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Yu X, Ye G, Zhao F, Wang B, Yu M, Wang H. Endoscope-controlled maxillary sinus floor elevation: a review of the literature. Br J Oral Maxillofac Surg 2021; 60:113-119. [PMID: 34991905 DOI: 10.1016/j.bjoms.2021.04.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 04/01/2021] [Indexed: 10/21/2022]
Abstract
A systematic review of the literature was conducted to assess the safety and efficacy of endoscope-assisted maxillary sinus elevation. PubMed, Embase, Web of Science, and the Cochrane database were searched for articles in English. Published studies involving patients who had undergone endoscope-assisted maxillary sinus floor augmentation were selected. The validity of the included articles was evaluated. After going through full texts, a total of 12 studies met the eligibility criteria and were included. It was concluded that endoscope-controlled maxillary sinus floor elevation was a viable and beneficial method, providing direct visualisation of the integrity of the mucosa and placing of bone graft material. The endoscope could be inserted into the maxillary sinus lumen, subantral space below the Schneiderian membrane, or through the alveolar crest. With the endoscope, perforations can be detected and managed precisely. However, high-quality clinical trials are still needed to validate the predictability and advantages of this surgical procedure.
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Affiliation(s)
- X Yu
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, 310006, China
| | - G Ye
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, 310006, China
| | - F Zhao
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, 310006, China
| | - B Wang
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, 310006, China
| | - M Yu
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, 310006, China.
| | - H Wang
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, 310006, China.
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Gandhi Y. Endoscopically monitored maxillary sinus augmentation - The chairside approach (Rationale and protocol). J Oral Biol Craniofac Res 2020; 10:247-252. [PMID: 32509513 DOI: 10.1016/j.jobcr.2020.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 05/07/2020] [Accepted: 05/08/2020] [Indexed: 10/24/2022] Open
Abstract
Sinus augmentation procedures have been reported since the time of Boyne, with variable techniques and outcomes. Sinus membrane perforations may or may not be detected at the intra-operative stage, thereby compromising the outcome. The aim of this study is to evaluate the usefulness and feasibility of an endoscope used intraorally during manipulation of the schnederian membrane. This would help confirm sinus health and integrity of the membrane during and after the augmentation.
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Affiliation(s)
- Yazad Gandhi
- Oral & Maxillofacial Surgeon, Saifee Hospital, Mumbai, India
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Guo T, Gulati K, Shen Z, Han P, Fan Z. Therapeutic outcomes of non-grafted and platelet concentrations-grafted transcrestal maxillary sinus elevation (TSFE): a systematic review and meta-analysis. Sci Rep 2020; 10:5935. [PMID: 32245996 PMCID: PMC7125188 DOI: 10.1038/s41598-020-62407-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 03/11/2020] [Indexed: 12/28/2022] Open
Abstract
To evaluate and compare the stability, quantity and quality of bone augmentation at maxillary sinus elevation sites by non-grafted transcrestal sinus floor elevation (TSFE) and platelet concentration grafted transcrestal sinus floor elevation (PC-TSFE). A complete literature search was performed up to April 2019. Clinical controlled trials, retrospective cohort studies, and prospective cohort studies were selected based on inclusion criteria. The clinical outcomes were implant survival rate (ISR), marginal/crestal bone loss (MBL/CBL) and endo-sinus bone gain (ESBG). Meta‐analysis was conducted on these 1-year based values. Furthermore, another meta-analysis on 1-year ISR value was conducted among studies with different residual bone heights (RBH) within the non-grafted TSFE group. A total of 18 studies were included: 13 in TSFE group and 5 in PC-TSFE group. No significant differences were displayed between the 1-year ISR of TSFE (97%, 95%CI = 0.96–0.99) and PC-TSFE group (99%, 95%CI = 0.97–1.00). Among the various studies with different RBH within TSFE group, no significant differences in 1-year ISR were displayed. The 1-year MBL/CBL value of PC-TSFE group (0.73 mm, 95%CI = 0.43–1.13 mm) did not show significant difference as compared to TSFE group (0.60 mm, 95%CI = 0.10–1.10 mm). Furthermore, no significant enhancement was observed on 1-year ESBG value on PC-TSFE group (3.51 mm, 95%CI = 2.31–4.71 mm) in comparison with the TSFE group (2.87 mm, 95%CI = 2.18m–3.55 mm). Grafting platelet concentrations around dental implants at TSFE sites did not significantly enhance the adjacent bone regeneration. Moreover, TSFE was shown to be a reliable therapeutic option for implant sites that need simultaneous maxillary sinus augmentation, even under limited RBH.
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Affiliation(s)
- Tianqi Guo
- The University of Queensland, School of Dentistry, Herston, QLD 4006, Australia
| | - Karan Gulati
- The University of Queensland, School of Dentistry, Herston, QLD 4006, Australia
| | - Ziyun Shen
- Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, 200072, PR China.,Department of Oral Implant, School and Hospital of Stomatology, Tongji University, Shanghai, 200072, PR China
| | - Pingping Han
- The University of Queensland, School of Dentistry, Herston, QLD 4006, Australia
| | - Zhen Fan
- Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, 200072, PR China. .,Department of Oral Implant, School and Hospital of Stomatology, Tongji University, Shanghai, 200072, PR China.
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Block MS. Bone Levels Are Preserved After Simultaneous Sinus Elevation at Time of Implant Placement. J Oral Maxillofac Surg 2019; 77:2019-2026. [PMID: 31348872 DOI: 10.1016/j.joms.2019.06.177] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 06/19/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE The purpose of this study was to confirm that after simultaneous implant placement and vertical bone augmentation in the posterior maxilla, the immediate postoperative bone height is maintained after 2 to 3 years of follow-up. PATIENTS AND METHODS Consecutive patients treated with implant placement in the posterior maxilla were evaluated. Cone-beam scans were taken preoperatively; immediately after implant placement; and for the sinus-grafted cases, 2 to 3 years after surgery. Crestal bone heights were measured. Patients were grouped according to the use of sinus augmentation or no sinus augmentation at the time of implant placement. RESULTS The increase in bone height was significant in the graft group when we compared immediate and 3-year follow-up measurements (P < .00001). In the graft group, there were no significant differences in bone height when we compared the immediate and 3-year follow-up periods (P = .31). CONCLUSIONS Simultaneous sinus floor elevation with grafting at implant placement results in stable bone levels after 2 to 3 years' follow-up.
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Duan DH, Fu JH, Qi W, Du Y, Pan J, Wang HL. Graft-Free Maxillary Sinus Floor Elevation: A Systematic Review and Meta-Analysis. J Periodontol 2017; 88:550-564. [PMID: 28168901 DOI: 10.1902/jop.2017.160665] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND This systematic review and meta-analysis aims to investigate survival rates of dental implants placed simultaneously with graft-free maxillary sinus floor elevation (GFSFE). Factors influencing amount of vertical bone gain (VBG), protruded implant length (PIL) in sinus at follow-up (PILf), and peri-implant marginal bone loss (MBL) are also evaluated. METHODS Electronic and manual searches for human clinical studies on simultaneous implant placement and GFSFE using the lateral window or transcrestal approach, published in the English language from January 1976 to March 2016, were conducted. The random-effects model and mixed-effect meta-regression were used to analyze weighted mean values of clinical parameters and evaluate factors that influenced amount of VBG. RESULTS Of 740 studies, 22 clinical studies were included in this systematic review. A total of 864 implants were placed simultaneously with GFSFE at edentulous sites having mean residual bone height of 5.7 ± 1.7 mm. Mean implant survival rate (ISR) was 97.9% ± 0.02% (range: 93.5% to 100%). Weighted mean MBL was 0.91 ± 0.11 mm, and it was significantly associated with the postoperative follow-up period (r = 0.02; R2 = 43.75%). Weighted mean VBG was 3.8 ± 0.34 mm, and this parameter was affected significantly by surgical approach, implant length, and PIL immediately after surgery (PILi) (r = 2.82, 0.57, 0.80; R2 = 19.10%, 39.27%, 83.92%, respectively). Weighted mean PILf was 1.26 ± 0.33 mm (range: 0.3 to 2.1 mm). CONCLUSION Within limitations of the present systematic review, GFSFE with simultaneous implant placement can achieve satisfactory mean ISR of 97.9% ± 0.02%.
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Affiliation(s)
- Deng-Hui Duan
- Department of General Dentistry, School and Hospital of Stomatology, Peking University, Beijing, People's Republic of China
| | - Jia-Hui Fu
- Discipline of Periodontics, Faculty of Dentistry, National University of Singapore, Singapore, Republic of Singapore
| | - Wei Qi
- Department of Endodontics, Jinan Stomatology Hospital, Jinan, Shandong, People's Republic of China
| | - Yi Du
- Department of General Dentistry, School and Hospital of Stomatology, Peking University, Beijing, People's Republic of China
| | - Jie Pan
- Department of General Dentistry, School and Hospital of Stomatology, Peking University, Beijing, People's Republic of China
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI
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Chen MH, Shi JY. Clinical and Radiological Outcomes of Implants in Osteotome Sinus Floor Elevation with and without Grafting: A Systematic Review and a Meta-Analysis. J Prosthodont 2017; 27:394-401. [PMID: 28084057 DOI: 10.1111/jopr.12576] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2016] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To systematically appraise the clinical and radiological outcomes after osteotome sinus floor elevation (OSFE) with or without grafting in the published dental literature. METHODS An electronic search was conducted using PubMed, Web of Science, and the Cochrane Central Register of Controlled Trial to identify studies after OSFE from January 1, 1994 to August 30, 2015. The primary outcome was the implant survival rates after OSFE with and without grafting materials. RESULTS After search and evaluation of the literature according to the inclusion criteria, 7 studies were included in the review. The random-effect model meta-analysis based on 463 implants in patients without grafting and 415 implants in patients with grafting showed that the risk ratio difference of survival rates was 1.010 (95%CI 0.910, 1.120), which did not reach statistical significance (p = 0.99). The membrane perforation rates ranged from 0% to 10.80%. No significant difference of crestal bone loss was reported between graft and nongraft groups. CONCLUSIONS Based on currently available evidence, OSFE techniques with and without grafting were both predictable in the short term. In addition, survival rates of dental implants in OSFE with or without grafting did not show any significant difference in the short term.
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Affiliation(s)
- Mei-Hua Chen
- Department of Periodontology, Shanghai Stomatology Hospital, Shanghai, China
| | - Jun-Yu Shi
- Department of Dental Implantation, Shanghai Ninth People's Hospital, Shanghai Key Laboratory Stomatology, Shanghai Jiaotong University, School of Medicine, Shanghai, China
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Block MS. Improvements in the Crestal Osteotome Approach Have Decreased the Need for the Lateral Window Approach to Augment the Maxilla. J Oral Maxillofac Surg 2016; 74:2169-2181. [DOI: 10.1016/j.joms.2016.06.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 06/06/2016] [Accepted: 06/06/2016] [Indexed: 10/21/2022]
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Zheng J, Zhang S, Lu E, Yang C, Zhang W, Zhao J. Endoscopic lift of the maxillary sinus floor in Beagles. Br J Oral Maxillofac Surg 2014; 52:845-9. [PMID: 25174319 DOI: 10.1016/j.bjoms.2014.08.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2014] [Accepted: 08/02/2014] [Indexed: 11/16/2022]
Abstract
The aim of this study was to introduce a modified endoscopic lift of the floor of the maxillary sinus in Beagles. Twelve operations (bilateral and randomly chosen) were done in 6 Beagles each in the test group (modified endoscopic operation), and the control group, in which the operation was done with an osteotome. All operations were evaluated by two indices of safety (perforation of the sinus membrane and nasal bleeding) and 3 effective indices (the intraoperative height after lifting, volume of bone grafts, and dislocation of the sinus grafts). The sinus membrane was not perforated and there were no nasal bleeds in either group. The intraoperative height after lifting was 13.7 (0.8) mm in the test group and 9.1 (0.5) mm in the control group, so it was significantly higher in the test group than the control group (p=0.0001). Similarly, the volume of bone graft was 0.9 (0.04) ml in the test group and 0.5 (0.02) ml in the control group (p=0.0001). The volume of the anterior and posterior bone grafts in the implant cavity in the test group did not differ significantly (p=0.102), while there were significant differences in the control group (p=0.002). Endoscopic lifting of the floor of the maxillary sinus is a safe and effective approach based on direct observation in Beagles.
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Affiliation(s)
- JiSi Zheng
- Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, and Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - ShanYong Zhang
- Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, and Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China.
| | - ErYi Lu
- Department of Prosthodontics, Ninth People's Hospital, Collage of Stomatology, Shanghai Jiao Tong University School of Medicine, and Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China.
| | - Chi Yang
- Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, and Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - WenJie Zhang
- Oral Bioengineering and regenerative medicine Lab, Shanghai Research Institute of Stomatology, Ninth People's Hospital, Collage of Stomatology, Shanghai Jiao Tong University School of Medicine, and Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - JingYang Zhao
- Department of Oral Implantology, Hospital Affiliated Qingdao University School of Medicine, Shandong, China
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Removal of impacted mandibular third molars using an inward fragmentation technique (IFT) - Method and first results. J Craniomaxillofac Surg 2013; 42:213-9. [PMID: 23850159 DOI: 10.1016/j.jcms.2013.05.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2013] [Revised: 05/08/2013] [Accepted: 05/10/2013] [Indexed: 11/22/2022] Open
Abstract
PURPOSE Conventional surgical extraction of impacted mandibular third molars (M3M) requires a lateral flap reflection in conjunction with lateral bone removal for outward mobilization of the tooth. The aim of this report is to outline a novel inward fragmentation technique (IFT) in conjunction with an occlusal miniflap approach to reduce the amount of bone removal to a minimum. PATIENTS AND METHODS Seventeen consecutive patients (7 men and 10 women; mean age 24.4 years, range 18-36 years) required the extraction of 21-impacted M3M with a close relationship to the inferior alveolar nerve (IAN). Occlusal miniflaps were used and only occlusal bone removal was performed to expose the M3M under endoscopic vision. A central space-making cavity was created followed by inward fragmentation and mobilization of the crown and subsequent root removal through the space created. RESULTS 20 of 21 sites healed uneventfully, one late infection was observed, no permanent neurosensory lesion occurred. The mean preoperative buccal bone height was 15.5 (11-18) mm and the postoperative buccal bone height 14.7 (11-17) mm. On the 2nd day, the mean swelling level was 1.38 (0-2) on a 4 point scale, the pain level was 2.30 (0-5) on a 10 cm VAS, mean pain duration was 2.04 days. CONCLUSION An inward fragmentation technique allows preservation of >90% of the buccal bone height adjacent to mandibular third molars and may reduce postoperative morbidity without raising the risk of IAN lesions.
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Oliva X, Oliva J, Oliva JD, Prasad HS, Rohrer MD. Osseointegration of Zirconia (Y-TZP) Dental Implants: A Histologic, Histomorphometric and Removal Torque Study in the Hip of Sheep. ACTA ACUST UNITED AC 2013. [DOI: 10.5005/jp-journals-10012-1093] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Mazor Z, Ioannou A, Venkataraman N, Kotsakis G. A Minimally Invasive Sinus Augmentation Technique using a Novel Bone Graft Delivery System. ACTA ACUST UNITED AC 2013. [DOI: 10.5005/jp-journals-10012-1097] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Beltrán V, Fuentes R, Engelke W. Endoscopic Visualization of Anatomic Structures as a Support Tool in Oral Surgery and Implantology. J Oral Maxillofac Surg 2012; 70:e1-6. [DOI: 10.1016/j.joms.2011.09.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2011] [Revised: 09/08/2011] [Accepted: 09/11/2011] [Indexed: 10/14/2022]
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Osteotome-mediated sinus floor elevation using only platelet-rich fibrin: an early report on 110 patients. IMPLANT DENT 2011; 19:447-56. [PMID: 20881816 DOI: 10.1097/id.0b013e3181f57288] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
PURPOSE This article describes a technique and reports on the early healing for localized sinus augmentation using a crestal approach in combination with an autologous leukocyte- and platelet-rich fibrin (PRF) concentrate. MATERIALS From November 2008 to January 2010, 138 implants were placed in 110 patients using osteotome-mediated sinus floor elevation (OMSFE) with PRF. RESULTS The mean residual subantral bone height of the alveolar ridge was 6.6 mm (range, 4-8 mm). The mean increase in the height of implant sites by OMSFE/PRF was 3.4 mm (range, 2.5-5 mm). A variety of 8- to 11.5-mm long (mean length, 10.1 mm) and 3.5- to 6-mm wide (mean width, 4.4 mm) screw-type implants were used. Of the 138 implants that had been placed, 97 have been restored and in function for an average loading time of 5.2 months (range, 1-11 months). The mean healing time for the loaded implants was 4 months until abutment insertion (range, 3-5 months). Three implants failed before loading for an early survival rate of both loaded and unloaded implants of 97.8%. CONCLUSIONS Early review of the OMSFE/PRF technique presented for localized sinus floor elevation and implant placement demonstrates a high degree of safety and success at sites with 5- to 8-mm residual subantral bone height.
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Nahlieli O, Moshonov J, Zagury A, Michaeli E, Casap N. Endoscopic approach to dental implantology. J Oral Maxillofac Surg 2010; 69:186-91. [PMID: 21050639 DOI: 10.1016/j.joms.2010.07.071] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2010] [Accepted: 07/20/2010] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To describe an innovative miniature visualization surgical endoscope and endoscopic techniques applicable to dental implant procedures. MATERIALS AND METHODS A newly developed modular dental implant endoscope is introduced, and the first impressions from its use in different implant procedures are reported. RESULTS Details of the device that combines an endoscope, irrigation cannulas, and a surgical microinstrument channel are presented. The advantages of using it in dental implant procedures are described, and examples of how miniature visualization and surgical endoscopic techniques can be applied to increase the success of implantation are outlined. The new modular implant endoscope accurately identified all microanatomical and pathological structures, and simplified dental implant procedures. CONCLUSION Endoscopy should be considered not only for intraoperative observation and assessment of implant sites, but also should be applied for active assistance during implant placement procedures.
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Affiliation(s)
- Oded Nahlieli
- Oral and Maxillofacial Surgery Department, Barzilai Medical Center, Ashkelon, Israel.
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