Wang X, Sun L, Wang L, Shi S, Zhang S, Song Y. Predictors of peri-implant bone remodeling outcomes after the osteotome sinus floor elevation: a retrospective study. BMC Oral Health 2022; 22:622. [PMID: 36539789 PMCID: PMC9764540 DOI: 10.1186/s12903-022-02592-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 11/14/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND This study aimed to evaluate the radiographic outcomes of implants after osteotome sinus floor elevation (OSFE), and further identify the separate predictors for these radiographic outcomes. METHODS In this retrospective cohort study, a total of 187 implants were inserted into 138 patients using the OSFE technique. Seventy-four patients in the grafted group, and 64 patients in the non-grafted group completed this study. The vertical bone gain (VBG) and marginal bone loss (MBL) at 3 years following surgery were assessed as outcome variables. Based on extensive literature results, variables considered potential predictors of outcome variables included sex, age, tooth position, implant length, implant diameter, with or without grafting materials, residual bone height, sinus width, bone density, and sinus membrane thickness. Subsequently, the binary logistic regression analysis was applied with VBG and MBL as dependent variables, respectively. The receiver operating characteristic curve (ROC) with its area under the curve (AUC) was performed to further determine the predictive value of these predictors. RESULTS One hundred and six implants in grafted group and 81 implants in the non-grafted group were analyzed. The average VBG was 2.12 ± 1.94 mm for the grafted group and 0.44 ± 1.01 mm for the non-grafted group at 3 years (P < 0.05). The mean MBL was 1.54 ± 1.42 mm for the grafted group and 1.13 ± 1.69 mm for the non-grafted group at 3 years (P > 0.05). After the adjustment for confounders, logistic regression analysis demonstrated that implant length, grafting, residual bone height, and sinus membrane thickness were predictors of VBG. The odds ratio for VBG was 3.90, 4.04, 4.13 and 2.62, respectively. Furthermore, grafting exhibited the largest AUC at 0.80. While tooth position and implant length were predictors of MBL, the odds ratio for MBL was 3.27 and 7.85, respectively. Meanwhile, implant length exhibited the largest AUC at 0.72. CONCLUSIONS OSFE with or without simultaneous grafting materials both showed predictable clinical outcomes. Additionally, the present study is the first quantitative and significant verification that VBG has a significant association with sinus membrane thickness, as well as residual bone height, implant length and grafting. Whereas tooth position and implant length are markedly associated with MBL.
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Affiliation(s)
- Xingxing Wang
- grid.233520.50000 0004 1761 4404State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Oral Implants, School of Stomatology, The Fourth Military Medical University, Xi’an, 710032 Shaanxi People’s Republic of China
| | - Lijuan Sun
- grid.233520.50000 0004 1761 4404State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Periodontology, School of Stomatology, The Fourth Military Medical University, Xi’an, 710032 Shaanxi People’s Republic of China
| | - Lei Wang
- grid.43169.390000 0001 0599 1243Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi’an Jiaotong University, Xi’an, 710004 Shaanxi People’s Republic of China
| | - Shaojie Shi
- 920th Hospital of Joint Logistics Support Force, Kunming, People’s Republic of China
| | - Sijia Zhang
- grid.233520.50000 0004 1761 4404State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Oral Implants, School of Stomatology, The Fourth Military Medical University, Xi’an, 710032 Shaanxi People’s Republic of China
| | - Yingliang Song
- grid.233520.50000 0004 1761 4404State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Oral Implants, School of Stomatology, The Fourth Military Medical University, Xi’an, 710032 Shaanxi People’s Republic of China
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Ren J, Geng N, Xia Y, Zhou Y, Tan J, Peng W, Chen S. A comparative study of the morphology and molecular biology between the Schneiderian membrane and palatine mucoperiosteum. Tissue Cell 2022; 79:101948. [DOI: 10.1016/j.tice.2022.101948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 09/22/2022] [Accepted: 09/23/2022] [Indexed: 11/29/2022]
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Costa MM, Botticelli D, Moses O, Omori Y, Fujiwara S, Silva ER, Xavier SP. Maxillary Sinus Augmentation Using Ceramic Alloplastic Granules or Paste: An Experimental Study in Rabbits. Dent J (Basel) 2021; 9:65. [PMID: 34205201 PMCID: PMC8226577 DOI: 10.3390/dj9060065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 05/26/2021] [Accepted: 05/28/2021] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Due to the lack of data comparing the biological behavior of two formulations, granules and paste, of alloplastic graft from microtomographic and histomorphometric points of view, the aim of the present experiment was to compare the histomorphometric and microtomographic healing of two formulations, i.e., granules (MR sites) or paste (MR-inject sites) of an alloplastic graft composed of a combination of beta-tricalcium phosphate and hydroxyapatite used for maxillary sinus lifting. METHODS A sinus lifting procedure was carried out bilaterally in 20 rabbits, and the elevated space was filled with either paste or granules of an alloplastic material. A collagen membrane was placed on the antrostomy and the animals were euthanized after 2 or 10 weeks, 10 animals each group. Microtomographic and histological analyses were performed. RESULTS Higher proportions of new bone formation were found at the MR, compared to the MR-inject sites both after 2 weeks (2.65 ± 2.89% vs. 0.08 ± 0.12%; p < 0.01) and 10 weeks of healing (34.20 ± 13.86 vs. 23.28 ± 10.35%; p = 0.022). CONCLUSIONS It was concluded that new bone formation was faster in the MR sites, compared to the MR-inject. However, a longer time of healing should be allowed to make final conclusions about the efficiency in bone formation of the paste formulation of the biomaterial used in the present study.
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Affiliation(s)
- Michael Medeiros Costa
- Department of Oral and Maxillofacial Surgery and Periodontology, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo 14040-904, Brazil; (M.M.C.); (E.R.S.); (S.P.X.)
| | | | - Ofer Moses
- Department of Periodontology and Dental Implantology, School of Dental Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Yuki Omori
- ARDEC Academy, 47923 Rimini, Italy; (D.B.); (Y.O.); (S.F.)
- Department of Oral Implantology, Osaka Dental University, Osaka 573-1144, Japan
| | | | - Erick Ricardo Silva
- Department of Oral and Maxillofacial Surgery and Periodontology, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo 14040-904, Brazil; (M.M.C.); (E.R.S.); (S.P.X.)
| | - Samuel Porfirio Xavier
- Department of Oral and Maxillofacial Surgery and Periodontology, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo 14040-904, Brazil; (M.M.C.); (E.R.S.); (S.P.X.)
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10
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Yu Y, Jiang Q, Zhang Z, Yu X, Deng F. Influence of implant protrusion length on non-grafting osteotome sinus floor elevation with simultaneous implant: a 3- to 9-year retrospective study. Int J Implant Dent 2021; 7:22. [PMID: 33763742 PMCID: PMC7991057 DOI: 10.1186/s40729-021-00304-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 02/12/2021] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND This study analyzed the influence of implant protrusion length (IPL) on the possible factors that affect the long-term outcomes utilizing non-grafting osteotome sinus floor elevation (OSFE) with simultaneous implant placement, and to explore the optimal range of IPL. MATERIALS AND METHODS A retrospective study design was adopted. The clinical and radiographic data of 105 implants in 65 patients were collected after 3-9 (mean 5.04) years follow-up. IPL was divided into three groups (group1, IPL<2mm; group2, 2mm≤IPL<4mm; group3, IPL≥4mm). Endo-sinus bone gain (ESBG), peri-implant marginal bone loss (MBL), bone to implant contact length (BICL), and percentage of ESBG (%ESBG) were used to evaluate non-grafting OSFE. A Kaplan-Meier analysis was performed to assess the cumulative survival rate. Multiple linear regression model was used to explore the relationship between the possible influence factors and ESBG. Analysis of variance (ANOVA) was applied to explore the correlation of IPL with ESBG, MBL, BICL, and %ESBG. RESULTS A total of 102 implants in 62 patients fulfilled the survival criteria, giving the cumulative survival rates of 96.4% and 94.1% for implant-based analysis and patient-based analysis, respectively. The mean ESBG, MBL, and BICL at the latest follow-up were 1.95±0.88 mm, 0.58±0.68 mm, and 5.51±1.47 mm. ESBG was found to be positively correlated to IPL. A significant decreased bone formation efficiency was found when IPL was over 4 mm (P=0.02). CONCLUSIONS An optimal range of IPL within 4 mm was recommended for better long-term outcomes when applying non-grafting OSFE with simultaneous implant placement.
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Affiliation(s)
- Yi Yu
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, People's Republic of China.,Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Qiming Jiang
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, People's Republic of China.,Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Zhengchuan Zhang
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, People's Republic of China.,Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Xiaolin Yu
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, People's Republic of China. .,Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, People's Republic of China.
| | - Feilong Deng
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, People's Republic of China. .,Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, People's Republic of China.
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11
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Pignaton TB, Spin-Neto R, Ferreira CEDA, Martinelli CB, de Oliveira GJPL, Marcantonio E. Remodelling of sinus bone grafts according to the distance from the native bone: A histomorphometric analysis. Clin Oral Implants Res 2020; 31:959-967. [PMID: 32716570 DOI: 10.1111/clr.13639] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 07/16/2020] [Accepted: 07/19/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVES To evaluate graft remodelling according to the distance from the native bone in maxillary sinuses grafted with anorganic bovine bone (ABB). MATERIAL AND METHODS Bilateral sinus grafting was performed in twenty patients with residual bone height <5 mm before implant placement. After 8 months, biopsy samples were harvested, and histomorphometric analysis was performed to examine bone formation according to the distance (in mm) from the native bone (sinus floor). In the grafted area, the percentages of new bone (NB), residual graft material (rABB), and soft tissue (ST) were evaluated. RESULTS A total of 103 biopsy samples were evaluated, and the percentages of NB, rABB, and ST were 31.62 ± 9.85%, 18.94 ± 7.88%, and 49.41 ± 9.52%, respectively, in the 1st mm; 27.15 ± 9.83%, 23.33 ± 9.45%, and 49.53 ± 11.73%, respectively, in the 2nd mm; 23.61 ± 13.02%, 21.35 ± 11.08%, and 55.03 ± 16.14%, respectively, in the 3rd mm; and 21.67 ± 12.29%, 19.67 ± 10.28%, and 58.66 ± 12.46%, respectively, in the 4th mm. The 1st millimetre of the grafted area (closer to the native bone) presented a larger amount of NB than the other portions of the grafted areas and a smaller amount of rABB than the 2nd mm of the grafted area (p < .05). The amount of ST was larger in the 3rd and 4th mm of the grafted area than in the first 2 millimetres (p < .05). CONCLUSION The distance from the native bone influences bone formation following maxillary sinus augmentation.
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Affiliation(s)
- Tulio Bonna Pignaton
- Department of Diagnosis and Surgery, Araraquara Dental School, UNESP, Araraquara, Brazil
| | - Rubens Spin-Neto
- Section of Oral Radiology, School of Dentistry,, Aarhus University, Aarhus, Denmark
| | | | | | | | - Elcio Marcantonio
- Department of Diagnosis and Surgery, Araraquara Dental School, UNESP, Araraquara, Brazil
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12
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Beck F, Reich KM, Lettner S, Heimel P, Tangl S, Redl H, Ulm C. The vertical course of bone regeneration in maxillary sinus floor augmentations: A histomorphometric analysis of human biopsies. J Periodontol 2020; 92:263-272. [PMID: 32715479 PMCID: PMC7984041 DOI: 10.1002/jper.19-0656] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Revised: 04/09/2020] [Accepted: 04/26/2020] [Indexed: 11/07/2022]
Abstract
Background Maxillary sinus floor augmentation (MSFA) is a well‐established and predictable augmentation method in severely resorbed maxillae. However, data on the vertical course of bone graft consolidation within the maxillary sinus are rare. The aim of the present study was to quantify the vertical distribution of new bone formation (nBF) in MSFA and to characterize the vertical gradient of bone graft consolidation. Methods Eighty‐five human sinus biopsies were harvested 6 ± 1 months after MSFA. Histological thin‐ground sections were prepared and histomorphometrically analyzed. The volume of newly formed bone (nBV/TV) was measured in serial zones of 100 μm proceeding from the bottom of the sinus floor (SF) up to the apical top of the biopsy. The gradient of nBV/TV within the augmentation area was determined by the vertical distribution of nBV/TV along these zones. Results In the premolar region, nBV/TV slightly declined from 20.4% in the zone adjacent to the SF to 17.7% at a distance of 8 mm. The gradient was steeper in the molar region: nBV/TV decreased from 18.7% to 12.8%. This decline was even more distinct when the volume fraction and the height of the residual bone of the SF were low. Conclusions nBF follows a gradient from native bone of the SF towards the apical part of the augmentation area. The distance to primordial bone thus plays a critical role for bone regeneration in MSFA, particularly in the molar region.
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Affiliation(s)
- Florian Beck
- Division of Oral SurgeryUniversity Clinic of Dentistry, Medical University of ViennaViennaAustria
| | - Karoline Maria Reich
- Karl Donath Laboratory for Hard Tissue and Biomaterial ResearchDivision of Oral SurgeryUniversity Clinic of Dentistry, Medical University of ViennaViennaAustria
- Austrian Cluster for Tissue RegenerationViennaAustria
| | - Stefan Lettner
- Karl Donath Laboratory for Hard Tissue and Biomaterial ResearchDivision of Oral SurgeryUniversity Clinic of Dentistry, Medical University of ViennaViennaAustria
- Austrian Cluster for Tissue RegenerationViennaAustria
| | - Patrick Heimel
- Karl Donath Laboratory for Hard Tissue and Biomaterial ResearchDivision of Oral SurgeryUniversity Clinic of Dentistry, Medical University of ViennaViennaAustria
- Austrian Cluster for Tissue RegenerationViennaAustria
| | - Stefan Tangl
- Karl Donath Laboratory for Hard Tissue and Biomaterial ResearchDivision of Oral SurgeryUniversity Clinic of Dentistry, Medical University of ViennaViennaAustria
- Austrian Cluster for Tissue RegenerationViennaAustria
| | - Heinz Redl
- Austrian Cluster for Tissue RegenerationViennaAustria
- Ludwig Boltzmann Institute for Experimental and Clinical TraumatologyAUVA Research CentreViennaAustria
| | - Christian Ulm
- Division of Oral SurgeryUniversity Clinic of Dentistry, Medical University of ViennaViennaAustria
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13
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Mu Z, Chen K, Yuan S, Li Y, Huang Y, Wang C, Zhang Y, Liu W, Luo W, Liang P, Li X, Song J, Ji P, Cheng F, Wang H, Chen T. Gelatin Nanoparticle-Injectable Platelet-Rich Fibrin Double Network Hydrogels with Local Adaptability and Bioactivity for Enhanced Osteogenesis. Adv Healthc Mater 2020; 9:e1901469. [PMID: 31994326 DOI: 10.1002/adhm.201901469] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 12/19/2019] [Indexed: 12/11/2022]
Abstract
Bone healing is a dynamic process regulated by biochemical signals such as chemokines and growth factors, and biophysical signals such as topographical and mechanical features of extracellular matrix or mechanical stimuli. Hereby, a mechanically tough and bioactive hydrogel based on autologous injectable platelet-rich fibrin (iPRF) modified with gelatin nanoparticles (GNPs) is developed. This composite hydrogel demonstrates a double network (DN) mechanism, wherein covalent network of fibrin serves to maintain material integrity, and self-assembled colloidal network of GNPs dissipates force upon loading. A rabbit sinus augmentation model is used to investigate the bioactivity and osteogenesis capacity of the DN hydrogels. The DN hydrogels adapt to the local environmental complexity of bone defects, i.e., accommodate the irregular shape of the defects and withstand the pressure formed in the maxillary sinus during animal's respiration process. The DN hydrogel is also demonstrated to absorb and prolong the release of the bioactive growth factors stemming from iPRF, which could have contributed to the early angiogenesis and osteogenesis observed inside the sinus. This adaptable and bioactive DN hydrogel can achieve enhanced bone regeneration in treating complex bone defects by maintaining long-term bone mass and withstanding the functional mechanical stimuli.
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Affiliation(s)
- Zhixiang Mu
- Laboratory of Oral Diseases and Biomedical SciencesChongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher EducationChongqing Medical University Chongqing 401147 P. R. China
| | - Kaiwen Chen
- Key State Laboratory of Fine ChemicalsSchool of BioengineeringDalian University of Technology No. 2 Linggong Road, High‐tech District Dalian 116024 P. R. China
| | - Shuai Yuan
- Laboratory of Oral Diseases and Biomedical SciencesChongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher EducationChongqing Medical University Chongqing 401147 P. R. China
| | - Yihan Li
- Laboratory of Oral Diseases and Biomedical SciencesChongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher EducationChongqing Medical University Chongqing 401147 P. R. China
| | - Yuanding Huang
- Laboratory of Oral Diseases and Biomedical SciencesChongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher EducationChongqing Medical University Chongqing 401147 P. R. China
| | - Chao Wang
- Laboratory of Oral Diseases and Biomedical SciencesChongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher EducationChongqing Medical University Chongqing 401147 P. R. China
| | - Yang Zhang
- Laboratory of Regenerative BiomaterialsDepartment of Biomedical EngineeringHealth Science CenterShenzhen University Shenzhen Guangdong Province 518037 P. R. China
| | - Wenzhao Liu
- Laboratory of Oral Diseases and Biomedical SciencesChongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher EducationChongqing Medical University Chongqing 401147 P. R. China
| | - Wenping Luo
- Laboratory of Oral Diseases and Biomedical SciencesChongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher EducationChongqing Medical University Chongqing 401147 P. R. China
| | - Panpan Liang
- Laboratory of Oral Diseases and Biomedical SciencesChongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher EducationChongqing Medical University Chongqing 401147 P. R. China
| | - Xiaodong Li
- Laboratory of Oral Diseases and Biomedical SciencesChongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher EducationChongqing Medical University Chongqing 401147 P. R. China
| | - Jinlin Song
- Laboratory of Oral Diseases and Biomedical SciencesChongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher EducationChongqing Medical University Chongqing 401147 P. R. China
| | - Ping Ji
- Laboratory of Oral Diseases and Biomedical SciencesChongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher EducationChongqing Medical University Chongqing 401147 P. R. China
| | - Fang Cheng
- Key State Laboratory of Fine ChemicalsSchool of Chemical EngineeringDalian University of Technology No. 2 Linggong Road, High‐tech District Dalian 116024 P. R. China
| | - Huanan Wang
- Key State Laboratory of Fine ChemicalsSchool of BioengineeringDalian University of Technology No. 2 Linggong Road, High‐tech District Dalian 116024 P. R. China
| | - Tao Chen
- Laboratory of Oral Diseases and Biomedical SciencesChongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher EducationChongqing Medical University Chongqing 401147 P. R. China
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14
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Evaluation of New Bone Formation in Sinus Floor Augmentation With Injectable Platelet-Rich Fibrin-Soaked Collagen Plug: A Pilot Study. IMPLANT DENT 2019; 28:220-225. [PMID: 31124818 DOI: 10.1097/id.0000000000000883] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
INTRODUCTION The objective of this study is to evaluate the new bone formation after sinus floor augmentation with collagen plugs used as carriers for injectable platelet-rich fibrin (i-PRF). MATERIALS AND METHODS Postoperative immediate and postoperative 6th month panoramic radiographies of patients treated between January 1, 2015, and February 1, 2018, with sinus floor augmentation using i-PRF-soaked collagen plugs were retrieved from the archives, and subantral bone heights of distal and mesial regions of simultaneously inserted implants were measured with a software program. Statistical analysis was performed to understand whether there is a significant change in new bone formation at 6th month follow-up control. RESULTS A total of 18 implants were inserted in 12 patients. There was significant new bone formation at 6th month follow-up radiography at mesial and distal regions of inserted implants (P < 0.05). CONCLUSION New bone was regenerated with i-PRF carried by collagen plugs in sinus floor augmentation.
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15
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Franceschetti G, Farina R, Minenna L, Riccardi O, Stacchi C, Di Raimondo R, Maietti E, Trombelli L. The impact of graft remodeling on peri-implant bone support at implants placed concomitantly with transcrestal sinus floor elevation: A multicenter, retrospective case series. Clin Oral Implants Res 2019; 31:105-120. [PMID: 31532857 DOI: 10.1111/clr.13541] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 08/08/2019] [Accepted: 09/03/2019] [Indexed: 12/16/2022]
Abstract
OBJECTIVES To evaluate the impact on peri-implant bone support (as assessed on periapical radiographs) of the remodeling dynamics of varying graft biomaterials used for transcrestal sinus floor elevation (tSFE). METHODS The study is a multicenter, retrospective series of cases undergone tSFE (performed according to the Smart Lift technique) and concomitant implant placement. At operator's discretion, tSFE was performed with bone core (BC) alone or supplemented by deproteinized bovine or porcine bone mineral (DBBM and DPBM, respectively), synthetic hydroxyapatite in a collagen matrix (S-HA), or ß-tricalcium phosphate (ß-TCP). Immediately after surgery, at 6-12 months post-surgery, and at later (≥24 months) follow-up intervals, the percentage proportion of the implant surface in direct contact with the radiopaque area was calculated for the entire implant surface (totCON%). Also, the height of the graft apical to the implant apex (aGH) was assessed. RESULTS At 6-12 months following tSFE, median totCON% was 100%, with a median aGH of 1.4 mm. A tendency of aGH to decrease in height was observed at later follow-up intervals for sites treated with all grafting procedures. In all treatment groups, the majority of the implant surface was still surrounded by the radiopaque area at the longest follow-up visits. CONCLUSIONS Although the height of the peri-implant radiopaque area apical to the implant apex tends to reduce overtime at sites which have received tSFE, the peri-implant bone support seems to be maintained long term irrespective of the graft material used.
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Affiliation(s)
- Giovanni Franceschetti
- Research Centre for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Ferrara, Italy
| | - Roberto Farina
- Research Centre for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Ferrara, Italy.,Operative Unit of Dentistry, University-Hospital of Ferrara, Ferrara, Italy
| | - Luigi Minenna
- Research Centre for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Ferrara, Italy
| | - Orio Riccardi
- Research Centre for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Ferrara, Italy.,Private practice, Rimini, Italy
| | | | | | - Elisa Maietti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy.,Center of Clinical Epidemiology, University of Ferrara, Italy
| | - Leonardo Trombelli
- Research Centre for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Ferrara, Italy.,Operative Unit of Dentistry, University-Hospital of Ferrara, Ferrara, Italy
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16
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Barbu HM, Iancu SA, Jarjour Mirea I, Mignogna MD, Samet N, Calvo-Guirado JL. Management of Schneiderian Membrane Perforations during Sinus Augmentation Procedures: A Preliminary Comparison of Two Different Approaches. J Clin Med 2019; 8:jcm8091491. [PMID: 31546766 PMCID: PMC6780245 DOI: 10.3390/jcm8091491] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Revised: 09/09/2019] [Accepted: 09/12/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The aim of this study was to retrospectively analyze two different sealing techniques for sinus membrane perforations produced during sinus floor augmentation by a lateral approach. METHODS A total of 172 lateral-approach sinus floor augmentation surgeries were performed on 130 patients. Sixty-one membrane perforations (35%) were reported. Most of the perforations were caused by accidental membrane tearing and 16 (26%) were caused by deliberate incision for mucocele removal. In 31 perforation cases (51%), the Schneiderian membrane was sealed by suturing, while the remaining 30 cases (49%) were sealed using a low-resorption collagen membrane coverage. RESULTS Out of the 31 cases treated with a suture-sealing techniques, 26 (84%) were successful, presenting graft integration. Failure occurred in the other five (16%) cases. Out of the 30 perforations sealed with low-resorption collagen membranes, 28 (93%) presented successful graft integration, while two (7%) failed. CONCLUSIONS Both surgical techniques yielded therapeutic success.
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Affiliation(s)
- Horia Mihail Barbu
- Oral Implantology Department, Titu Maiorescu University, 031593 Bucharest, Romania.
| | | | | | - Michele Davide Mignogna
- Head & Neck Clinical Section, Department of Neuroscience, Reproductive and Odontostomatological Sciences, Federico II University of Naples, 80138 Naples, Italy.
| | - Nachum Samet
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA 02115, USA.
| | - José Luis Calvo-Guirado
- Department of Oral and Implant Surgery, Universidad Católica of Murcia, 30107 Murcia, Spain.
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17
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Autologous Fibrin Glue With Collagen Carrier During Maxillary Sinus Lift Procedure. J Craniofac Surg 2019; 30:843-845. [PMID: 31048612 DOI: 10.1097/scs.0000000000005203] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
This study aimed to describe the use of autologous fibrin glue (AFG) with a collagen carrier during maxillary sinus lift procedures with immediate implants during 3 years of follow-up. Twelve patients who had lost their teeth in the region associated to maxillary sinus, with a bone remnant 3 to 5 mm in height, were selected to perform a maxillary sinus augmentation with AFG and collagen membrane, placing the implant immediately. After 5 months, the implants were connected and rehabilitated. The patients were followed-up for a 3-year period, being evaluated every 6 months. At the end of the 3-year follow-up period, 100% implant success was observed, with a mean of bone augmentation of 7.75 mm. Three maxillary sinus membranes were perforated and healed by using AFG and collagen membrane without identify any complication during the follow-up period. Finally, the use of collagen carrier combined with AFG as a filling material during the maxillary sinus lift procedure may be a low-cost and reliable alternative that allows bone formation.
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18
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Pignaton TB, Wenzel A, Ferreira CEDA, Borges Martinelli C, Oliveira GJPL, Marcantonio E, Spin-Neto R. Influence of residual bone height and sinus width on the outcome of maxillary sinus bone augmentation using anorganic bovine bone. Clin Oral Implants Res 2019; 30:315-323. [PMID: 30803035 DOI: 10.1111/clr.13417] [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: 05/02/2018] [Revised: 12/20/2018] [Accepted: 02/15/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate the influence of the posterior residual bone height and sinus width on the outcome of maxillary sinus bone augmentation using anorganic bovine bone. MATERIAL AND METHODS Bilateral sinus bone augmentation was performed using anorganic bovine bone in 20 patients with residual bone height <2 mm in at least one site on each side. Trephine samples were removed at the implant insertion site 8 months after the grafting procedure, and histological and histomorphometric analyses were performed to examine the relative amount (%) of new bone, anorganic bovine bone, and soft tissue in the grafted area. Based on cone beam computed tomography evaluation, the sites of implant insertion were classified according to sinus width into narrow, average, and wide, and according to residual bone height into ≤2 and >2 mm. RESULTS A total of 146 implants were installed and 103 biopsies were evaluated. New bone formation in sites classified as narrow (69 sites), average (19 sites), and wide (15 sites) was 28.5% ± 9.24, 28.9% ± 8.61, and 30.3% ± 7.80, respectively. The mean posterior maxillary residual bone height was 4.0 ± 2.43 mm, and 26 and 77 sites were classified as ≤2 and >2 mm, respectively. New bone formation was 26.2% ± 9.10 and 29.8% ± 8.67 for residual bone height ≤2 and >2 mm, respectively. The differences were non-significant. CONCLUSIONS Within the limitations of the present study, posterior residual bone height and sinus width were not factors with influence on new bone formation in sinuses grafted exclusively with anorganic bovine bone after 8 months of healing.
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Affiliation(s)
- Túlio Bonna Pignaton
- Department of Periodontology, UNESP - Univ. Estadual Paulista, Araraquara Dental School, Araraquara, Brazil.,Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Ann Wenzel
- Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | | | | | - Guilherme J P L Oliveira
- Department of Periodontology, UNESP - Univ. Estadual Paulista, Araraquara Dental School, Araraquara, Brazil
| | - Elcio Marcantonio
- Department of Periodontology, UNESP - Univ. Estadual Paulista, Araraquara Dental School, Araraquara, Brazil
| | - Rubens Spin-Neto
- Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
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19
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Lie N, Merten HA, Yamauchi K, Wiltfang J, Kessler P. Pre-implantological bone formation in the floor of the maxillary sinus in a self-supporting space. J Craniomaxillofac Surg 2019; 47:454-460. [PMID: 30683623 DOI: 10.1016/j.jcms.2019.01.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 11/06/2018] [Accepted: 01/04/2019] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION In edentulous patients the form and size of the maxillary sinus vary greatly. Therefore sinus floor augmentation is a standard procedure for implantological purposes. As the sinus membrane cannot be characterized as periosteum, various augmentation materials are used. HYPOTHESIS an artificially generated space underneath the sinus membrane in the floor of the sinus will lead to spontaneous callus forming and a stable bony consolidation without augmentation material. METHODS Ten edentulous patients with highly atrophic maxillae were selected. Augmentation of the sinus floor was carried out in a split-mouth study design: On one side a combination of autogenous and xenogenous bone was used, and on the contralateral side a sinus membrane elevation was performed without using any substitutes. After a 6-month interval bone specimens from the test regions were harvested during implant placement. RESULTS Clear histological evidence of new bone formation was found in all human bone specimens. An active de-novo bone formation process could be proven by the presence of Haversian systems (osteons) displaying osteoblastic and osteoclastic activity. CONCLUSION In the maxillary sinus of edentulous patients a spontaneous callus-derived de-novo bone formation is possible by elevating the sinus membrane without using augmentation materials.
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Affiliation(s)
- Nynke Lie
- Department of Cranio-Maxillofacial Surgery, (Head: Prof. Dr. P.A.W.H. Kessler), Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX, Maastricht, the Netherlands; GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX, Maastricht, the Netherlands.
| | - Hans-Albert Merten
- Department of Orthodontics Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Kensuke Yamauchi
- Department of Oral-Maxillofacial Surgery, Tohoku University, Sendai, Japan
| | - Jörg Wiltfang
- Department of Oral-Maxillofacial Surgery, University of Kiel, Arnold-Heller-Straße, D-24105, Kiel, Germany
| | - Peter Kessler
- Department of Cranio-Maxillofacial Surgery, (Head: Prof. Dr. P.A.W.H. Kessler), Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX, Maastricht, the Netherlands; GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX, Maastricht, the Netherlands
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20
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Bertl K, Mick RB, Heimel P, Gahleitner A, Stavropoulos A, Ulm C. Variation in bucco-palatal maxillary sinus width does not permit a meaningful sinus classification. Clin Oral Implants Res 2018; 29:1220-1229. [PMID: 30430654 DOI: 10.1111/clr.13387] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 10/21/2018] [Accepted: 10/30/2018] [Indexed: 12/14/2022]
Abstract
OBJECTIVES The bucco-palatal sinus width (SW) appears as relevant factor for graft consolidation after maxillary sinus (MS) floor augmentation. The present study aimed to assess (a) SW at different height levels of posterior teeth, (b) possible factors influencing SW, and (c) whether a simple/meaningful sinus classification based on SW is possible. METHODS The following parameters were recorded on computed tomographies of 76 edentulous and 86 partially edentulous maxillary quadrants displaying 383 tooth sites in total: (a) alveolar ridge height, (b) -area, (c) -width 2 mm apical to the alveolar crest, (d) -width at the sinus floor, and (e) SW and sinus area at a level 2, 4, 6, 8, and 10 mm above the sinus floor. The possible influence of gender, tooth position [i.e., premolar (PM); molar (M)], tooth-gap extent, and residual alveolar ridge dimensions on SW was assessed. Further, based on percentiles of average values or on the frequency distribution of SW <10, 10-15, or >15 mm, it was attempted to classify the sinus at each given site into narrow, average, or wide. RESULTS Gender and tooth-gap extent presented no relevant impact on MS dimensions; however, significant differences were observed among the various tooth positions regarding all evaluated parameters. The lower the residual alveolar ridge, the wider the MS at 4-10 mm height, while the wider the residual alveolar ridge, the wider the MS. Large variation in SW classes among the different height levels within the same tooth position and among tooth positions within the same person was observed, irrespective of the threshold applied. Further, at a MS height of 10 mm at PM1, PM2, M1, and M2, SW was <10 mm in 68%, 33%, 0%, and 7% of the cases, respectively, while in 3%, 21%, 65%, and 57%, respectively, SW was >15 mm. CONCLUSIONS There is a large variation in SW depending on the height level within the sinus and on tooth position, which does not permit a simple/meaningful classification of each sinus as "narrow," "average," or "wide." Nevertheless, narrow sinuses (<10 mm) are rather prevalent in the premolar region, while wide sinuses (>15 mm) in the molar region; further, a wider and shorter residual alveolar ridge is associated with a wider SW.
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Affiliation(s)
- Kristina Bertl
- Department of Periodontology, Faculty of Odontology, University of Malmö, Malmö, Sweden.,Division of Oral Surgery, School of Dentistry, Medical University of Vienna, Vienna, Austria
| | - René-Bernard Mick
- Division of Oral Surgery, School of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Patrick Heimel
- Karl Donath Laboratory for Hard Tissue and Biomaterial Research, Division of Oral Surgery, Medical University of Vienna, Vienna, Austria.,Austrian Cluster for Tissue Regeneration, Vienna, Austria.,Ludwig Boltzmann Institute for Clinical and Experimental Traumatology, Vienna, Austria
| | - André Gahleitner
- Department of Diagnostic Radiology, Division of Osteoradiology, General Hospital, Medical University of Vienna, Vienna, Austria
| | - Andreas Stavropoulos
- Department of Periodontology, Faculty of Odontology, University of Malmö, Malmö, Sweden
| | - Christian Ulm
- Division of Oral Surgery, School of Dentistry, Medical University of Vienna, Vienna, Austria
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21
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Ranaan J, Bassir SH, Andrada L, Shamshiri AR, Maksoud M, Raanan R, Guze K. Clinical efficacy of the graft free slit-window sinus floor elevation procedure: A 2-year randomized controlled clinical trial. Clin Oral Implants Res 2018; 29:1107-1119. [DOI: 10.1111/clr.13374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 08/16/2018] [Accepted: 08/28/2018] [Indexed: 12/29/2022]
Affiliation(s)
- Justin Ranaan
- Division of Periodontology, Department of Oral Medicine, Infection, and Immunity; Harvard School of Dental Medicine; Boston Massachusetts
| | - Seyed Hossein Bassir
- Division of Periodontology, Department of Oral Medicine, Infection, and Immunity; Harvard School of Dental Medicine; Boston Massachusetts
- Department of Periodontology, School of Dental Medicine; Stony Brook University; Stony Brook New York
| | - Luciano Andrada
- Division of Periodontology, Department of Oral Medicine, Infection, and Immunity; Harvard School of Dental Medicine; Boston Massachusetts
| | - Ahmad Reza Shamshiri
- Department of Epidemiology and Biostatistics, School of Public Health; Tehran University of Medical Sciences; Tehran Iran
| | - Mohamed Maksoud
- Division of Periodontology, Department of Oral Medicine, Infection, and Immunity; Harvard School of Dental Medicine; Boston Massachusetts
| | | | - Kevin Guze
- Division of Periodontology, Department of Oral Medicine, Infection, and Immunity; Harvard School of Dental Medicine; Boston Massachusetts
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22
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Multiple Perforations of the Sinus Floor During Maxillary Sinus Floor Augmentation to Provide Access to the Bone Marrow Space: A Technical Report. IMPLANT DENT 2018; 26:956-960. [PMID: 29095785 DOI: 10.1097/id.0000000000000682] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Sinus floor augmentation is a routinely used surgical technique for increasing the bone height/volume of the atrophic posterior maxilla. Optimal integration of the implanted augmentation material within the newly formed bone will-at least partly-depend on adequate vascularization to ensure sufficient recruitment of osteoblast and osteoclast precursor cells. METHODS The present technical note describes a modification intended to facilitate increased blood inflow into the augmented space. After preparation of the lateral window and elevation of the Schneiderian membrane, the cortical bone of the sinus floor is perforated several times either by using a piezoelectric device or a microsurgical handpiece with the corresponding tip or bur; these perforations should extend into the trabecular bone. RESULTS AND CONCLUSION The experiences with this modified technique after 12 patients are presented and discussed. It is expected that by means of this relatively simple technique, increased blood and cell inflow into the augmented space is achieved. This may, in turn, enhance new bone formation and improve the integration of the augmentation material.
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Bertl K, Domic D, Hirtler L, Heimel P, Esfandeyari A, Stavropoulos A, Ulm C. Micro-CT evaluation of the cortical bone micro-architecture in the anterior and posterior maxilla and the maxillary sinus floor. Clin Oral Investig 2018; 23:1453-1459. [PMID: 30112634 DOI: 10.1007/s00784-018-2573-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Accepted: 08/09/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To perform a within-subject comparison of the cortical bone micro-architecture of the maxillary sinus floor (MSF) to that of the buccal aspect of the anterior and posterior maxilla. METHODS Micro-CT scans of the buccal aspect of the anterior and posterior maxilla and of the MSF in 14 human anatomical specimens were recorded. Within-subject comparisons were performed for cortical thickness (Ct.Th) and porosity (Ct.Po), average pore volume (AvgPo.V), and pore density (Po.Dn). RESULTS The MSF presented the lowest and the anterior maxilla the highest Ct.Th, while Ct.Po was significantly higher at the MSF compared to the posterior maxilla (p = 0.021). No relevant differences were recorded for AvgPo.V and Po.Dn among regions (p > 0.067). Further, an increased Ct.Th at the MSF was significantly associated with a lower Po.Dn, while a higher Ct.Th and an increased AvgPo.V in the anterior maxilla were associated with a higher Ct.Th and an increased AvgPo.V, respectively, in the posterior maxilla and MSF. Finally, within each region, the AvgPo.V was associated positively with Ct.Po and negatively with Po.Dn. CONCLUSIONS The cortical bone of the MSF is slightly less thick and slightly more porous compared to the cortical bone at the buccal aspect of the anterior and posterior maxilla. CLINICAL RELEVANCE During lateral and vertical bone augmentation procedures, the cortical recipient bone is perforated several times to open the bone marrow compartment to facilitate provision of osteoinductive cells and molecules in the augmented space. Whether it is meaningful to approach the MSF in a similar way during MSF augmentation procedures or whether the slightly more porous structure of the MSF observed herein reduces the cortical barrier function already sufficiently has to be assessed in future clinical trials.
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Affiliation(s)
- Kristina Bertl
- Department of Periodontology, Faculty of Odontology, University of Malmö, Carl Gustafs väg 34, 20506, Malmö, Sweden
- Division of Oral Surgery, School of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Danijel Domic
- Division of Oral Surgery, School of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Lena Hirtler
- Division of Anatomy, Center for Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria
| | - Patrick Heimel
- Karl Donath Laboratory for Hard Tissue and Biomaterial Research, Division of Oral Surgery, Medical University of Vienna, Vienna, Austria
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
- Ludwig Boltzmann Institute for Clinical and Experimental Traumatology, Vienna, Austria
| | - Azadeh Esfandeyari
- Division of Oral Surgery, School of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Andreas Stavropoulos
- Department of Periodontology, Faculty of Odontology, University of Malmö, Carl Gustafs väg 34, 20506, Malmö, Sweden.
| | - Christian Ulm
- Division of Oral Surgery, School of Dentistry, Medical University of Vienna, Vienna, Austria
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Stacchi C, Lombardi T, Ottonelli R, Berton F, Perinetti G, Traini T. New bone formation after transcrestal sinus floor elevation was influenced by sinus cavity dimensions: A prospective histologic and histomorphometric study. Clin Oral Implants Res 2018; 29:465-479. [PMID: 29569763 DOI: 10.1111/clr.13144] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The aim of this multicenter prospective study was to analyze clinically and histologically the influence of sinus cavity dimensions on new bone formation after transcrestal sinus floor elevation (tSFE). MATERIAL AND METHODS Patients needing maxillary sinus augmentation (residual crest height <5 mm) were treated with tSFE using xenogeneic granules. Six months later, bone-core biopsies were retrieved for histological analysis in implant insertion sites. Bucco-palatal sinus width (SW) and contact between graft and bone walls (WGC) were evaluated on cone beam computed tomography, and correlations between histomorphometric and anatomical parameters were quantified by means of forward multiple linear regression analysis. RESULTS Fifty consecutive patients were enrolled and underwent tSFE procedures, and forty-four were included in the final analysis. Mean percentage of newly formed bone (NFB) at 6 months was 21.2 ± 16.9%. Multivariate analysis showed a strong negative correlation between SW and NFB (R2 = .793) and a strong positive correlation between WGC and NFB (R2 = .781). Furthermore, when SW was stratified into three groups (<12 mm, 12 to 15 mm, and >15 mm), NFB percentages (36%, 13% and 3%, respectively) resulted significantly different. CONCLUSIONS This study represented the first confirmation based on histomorphometric data that NFB after tSFE was strongly influenced by sinus width and occurred consistently only in narrow sinus cavities (SW <12 mm, measured between buccal and palatal walls at 10-mm level, comprising the residual alveolar crest).
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Affiliation(s)
- Claudio Stacchi
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | | | | | - Federico Berton
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Giuseppe Perinetti
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Tonino Traini
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Chieti, Italy
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Influence of Maxillary Sinus Width on New Bone Formation After Transcrestal Sinus Floor Elevation: A Proof-of-Concept Prospective Cohort Study. IMPLANT DENT 2018; 26:209-216. [PMID: 28125520 DOI: 10.1097/id.0000000000000554] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Graft maturation in the maxillary sinus requires adequate angiogenesis and osteoprogenitor cells migration from the surrounding bony walls: the aim of this study was to analyze the correlation between sinus cavity dimensions and new bone formation after transcrestal sinus floor elevation (tSFE). METHODS Patients needing maxillary sinus augmentation (residual crest height ≤ 4 mm) were treated with tSFE using xenogeneic granules. Six months later, bone-core biopsies were retrieved for histological analysis in the implant insertion sites. Buccopalatal sinus width (SW) was evaluated on cone beam computed tomography, and correlations between histomorphometric and anatomical parameters were quantified by means of linear regression analysis. RESULTS Eight consecutive patients underwent tSFE procedures: at 6 months, average percentage of newly formed bone resulted 24.2% ± 7.9%. Statistical analysis showed a strong inverse correlation between SW and new bone formation (R = 0.88), and a strong direct correlation between the number of exposed bone walls and new bone formation (R = 0.82). CONCLUSION Within the limitations of this proof-of-concept study, in which a restricted number of patients were analyzed, tSFE showed more predictable results in narrow than in large sinuses, in terms of new bone formation.
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Parra M, Olate S, Cantín M. Clinical and biological analysis in graftless maxillary sinus lift. J Korean Assoc Oral Maxillofac Surg 2017; 43:214-220. [PMID: 28875135 PMCID: PMC5583195 DOI: 10.5125/jkaoms.2017.43.4.214] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 08/05/2016] [Accepted: 08/26/2016] [Indexed: 11/07/2022] Open
Abstract
Maxillary sinus lift for dental implant installation is a well-known and versatile technique; new techniques are presented based on the physiology of intrasinus bone repair. The aim of this review was to determine the status of graftless maxillary sinus lift and analyze its foundations and results. A search was conducted of the literature between 1995 and 2015 in the Medline, ScienceDirect, and SciELO databases using the keywords "maxillary sinus lift," "blood clot," "graftless maxillary sinus augmentation," and "dental implant placement." Ten articles were selected for our analysis of this technique and its results. Despite the limited information, cases that were followed for at least six months and up to four years had a 90% success rate. Published techniques included a lateral window, elevation of the sinus membrane, drilling and dental implant installation, descent of the membrane with variations in the installation of the lateral wall access and suturing. The physiology behind this new bone formation response and the results of the present research were also discussed. We concluded that this is a promising and viable technique under certain inclusion criteria.
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Affiliation(s)
- Marcelo Parra
- Master in Dental Science Program, Universidad de La Frontera, Temuco, Chile
| | - Sergio Olate
- Department of Oral and Maxillofacial Surgery, Universidad de La Frontera, Temuco, Chile.,Center of Excellence in Surgical and Morphological Studies (CEMYQ), Universidad de La Frontera, Temuco, Chile.,Center for Biomedical Research, Universidad Autónoma de Chile, Temuco, Chile
| | - Mario Cantín
- Center of Excellence in Surgical and Morphological Studies (CEMYQ), Universidad de La Frontera, Temuco, Chile.,Center for Biomedical Research, Universidad Autónoma de Chile, Temuco, Chile
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Fan J, Hu P, Li Y, Wang F, Dong X, Liu B, Liu L, Zhang Y, Gu X. Goat Model for Direct Visualizing the Effectiveness of Detaching Sinus Mucosa in Real Time During Crestal Maxillary Sinus Floor Elevation. J ORAL IMPLANTOL 2017; 43:247-253. [PMID: 28488942 DOI: 10.1563/aaid-joi-d-16-00102] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The procedure of crestal maxillary sinus floor elevation presents a great challenge to the field of implant dentistry. Due to the limited visualization in this procedure, the effectiveness of detaching sinus mucosa could not be assessed in real time. We recently developed an ex vivo goat sinus model by cutting the goat residual skulls along four lines determined from computerized tomography (CT) scans, extracting the maxillary premolar or molar teeth, and preparing implant socket in the maxilla. The generated ex vivo goat sinus models exposed the maxilla and the whole maxillary sinus mucosa, thus enabling real-time observation of detaching maxillary sinus mucosa via directly visualizing the working situation of sinus lift tool in the models and directly measuring the length of detached mucosa and space volume generated under the elevated sinus mucosa. One commercially available umbrella-shaped sinus lift curette was used to detach the maxillary sinus mucosa to evaluate the effectiveness of the ex vivo goat sinus models. The results showed that this curette could detach the sinus mucosa 3.75 mm in length in the mesiodistal direction and 2.81 mm in the buccal-palatal direction. Moreover, a space volume of 52.7 μl could be created under the elevated sinus mucosa in the goat ex vivo models. All the experimental results suggested that this ex vivo goat sinus model might be useful in the evaluation of improved or newly designed sinus lift tools for elevating the maxillary sinus mucosa via the crestal approach.
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Affiliation(s)
- Jiadong Fan
- Department of Stomatology, First Affiliated Hospital of PLA General Hospital, Beijing, China
| | - Pin Hu
- Department of Stomatology, First Affiliated Hospital of PLA General Hospital, Beijing, China
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Wang F, Zhou W, Monje A, Huang W, Wang Y, Wu Y. Influence of Healing Period Upon Bone Turn Over on Maxillary Sinus Floor Augmentation Grafted Solely with Deproteinized Bovine Bone Mineral: A Prospective Human Histological and Clinical Trial. Clin Implant Dent Relat Res 2016; 19:341-350. [PMID: 27862924 DOI: 10.1111/cid.12463] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE To investigate the influence of maturation timing upon histological, histomorphometric and clinical outcomes when deproteinized bovine bone mineral (DBBM) was used as a sole biomaterial for staged maxillary sinus floor augmentation (MSFA). MATERIALS AND METHODS Patients with a posterior edentulous maxillary situation and a vertical bone height ≤ 4 mm were included in this study. A staged MSFA was carried out. After MSFA with DBBM as a sole grafting material, biopsy cores were harvested with simultaneous implant placement followed by a healing period of 5, 8, and 11 months, respectively. Micro-CT, histologic and histomorphometric analyses were performed. RESULTS Forty-one patients were enrolled and 38 bone core biopsies were harvested. Significantly greater BV/TV was observed between 5- and 8-month healing from micro-CT analysis. Histomorphometric analyses showed the ratio of mineralized newly formed bone increased slightly from 5 to 11 months; however, no statistically significant difference was reached (p = .409). Residual bone substitute decreased from 37.3 ± 5.04% to 20.6 ± 7.45%, achieving a statistical significant difference from of 5 up to 11 months (p < .01). Moreover, no implant failure, biological or technical complication occurred after 12-month follow-up of functional loading. CONCLUSION DBBM utilized as sole grafting material in staged MSFA demonstrated to be clinically effective regardless of the healing period. Histomorphometrical and micro-CT assessments revealed that at later stages of healing (8 and 11 months) there is a higher proportion of newly-bone formation compared to earlier stages (5 months). Moreover, the longer the maturation period, the substantially lesser remaining biomaterial could be expected. Even though, these facts did not seem to negatively impact on the implant prognosis 1-year after loading.
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Affiliation(s)
- Feng Wang
- Assistant professor, Department of Oral Implantology, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory of Stomatology, Shanghai, China, 200011
| | - Wenjie Zhou
- Second Dental Clinic, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory of Stomatology, Shanghai, China, 200011
| | - Alberto Monje
- Research fellow, Department of Periodontics and Oral Medicine, The University of Michigan, MI, USA
| | - Wei Huang
- Professor, Department of Oral Implantology, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory of Stomatology, Shanghai, China, 200011
| | - Yueping Wang
- Faculty, Second Dental Clinic, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory of Stomatology, Shanghai, China, 200011
| | - Yiqun Wu
- Professor, Department of Oral Implantology, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory of Stomatology, Shanghai, China, 200011
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Falah M, Sohn DS, Srouji S. Graftless sinus augmentation with simultaneous dental implant placement: clinical results and biological perspectives. Int J Oral Maxillofac Surg 2016; 45:1147-53. [PMID: 27256011 DOI: 10.1016/j.ijom.2016.05.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Revised: 03/15/2016] [Accepted: 05/09/2016] [Indexed: 12/20/2022]
Abstract
After a sinus lifting procedure, the compartment around the implants under the sinus mucosal lining in the sinus floor is filled with a blood clot from surrounding bleeding. The aim of this study was to evaluate the feasibility of bone formation following graftless sinus lifting with the simultaneous placement of dental implants. Thirty graftless sinus lifting procedures were performed and 72 dental implants placed in 18 consecutive patients, using the lateral window approach. Clinical and radiological follow-up was conducted throughout the 6-month healing period. Biopsies of 30 cases were collected at 6 months post-treatment: 15 biopsies were taken from the newly formed bone near the basal floor and 15 from the newly formed bone near the elevated membrane. New bone consolidation in the maxillary sinus was apparent radiologically and histologically at 6 months after sinus augmentation, providing an average 6.14±1.34mm of bone-gain. Based on histological analysis and histomorphometric data, the consolidated bone in the augmented sinus comprised 56.7±11.9% to 59.9±13.4% vital bone tissue. Out of the 72 implants placed, only four failed, indicating a 94% overall implant survival rate. Based on this case series, blood clot can be considered autologous osteogenic graft material, to which osteoprogenitors can migrate, differentiate, and regenerate bone.
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Affiliation(s)
- M Falah
- Eliachar Research Laboratory, Western Galilee Hospital, Nahariya, Israel
| | - D-S Sohn
- Department of Dentistry and Oral and Maxillofacial Surgery, Daegu Catholic University Hospital, Daegu, Republic of Korea
| | - S Srouji
- Oral and Maxillofacial Institute, Galilee Medical Center, Nahariya, Israel; Faculty of Medicine in the Galilee, Bar-Ilan University, Ramat Gan, Tel Aviv, Israel.
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Bresaola MD, Matsumoto MA, Zahoui A, Biguetti CC, Nary-Filho H. Influence of rapid- and slow-rate resorption collagen membrane in maxillary sinus augmentation. Clin Oral Implants Res 2016; 28:320-326. [PMID: 26916561 DOI: 10.1111/clr.12801] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2016] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To evaluate the effects of low- and rapid-resorption-rate bioabsorbable collagen membranes in maxillary sinus augmentation procedure in rabbits considering Schneiderian membrane (SM) reaction and bone tissue formation. MATERIALS AND METHODS Eighteen male adult rabbits underwent bilateral maxillary sinus augmentation with particulate bovine hydroxyapatite to be divided into three groups, as follows: Group C - control, no membrane; Group RR - rapid resorbable collagen membrane; and Group SR - slow-resorbable collagen membrane. The animals were euthanized after 30 and 120 days for specimen's removal to be prepared and analyzed under light microscopy, histomorphometry, and immunohistochemistry for Runx2 and VEGF labeling. RESULTS Histopathology evaluation presented similar healing pattern among the groups with a satisfactory response of SM, both at day 30 and day 120. Bone histomorphometry did not reveal significant differences among the groups, as well as immunohistochemistry analysis, which presented intense immunolabeling for both proteins in all groups. CONCLUSIONS The presence of both membranes did not negatively interfere in bone formation and remodeling, and the focal mild inflammatory reaction caused by their degrading process did not impair the reconstructive procedure.
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Affiliation(s)
| | - Mariza Akemi Matsumoto
- Department of Basic Sciences, State of São Paulo University - FOA/UNESP, Araçatuba, Brazil.,Oral Biology Doctoral's Program, Sagrado Coração University, USC, Araçatuba, Brazil
| | - Abbas Zahoui
- Oral Biology Master's Program, Sagrado Coração University, USC, Bauru, Brazil
| | - Claudia Cristina Biguetti
- Oral Biology Doctoral's Program, Bauru School of Dentistry, University of São Paulo - FOB/USP, Bauru, Brazil
| | - Hugo Nary-Filho
- Oral Biology Master's and Doctoral's Program, Department of Oral Maxillofacial Surgery, Sagrado Coração University, USC, Bauru, Brazil
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Falah M, Srouji S. Raised Schneiderian membrane compared with peeled bony walls in the formation of bone. Br J Oral Maxillofac Surg 2015; 54:115-6. [PMID: 26608689 DOI: 10.1016/j.bjoms.2015.10.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Accepted: 10/23/2015] [Indexed: 10/22/2022]
Affiliation(s)
- Mizied Falah
- Drug Discovery Informatics Lab, QRC-Qasemi Research Center, Al-Qasemi Academic College, Baka El-Garbiah 30100, Israel.
| | - Samer Srouji
- Oral and Maxillofacial Surgery Department; Chief of Oral and Maxillofacial Institute, Galilee Medical Center, Nahariya, Israel. Faculty of Medicine in the Galilee, Bar-ilan University, Henrietta Szold 8, P.O.B 1589, 1311502.
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Göçmen G, Atalı O, Aktop S, Sipahi A, Gönül O. Hyaluronic Acid Versus Ultrasonic Resorbable Pin Fixation for Space Maintenance in Non-Grafted Sinus Lifting. J Oral Maxillofac Surg 2015; 74:497-504. [PMID: 26679552 DOI: 10.1016/j.joms.2015.10.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 10/07/2015] [Accepted: 10/28/2015] [Indexed: 11/16/2022]
Abstract
PURPOSE An ultrasonic resorbable pin (SonicWeld, KLS Martin, Mühlheim, Germany) was compared with hyaluronic acid (Hyaloss Matrix, Anika Therapeutics, Bedford, MA) for their ability to maintain space in non-grafted sinus lifting. MATERIALS AND METHODS A comparative split-mouth study was designed and implemented. Six women and 4 men were included (mean age, 56.7 yr). The primary predictors hyaluronic acid (HA) application and ultrasonic resorbable pin fixation (URPF) were coded as binary variables. The primary outcome variables were height of alveolar bone (HAB) and reduction in sinus volume (RSV). Secondary outcomes were bone density and implant survival. RESULTS The postoperative mean HAB was significantly higher than the preoperative mean HAB on the 2 sides (P < .05). Mean increases in HAB and RSV on the URPF side were significantly greater than those on the HA side (P < .05). In total, patients were treated with 40 implants. No type I bone quality was identified; 14 (35%) implants were inserted in type II bone, 22 (50%) in type III bone, and 6 (15%) in type IV bone. There was no statistically meaningful difference between the 2 sides for implant survival or bone quality. At 6 months, all implants were clinically stable and the definitive prostheses were functional, resulting in a survival rate of 100%. CONCLUSIONS There was sufficient bone height to eventually place implants on the 2 sides in all patients. The 2 techniques yielded predictable outcomes in implant survival and bone quality. However, HAB and RSV were considerably greater on the URPF side.
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Affiliation(s)
- Gökhan Göçmen
- Resident, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Marmara University, Istanbul, Turkey.
| | - Onur Atalı
- Resident, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Marmara University, Istanbul, Turkey
| | - Sertac Aktop
- Resident, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Marmara University, Istanbul, Turkey
| | - Ayşegül Sipahi
- Resident, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Marmara University, Istanbul, Turkey
| | - Onur Gönül
- Assistant Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Marmara University, Istanbul, Turkey
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