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Hayashi K, Kishida R, Tsuchiya A, Ishikawa K. Transformable Carbonate Apatite Chains as a Novel Type of Bone Graft. Adv Healthc Mater 2024; 13:e2303245. [PMID: 38229572 DOI: 10.1002/adhm.202303245] [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: 09/25/2023] [Revised: 12/07/2023] [Indexed: 01/18/2024]
Abstract
The aging global population is generating an ever-increasing demand for bone regeneration. Various materials, including blocks, granules, and sponges, are developed for bone regeneration. However, blocks require troublesome shaping and exhibit poor bone-defect conformities; granules migrate into the surrounding tissues during and after filling of the defect, causing handling difficulties and complications; and sponges contain polymers that are subject to religious restrictions, lack osteoconductivity, and may cause inflammation and allergies. Herein, carbonate apatite chains that overcome the limitations of conventional materials are presented. Although carbonate apatite granules migrate, causing inflammation and ectopic calcification, the chains remain in the defects without causing any complications. The chains conform to the defect shape and transform into 3D porous structures, resulting in faster bone regeneration than that observed using granules. Thus, these findings indicate that even traditional calcium phosphates materials can be converted to state-of-the-art materials via shape control.
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Affiliation(s)
- Koichiro Hayashi
- Department of Biomaterials, Faculty of Dental Science, Kyushu University 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Ryo Kishida
- Department of Biomaterials, Faculty of Dental Science, Kyushu University 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Akira Tsuchiya
- Department of Biomaterials, Faculty of Dental Science, Kyushu University 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Kunio Ishikawa
- Department of Biomaterials, Faculty of Dental Science, Kyushu University 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
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Munakata M, Kataoka Y, Yamaguchi K, Sanda M. Risk Factors for Early Implant Failure and Selection of Bone Grafting Materials for Various Bone Augmentation Procedures: A Narrative Review. Bioengineering (Basel) 2024; 11:192. [PMID: 38391678 PMCID: PMC10886188 DOI: 10.3390/bioengineering11020192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 02/13/2024] [Accepted: 02/15/2024] [Indexed: 02/24/2024] Open
Abstract
Implant therapy is now an established treatment with high long-term success and survival rates. However, early implant failure, which occurs within one year of superstructure placement, occurs at a higher rate than late failure, which is represented by peri-implantitis caused by bacterial infection. Furthermore, various risk factors for early failure have been reported, including patient-related factors, such as systemic diseases, smoking, and bone quality and quantity, as well as surgery-related factors, such as surgeons' skill, osteogenesis technique, and selection of graft material, and implant-related factors, such as initial implant fixation and implant length diameter. Due to the wide variety of relevant factors reported, it is difficult to identify the cause of the problem. The purpose of this review is to discuss the risk factors associated with various types of bone augmentation which have a close causal relationship with early implant failure, and to determine the optimal bone grafting material for bone augmentation procedures to avoid early implant failure.
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Affiliation(s)
- Motohiro Munakata
- Department of Implant Dentistry, Showa University School of Dentistry, 2-1-1, Kita-senzoku, Ota-ku, Tokyo 1458515, Japan
| | - Yu Kataoka
- Department of Dental Education, Showa University School of Dentistry, 1-8-5, Hatanodai, Shinagawa-ku, Tokyo 1428555, Japan
- Department of Biomaterials and Engineering, Showa University School of Dentistry, 1-8-5, Hatanodai, Shinagawa-ku, Tokyo 1428555, Japan
| | - Kikue Yamaguchi
- Department of Implant Dentistry, Showa University School of Dentistry, 2-1-1, Kita-senzoku, Ota-ku, Tokyo 1458515, Japan
| | - Minoru Sanda
- Department of Prosthodontics, Showa University School of Dentistry, 2-1-1, Kita-senzoku, Ota-ku, Tokyo 1458515, Japan
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Gaspar J, Botelho J, Proença L, Machado V, Chambrone L, Neiva R, Mendes JJ. Osseodensification versus lateral window technique for sinus floor elevation with simultaneous implant placement: A randomized clinical trial on patient-reported outcome measures. Clin Implant Dent Relat Res 2024; 26:113-126. [PMID: 38018261 DOI: 10.1111/cid.13294] [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: 09/13/2023] [Revised: 10/09/2023] [Accepted: 11/06/2023] [Indexed: 11/30/2023]
Abstract
OBJECTIVES To compare patient-reported outcome measures and additional surgical outcomes after sinus floor elevation (SFE) with osseodensification (OD) versus lateral window (LW), both with simultaneous implant placement. MATERIALS AND METHODS Twenty participants requiring single-implant rehabilitation with residual bone height (RBH) ≤4 mm were enrolled. Pain experience, quality of life (QoL) via the Oral Health Impact Profile-14 (OHIP-14), analgesics intake, and other symptoms were self-reported for a week on a daily basis. Surgery duration, complications, and implant stability quotient at baseline (ISQ T0 ) and after 6 months (ISQ T6 ) were registered. Participants were followed up for 1 year. RESULTS From Day 0 (day of surgery) to Day 3, pain experience was significantly lower (p < 0.05) in the OD group. OHIP-14 score was significantly lower (p < 0.05) in the OD group on all postoperative days, except on Day 5. Average analgesics intake was significantly lower (p < 0.001) in the OD group. Surgery mean duration was significantly higher (p < 0.001) in LW compared to OD (71.1 ± 10.4 vs. 32.9 ± 5.3 min). After osseointegration period, all implants were successfully restored with screw-retained crowns. CONCLUSIONS Within the limitations of this study, it can be concluded that OD and LW techniques were similarly effective in SFE with simultaneous implant placement when RBH ≤ 4 mm. However, OD significantly outperformed LW in pain experience, impact on self-perceived QoL, surgery duration, postoperative edema, and analgesics intake.
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Affiliation(s)
- João Gaspar
- Clinical Research Unit, Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health and Science, Caparica, Almada, Portugal
| | - João Botelho
- Clinical Research Unit, Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health and Science, Caparica, Almada, Portugal
- Evidence-Based Hub, Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health and Science, Almada, Portugal
| | - Luís Proença
- Clinical Research Unit, Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health and Science, Caparica, Almada, Portugal
- Evidence-Based Hub, Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health and Science, Almada, Portugal
| | - Vanessa Machado
- Clinical Research Unit, Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health and Science, Caparica, Almada, Portugal
- Evidence-Based Hub, Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health and Science, Almada, Portugal
| | - Leandro Chambrone
- Evidence-Based Hub, Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health and Science, Almada, Portugal
- Department of Periodontology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Rodrigo Neiva
- Department of Periodontology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - José João Mendes
- Evidence-Based Hub, Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health and Science, Almada, Portugal
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Elad A, Pul L, Rider P, Rogge S, Witte F, Tadić D, Mijiritsky E, Kačarević ŽP, Steigmann L. Resorbable magnesium metal membrane for sinus lift procedures: a case series. BMC Oral Health 2023; 23:1006. [PMID: 38097992 PMCID: PMC10722874 DOI: 10.1186/s12903-023-03695-4] [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: 08/04/2023] [Accepted: 11/22/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND The purpose of this case series was to demonstrate the use of a magnesium membrane for repairing the perforated membrane in both direct and indirect approaches, as well as its application in instances where there has been a tear of the Schneiderian membrane. CASE PRESENTATION The case series included four individual cases, each demonstrating the application of a magnesium membrane followed by bone augmentation using a mixture of xenograft and allograft material in the sinus cavity. In the first three cases, rupture of Schneiderian membrane occurred as a result of tooth extraction, positioning of the dental implant, or as a complication during the procedure. In the fourth case, Schneiderian membrane was perforated as a result of the need to aspirate a polyp in the maxillary sinus. In case one, 10 mm of newly formed bone is visible four months after graft placement. Other cases showed between 15 and 20 mm of newly formed alveolar bone. No residual magnesium membrane was seen on clinical inspection. The vertical and horizontal augmentations proved stable and the dental implants were placed in the previously grafted sites. CONCLUSION Within the limitations of this case series, postoperative clinical examination, and panoramic and CBCT images demonstrated that resorbable magnesium membrane is a viable material for sinus lift and Schneiderian membrane repair. The case series showed successful healing and formation of new alveolar bone with separation of the oral cavity and maxillary sinus in four patients.
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Affiliation(s)
| | - Luka Pul
- Department of Dental Medicine, Faculty of Dental Medicine and Health Osijek, J.J. Strossmayer University of Osijek, Crkvena 21, 31 000, Osijek, Croatia
| | | | - Svenja Rogge
- Botiss Biomaterials GmbH, 15806, Zossen, Germany
| | - Frank Witte
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité-Universitätsmedizin Berlin, Aßmannshauser Straße, 4-6, 14197, Berlin, Germany
| | - Dražen Tadić
- Botiss Biomaterials GmbH, 15806, Zossen, Germany
| | - Eitan Mijiritsky
- Department of Head and Neck and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, The Sackler Faculty of Medicine, Tel-Aviv University, 6139001, Tel Aviv, Israel
| | - Željka Perić Kačarević
- Botiss Biomaterials GmbH, 15806, Zossen, Germany.
- Department of Anatomy, Histology, Embryology, Pathology Anatomy and Pathology Histology, Faculty of Dental Medicine and Health Osijek, J.J. Strossmayer University of Osijek, Crkvena 21, 31 000, Osijek, Croatia.
| | - Larissa Steigmann
- Department of Oral Medicine, Infection, and Immunity, Division of Periodontology, Harvard School of Dental Medicine, Boston, MA, USA
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Yamaguchi K, Munakata M, Sato D, Kataoka Y, Kawamata R. The Effectiveness and Practicality of a Novel Barrier Membrane for the Open Window in Maxillary Sinus Augmentation with a Lateral Approach, with Risk Indicators for Bone Graft Displacement and Bone Height Decrease: A Prospective Study in Humans. Bioengineering (Basel) 2023; 10:1110. [PMID: 37892840 PMCID: PMC10604179 DOI: 10.3390/bioengineering10101110] [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: 08/19/2023] [Revised: 09/09/2023] [Accepted: 09/19/2023] [Indexed: 10/29/2023] Open
Abstract
Maxillary sinus augmentation with a lateral approach (MSA) is a well-established treatment. In this prospective study, we evaluated risk factors for postoperative bone graft displacement and reported the clinical application of long-term resorbable L-lactic acid/-caprolactone (PLA/PCL) as a barrier membrane to cover the open window in the lateral wall in MSA. Twenty-four patients underwent MSA according to the relevant criteria; CT data obtained before and 1 week (1 w) and 5-6 months (5 m) post-MSA, bone height changes, bone height reduction rates at 1 w and 5 m post-MSA, bone graft displacement measurements, and risk factors were examined. All patients showed bone height increments (p < 0.005). However, no difference was observed between 1 w and 5 m post-MSA. Bone graft displacement was observed in eight patients; the reduction rate from 1 w to 5 m post-MSA was 8.38% ± 4.88%. Sex, septa, maxillary sinus floor-palatal bone distance, and maxillary sinus floor-maxillary ostium distance were associated with bone graft displacement (p < 0.05). The height from the maxillary sinus floor to the palatal bone and the sinus angle influenced the augmentation degree (p < 0.05). The PLA/PCL membrane is compared favorably with other membranes and may be useful as a barrier membrane for the MSA open window.
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Affiliation(s)
- Kikue Yamaguchi
- Department of Implant Dentistry, Showa University School of Dentistry, 2-1-1, Kita-senzoku, Ota-ku, Tokyo 1458515, Japan
| | - Motohiro Munakata
- Department of Implant Dentistry, Showa University School of Dentistry, 2-1-1, Kita-senzoku, Ota-ku, Tokyo 1458515, Japan
| | - Daisuke Sato
- Department of Implant Dentistry, Showa University School of Dentistry, 2-1-1, Kita-senzoku, Ota-ku, Tokyo 1458515, Japan
| | - Yu Kataoka
- Department of Dental Education, Showa University School of Dentistry, 1-8-5, Hatanodai, Shinagawa-ku, Tokyo 1428555, Japan
- Department of Biomaterials and Engineering, Showa University School of Dentistry, 1-8-5, Hatanodai, Shinagawa-ku, Tokyo 14228555, Japan
| | - Ryota Kawamata
- Department of Implant Dentistry, Showa University School of Dentistry, 2-1-1, Kita-senzoku, Ota-ku, Tokyo 1458515, Japan
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Schulz MC, Holtzhausen S, Nies B, Heinemann S, Muallah D, Kroschwald L, Paetzold-Byhain K, Lauer G, Sembdner P. Three-Dimensional Plotted Calcium Phosphate Scaffolds for Bone Defect Augmentation—A New Method for Regeneration. J Pers Med 2023; 13:jpm13030464. [PMID: 36983646 PMCID: PMC10058839 DOI: 10.3390/jpm13030464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/19/2023] [Accepted: 02/24/2023] [Indexed: 03/06/2023] Open
Abstract
For sinus grafting, different methods and materials are available. One possible shortcoming of particulate bone grafts is either overfilling or augmenting the planned implant area insufficiently. To overcome this risk and to determine the implant position prior augmentation, we present an approach using three-dimensional printed scaffolds. A patient with a remaining anterior dentition and bilateral severely atrophied posterior maxilla was seeking oral rehabilitation. The cone beam computed tomography (CBCT) showed residual bone heights between one and two millimeters. Following the three-dimensional reconstruction of the CBCT data, the positions of the implants were determined in areas 16 and 26. Three-dimensional scaffolds adapted to the topography of the sinus were virtually designed and printed using a calcium phosphate cement paste. Bilateral sinus floor augmentation applying the printed scaffolds with an interconnecting porosity followed. After nine months, a satisfying integration of the scaffolds was obvious. At the re-entry, vital bone with sufficient blood supply was found. One implant could be placed in positions 16 and 26, respectively. After five months, the implants could be uncovered and were provided with a temporary denture. The application of three-dimensionally printed scaffolds from calcium phosphate cement paste seems to be a promising technique to graft the severely atrophied posterior maxilla for the placement of dental implants.
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Affiliation(s)
- Matthias C. Schulz
- Department of Oral and Maxillofacial Surgery, University Hospital Tübingen, Eberhard Karls Universität Tübingen, Osianderstraße 2-8, 72076 Tübingen, Germany
- Department of Oral and Maxillofacial Surgery, University Hospital “Carl Gustav Carus”, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany
- Correspondence: ; Tel.: +49-7071-2986-174
| | - Stefan Holtzhausen
- Institute of Machine Elements and Machine Design, Chair of Virtual Product Development, Technische Universität Dresden, 01062 Dresden, Germany
| | - Berthold Nies
- INNOTERE GmbH, Meissner Str. 191, 01445 Radebeul, Germany
| | | | - David Muallah
- Department of Oral and Maxillofacial Surgery, University Hospital “Carl Gustav Carus”, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany
| | - Lysann Kroschwald
- Department of Oral and Maxillofacial Surgery, University Hospital “Carl Gustav Carus”, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany
| | - Kristin Paetzold-Byhain
- Institute of Machine Elements and Machine Design, Chair of Virtual Product Development, Technische Universität Dresden, 01062 Dresden, Germany
| | - Günter Lauer
- Department of Oral and Maxillofacial Surgery, University Hospital “Carl Gustav Carus”, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany
| | - Philipp Sembdner
- Institute of Machine Elements and Machine Design, Chair of Virtual Product Development, Technische Universität Dresden, 01062 Dresden, Germany
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Valentini P, Artzi Z. Sinus augmentation procedure via the lateral window technique-Reducing invasiveness and preventing complications: A narrative review. Periodontol 2000 2022; 91:167-181. [PMID: 35924476 DOI: 10.1111/prd.12443] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 04/30/2022] [Accepted: 05/07/2022] [Indexed: 11/28/2022]
Abstract
Sinus augmentation has become an integrated surgical phase in posterior maxillary implant prosthesis reconstruction. Since the residual alveolar bony height usually requires additional volume particularly at this anatomical region, sinus floor augmentation is advocated routinely. Over the years, Implant success rate is proved to be comparable to the one in the pristine bone, which is well documented in the literature. Anatomical aspects as well as surgeon skills are at most importance to achieve predictable outcome. In this narrative review, the different osteotomy techniques, the indications toward 1 or 2-stage approaches, the control of the Schneiderian membrane integrity as well as the management of intra- and post-operative complications are thoroughly discussed according the current data. In light of the excellent long-term implant success rate concurrent with the application of contemporary advanced techniques of the sinus augmentation via the lateral wall osteotomy approach, reduce invasiveness and less complication occurrences are well documented. A well-codified patient selection involving the rhinologist as an integral medical team would be significantly beneficial toward early diagnosis. In-depth knowledge of the anatomy, execution of a well standardized surgical technique, and understanding the complication etiology and their management are prerequisites for reducing patient morbidity to minimal discomfort and predictable successful outcome.
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Affiliation(s)
- Pascal Valentini
- Department of Implant Surgery, Tattone Hospital, Institute of Health, University of Corsica Pasquale Paoli, Corte, France
| | - Zvi Artzi
- Department of Periodontology and Oral Implantology, School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
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Molnár B, Jung AK, Papp Z, Martin A, Orbán K, Pröhl A, Jung O, Barbeck M, Windisch P. Comparative analysis of lateral maxillary sinus augmentation with a xenogeneic bone substitute material in combination with piezosurgical preparation and bony wall repositioning or rotary instrumentation and membrane coverage: a prospective randomized clinical and histological study. Clin Oral Investig 2022; 26:5261-5272. [PMID: 35593928 PMCID: PMC9381628 DOI: 10.1007/s00784-022-04494-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 04/13/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The present randomized controlled clinical study aimed to investigate if, in lateral maxillary sinus augmentation, the repositioned bony wall or the application of a collagen membrane results in more preferable new hard tissue formation. MATERIALS AND METHODS Forty patients were divided into two study groups. Both groups received a xenogeneic bone substitute material (BSM) during lateral sinus augmentation. In the bony wall group (BW), following piezosurgery, the retrieved bony wall was repositioned. In the collagen membrane group (CM), following rotary instrument preparation, collagen membrane coverage was applied. After 6 months, biopsies were taken to histologically analyze the percentage of BSM, connective tissue (CT), and newly formed bone (NFB) following both approaches. RESULTS Forty implants were placed and 29 harvested biopsies could be evaluated. Duration of surgery, membrane perforations, and VAS were detected. Histomorphometrical analysis revealed comparable amounts of all analyzed parameters in both groups in descending order: CT (BW: 39.2 ± 9%, CM: 37,9 ± 8.5%) > BSM (BW: 32.9 ± 6.3%, CM: 31.8 ± 8.8%) > NB (BW: 27.8 ± 11.2%, CM: 30.3 ± 4.5%). CONCLUSIONS The results of the present study show that the closure of the access window by means of the retrieved bony wall or a native collagen membrane led to comparable bone augmentation results. CLINICAL TRIAL clinicaltrials.gov NCT04811768. CLINICAL RELEVANCE Lateral maxillary sinus augmentation with the application of a xenogeneic BSM in combination with a native collagen membrane for bony window coverage represents a reliable method for surgical reconstruction of the posterior maxilla. Piezosurgery with bony window repositioning delivers comparable outcomes without membrane coverage.
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Affiliation(s)
- Bálint Molnár
- Department of Periodontology, Semmelweis University Budapest, Szentkiralyi u. 47, 1088, Budapest, Hungary.
| | - Anne-Kathrin Jung
- Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, Rostock, Germany
| | - Zsuzsanna Papp
- Department of Periodontology, Semmelweis University Budapest, Szentkiralyi u. 47, 1088, Budapest, Hungary
| | - Anna Martin
- Department of Periodontology, Semmelweis University Budapest, Szentkiralyi u. 47, 1088, Budapest, Hungary
| | - Kristóf Orbán
- Department of Periodontology, Semmelweis University Budapest, Szentkiralyi u. 47, 1088, Budapest, Hungary
| | | | - Ole Jung
- Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, Rostock, Germany
| | | | - Péter Windisch
- Department of Periodontology, Semmelweis University Budapest, Szentkiralyi u. 47, 1088, Budapest, Hungary
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Nguyen TTH, Eo MY, Seo MH, Kim SM. Analysis of acute sinusitis-related early failed implant surface: a combined histological, electron microscopy, and X-ray spectroscopy approach. Maxillofac Plast Reconstr Surg 2022; 44:18. [PMID: 35469096 PMCID: PMC9038979 DOI: 10.1186/s40902-022-00346-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 04/02/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Even though dental implants are a reliable choice for dental rehabilitation, implant failures due to various etiologies have been reported. Early implant failures account for 2 to 6% of installed implants and are reported to have a higher rate than late failures, regardless of loading time. We herein report three cases of acute sinusitis and early implant failure with implants that failed within 1 month after installation. The aim of this study was to evaluate the surface properties of early failed implants and peri-implant tissue to determine the early osseointegration pattern in acute sinusitis-related failed implants as well as the possible role of surface contamination in the failure of osseointegration.
Results
A combined histological, electron microscopy, and X-ray spectroscopy approach was used to characterize the surface of non-osseointegrated titanium implants and the surrounding biological tissues. Morphologic scanning electron microscopy revealed a heterogeneous surface and irregular osseointegration. The implant surface was covered mostly by carbon- and oxygen-rich organic matter. Energy-dispersive X-ray spectroscopy surface analysis of three implants showed the incorporation of some contaminants in both the upper and apical regions. Carbon, nitrogen, sodium, silicon, chlorine, sulfur, gold, and zirconium were detected on the surface of one or more failed implants. Fibrosis, lymphocytic, and macrophage infiltrates and a high activation of osteoclasts surrounding the bone graft particles were detected in the surrounding tissues.
Conclusions
The etiology and mechanism of early implant failure, especially in sinus-related cases, as well as the proper management interventions to minimize the rate of early implant failures, are of great concern. No matter how confident and accurate the surgeon’s operation, there may be unknown errors in the whole procedure that no one knows about. Rather than errors related to the implant surface, it is expected that there were invisible problems during the evaluation of the patient’s own unique sinus mucosal inflammation or the operator’s own procedure. Furthermore, well-designed researches are necessary to reveal the effect of material-related factors on acute sinus complication and early implant failure.
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Kotsu M, Apaza Alccayhuaman KA, Ferri M, Iezzi G, Piattelli A, Fortich Mesa N, Botticelli D. Osseointegration at Implants Installed in Composite Bone: A Randomized Clinical Trial on Sinus Floor Elevation. J Funct Biomater 2022; 13:jfb13010022. [PMID: 35323222 PMCID: PMC8950152 DOI: 10.3390/jfb13010022] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 02/19/2022] [Accepted: 02/24/2022] [Indexed: 02/08/2023] Open
Abstract
Osseointegration of implants installed in conjunction with sinus floor elevation might be affected by the presence of residual graft. The implant surface characteristics and the protection of the access window using a collagen membrane might influence the osseointegration. To evaluate these factors, sinus floor elevation was performed in patients using a natural bovine bone grafting material. The access windows were either covered with a collagen membrane made of porcine corium (Mb group) or left uncovered (No-Mb group) and, after six months, two mini-implants with either a moderate rough or turned surfaces were installed. After 3 months, biopsies containing the mini-implants were retrieved, processed histologically, and analyzed. Twenty patients, ten in each group, were included in the study. The two mini-implants were retrieved from fourteen patients, six belonging to the Mb group, and eight to the No-Mb group. No statistically significant differences were found in osseointegration between groups. However, statistically significant differences were found between the two surfaces. It was concluded that implants with a moderately rough surface installed in a composite bone presented much higher osseointegration compared to those with a turned surface. The present study failed to show an effect of the use of a collagen membrane on the access window.
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Affiliation(s)
| | | | - Mauro Ferri
- ARDEC Foundation, Cartagena de Indias 130001, Colombia;
| | - Giovanna Iezzi
- Department of Medical Oral and Biotechnological Sciences, University of Chieti-Pescara, 66100 Chieti, Italy; (G.I.); (A.P.)
| | - Adriano Piattelli
- Department of Medical Oral and Biotechnological Sciences, University of Chieti-Pescara, 66100 Chieti, Italy; (G.I.); (A.P.)
| | - Natalia Fortich Mesa
- School of Dentistry, University Corporation Rafael Núñez, Cartagena de Indias 130001, Colombia;
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Sim JE, Kim S, Hong JY, Shin SI, Chung JH, Lim HC. Effect of the size of the bony access window and the collagen barrier over the window in sinus floor elevation: a preclinical investigation in a rabbit sinus model. J Periodontal Implant Sci 2022; 52:325-337. [PMID: 36047585 PMCID: PMC9436639 DOI: 10.5051/jpis.2105560278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 01/19/2022] [Accepted: 03/02/2022] [Indexed: 11/24/2022] Open
Abstract
Purpose The aim of this study was to investigate the effect of (1) the size of the bony access window and (2) collagen membrane coverage over the window in sinus floor elevation in a rabbit sinus model. Methods Small bony access windows (SW; ø 2.8 mm) were made in 6 rabbits and large windows (LW; ø 6 mm) in 6 other rabbits. Both sinuses in each rabbit were allocated to groups with or without coverage of a collagen membrane (CM) on the window, resulting in 4 groups: SW, LW, SW+CM, and LW+CM. After 4 weeks of healing, micro-computed tomographic, histologic, and histomorphometric analyses were performed. Results Bony healing in the window area was incomplete in all groups, but most bone graft particles were well confined in the augmented cavity. Histologically, the pattern of new bone formation was similar in all groups. Histomorphometrically, the percentage of newly formed bone was greater in the groups with CM than in the groups without CM, and in the groups with SW than in the groups with LW (12.92%±6.40% in the SW+CM group, 4.21%±7.73% in the SW group, 10.45%±4.81% in the LW+CM group, 11.77%±3.83% in the LW group). The above differences were not statistically significant (P>0.05). Conclusions The combination of a small bony access window and the use of a collagen membrane over the window favored new bone formation compared to other groups, but this result should be further investigated due to the limitations of the present animal model.
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Affiliation(s)
- Jeong-Eun Sim
- Department of Dentistry, Graduate School, Kyung Hee University, Seoul, Korea
| | - Sangyup Kim
- Department of Dentistry, Graduate School, Kyung Hee University, Seoul, Korea
| | - Ji-Youn Hong
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, School of Dentistry, Kyung Hee University, Seoul, Korea
- Department of Periodontology, Dental Hospital, Kyung Hee University Medical Center, Seoul, Korea
| | - Seung-Il Shin
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, School of Dentistry, Kyung Hee University, Seoul, Korea
- Department of Periodontology, Dental Hospital, Kyung Hee University Medical Center, Seoul, Korea
| | - Jong-Hyuk Chung
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, School of Dentistry, Kyung Hee University, Seoul, Korea
- Department of Periodontology, Dental Hospital, Kyung Hee University Medical Center, Seoul, Korea
| | - Hyun-Chang Lim
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, School of Dentistry, Kyung Hee University, Seoul, Korea
- Department of Periodontology, Dental Hospital, Kyung Hee University Medical Center, Seoul, Korea
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Munakata M, Yamaguchi K, Sato D, Yajima N, Tachikawa N. Factors influencing the sinus membrane thickness in edentulous regions: a cone-beam computed tomography study. Int J Implant Dent 2021; 7:16. [PMID: 33649993 PMCID: PMC7921232 DOI: 10.1186/s40729-021-00298-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 02/02/2021] [Indexed: 11/10/2022] Open
Abstract
Background During implant treatment in the maxillary molar area, maxillary sinus floor augmentation is often performed to ameliorate the reduced alveolar bone height attributable to bone remodeling and pneumatization-induced expansion of the maxillary sinus. However, this augmentation may cause complications such as misplaced implants, artery damage, and maxillary sinus mucosal perforation; infections like maxillary sinusitis; and postsurgical complications such as bone graft leakage and postoperative nasal hemorrhaging. To reduce the complications during maxillary sinus floor augmentation and postoperative infections, we performed retrospective investigations of various systemic and local factors that influence pre-operative sinus mucosal thickness (SMT) by using cone-beam computed tomography (CBCT). Subjects included patients who underwent maxillary sinus floor augmentation in an edentulous maxillary molar area with a lateral approach. Pre-operative SMT, existing bone mass, and nasal septum deviation were measured using CBCT images. Relationships between SMT and the following influencing factors were investigated: (1) age, (2) sex, (3) systemic disease, (4) smoking, (5) period after tooth extraction, (6) reason for tooth extraction, (7) residual alveolar bone height (RBH), (8) sinus septa, and (9) nasal septum deviation. Correlations were also investigated for age and RBH (p < 0.05). Results We assessed 35 patients (40 sinuses; 11 male, 24 female). The average patient age was 58.90 ± 9.0 years (males, 57.9 ± 7.7 years; females, 59.9 ± 9.4 years; age range, 41–79 years). The average SMT was 1.09 ± 1.30 mm, incidence of SMT > 2 mm was 25.0%, incidence of SMT < 0.8 mm was 50.0%, and the average RBH was 2.14 ± 1.02 mm. The factors that influenced SMT included sex (p = 0.0078), period after tooth extraction (p = 0.0075), reason for tooth extraction (p = 0.020), sinus septa (p = 0.0076), and nasal septum deviation (p = 0.038). Conclusions Factors associated with higher SMT included male sex, interval following tooth extraction < 6 months, periapical lesions, sinus septa, and nasal septum deviation. Factors associated with SMT > 2 mm were sex and reason for tooth extraction, while factors associated with SMT < 0.8 mm were time following tooth extraction and nasal septum deviation. Despite the limitations of this study, these preoperative evaluations may be of utmost importance for safely conducting maxillary sinus floor augmentation.
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Affiliation(s)
- Motohiro Munakata
- Department of Implant Dentistry, Showa University School of Dentistry, 2-1-1, Kita-Senzoku, Ota-ku, 145-8515, Tokyo, Japan.
| | - Kikue Yamaguchi
- Department of Implant Dentistry, Showa University School of Dentistry, 2-1-1, Kita-Senzoku, Ota-ku, 145-8515, Tokyo, Japan
| | - Daisuke Sato
- Department of Implant Dentistry, Showa University School of Dentistry, 2-1-1, Kita-Senzoku, Ota-ku, 145-8515, Tokyo, Japan
| | - Naoko Yajima
- Department of Implant Dentistry, Showa University School of Dentistry, 2-1-1, Kita-Senzoku, Ota-ku, 145-8515, Tokyo, Japan
| | - Noriko Tachikawa
- Tokyo Medical and Dental University Dental Hospital, Tokyo Medical and Dental University, Tokyo, Japan
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Starch-Jensen T, Deluiz D, Duch K, Tinoco EMB. Maxillary Sinus Floor Augmentation With or Without Barrier Membrane Coverage of the Lateral Window: a Systematic Review and Meta-Analysis. EJOURNAL OF ORAL MAXILLOFACIAL RESEARCH 2019; 10:e1. [PMID: 32158525 PMCID: PMC7012617 DOI: 10.5037/jomr.2019.10401] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 12/23/2019] [Indexed: 01/17/2023]
Abstract
Objectives Test the hypothesis of no difference in implant treatment outcomes after maxillary sinus floor augmentation with or without barrier membrane coverage of the lateral window. Material and Methods A MEDLINE (PubMed), Embase and Cochrane library search in combination with a hand-search of relevant journals was conducted. Human studies published in English until the 5th of July, 2019 were included. Randomised controlled trials and controlled trials with an observation period of minimum six months were included. Primary outcomes included survival of suprastructures and implants. Secondary outcomes included implant stability quotient, peri-implant marginal bone loss, bone regeneration, patient-reported outcome measures, biologic and mechanical complications. Results The electronic search and hand-searching resulted in 1068 entries. Six randomised controlled trials characterised by low to high risk of bias and one controlled trial with high risk of bias fulfilled the inclusion criteria. High implant survival rate was reported with both treatment modalities. Meta-analyses disclosed a mean difference of newly formed bone of 6.4% (confidence interval = 0 to 12.9) and non-mineralised tissue of -1.1% (confidence interval = -2.7 to 0.5), indicating more newly formed bone and diminished non-mineralised with barrier membrane coverage. Conclusions There seem to be no statistically significant differences in implant treatment outcomes after maxillary sinus floor augmentation with or without barrier membrane coverage of the lateral window. However, barrier membrane coverage increases percentage of newly formed bone and diminishes proliferation of non-mineralised tissue. Thus, barrier membrane coverage seems to be beneficial and also preventing displacement of the grafting material.
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Affiliation(s)
- Thomas Starch-Jensen
- Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, AalborgDenmark
| | - Daniel Deluiz
- Department of Periodontology, Rio de Janeiro State University, Rio de JaneiroBrazil
| | - Kirsten Duch
- Unit of Clinical Biostatistics, Aalborg University Hospital, AalborgDenmark
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Minetti E, Palermo A, Contessi M, Gambardella U, Schmitz J, Giacometti E, Celko M, Trisi P. Autologous tooth graft for maxillary sinus augmentation: A multicenter clinical study. ACTA ACUST UNITED AC 2019. [DOI: 10.4103/gfsc.gfsc_13_19] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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