Peri-implant complications for posterior endosteal implants

Perforation of the Schneiderian membrane during sinus floor elevation: a risk factor for long-term success of dental implants?

PURPOSE

In cases of highly atrophic alveolar ridges, augmentation procedures became a frequent procedure to gain optimal conditions for dental implants. Especially in the maxilla sinus floor elevation procedures represent the gold standard pre-prosthetic and mainly successful procedure. The perforation of the Schneiderian is one of the most common complications. The aim of this study was to evaluate whether the intraoperative perforation of the Schneiderian membrane has an impact on long-term implant success.

METHODS

Thirty-four patients from a former study collective of the years 2005 and 2006 with a total of 41 perforations were invited for a follow-up examination to determine the long-term success rates after sinus floor elevation and subsequent implantation.

RESULTS

Twenty-one patients with 25 perforations were subsequently re-evaluated. One implant was lost due to a of periimplant infection after 232 days, resulting in an implant survival rate of 98% within a mean follow-up period of 8.9 years (± 1.5 years).

CONCLUSION

Regarding the long-term success, there was no increased risk for implant failure or other persisting complications, e.g., sinusitis, after intraoperative perforation during sinus floor elevation in this study.

A low cost minimally invasive adhesive alternative for maxillary central incisor replacement

OBJECTIVE

The beneficial mechanical properties of zirconia, together with the adhesive techniques, provide a wide range of clinical applications, including the construction of thin structures and minimally invasive adhesive restorations.

CLINICAL CONSIDERATIONS

A periodontal disease-related missing maxillary central incisor, in a pregnant patient with chronic periodontal disease in the first trimester of pregnancy, and with type II diabetes treated with resin-bonded fixed partial denture using the missing tooth cemented to a zirconia framework and then bonded to the abutment teeth.

CONCLUSIONS

According to the systemic conditions presented in this case report, using a low-cost technology and the missing tooth it was possible to obtain an easier and satisfactory esthetic and functional result.

CLINICAL SIGNIFICANCE

The mechanical properties of zirconia made it possible to treat a pregnant patient with chronic periodontal disease in the first trimester of pregnancy, and with type II diabetes with a thin zirconia framework and minimally invasive adhesive restorations.

Impact of surgical management in cases of intraoperative membrane perforation during a sinus lift procedure: a follow-up on bone graft stability and implant success

Background

Until now, sinus floor elevation represents the gold standard procedure in the atrophic maxilla in order to facilitate dental implant insertion. Although the procedure remains highly predictive, the perforation of the Schneiderian membrane might compromise the stability of the augmented bone and implant success due to chronic sinus infection. The aim of this retrospective cohort study was to show that a membrane tear, if detected and surgically properly addressed, has no influence on the survival of dental implants and bone resorption in the augmented area.

Methods

Thirty-one patients with 39 perforations could be included in this evaluation, and a control group of 32 patients with 40 sinus lift procedures without complications were compared regarding the radiographically determined development of bone level, peri-implant infection, and implant loss.

Results

Implant survival was 98.9% in the perforation group over an observation period of 2.7 (± 2.03) years compared to 100% in the control group after 1.8 (± 1.57) years. The residual bone level was significantly lower in the perforation group (p = 0.05) but showed no difference direct postoperatively (p = 0.7851) or in the follow-up assessment (p = 0.2338). Bone resorption remained not different between both groups (p = 0.945). A two-stage procedure was more frequent in the perforation group (p = 0.0003) as well as peri-implantitis (p = 0.0004).

Conclusions

Within the limits of our study, the perforation of the Schneiderian membrane did not have a negative impact on long-term graft stability or the overall implant survival.