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Sulyhan-Sulyhan K, Barberá-Millán J, Larrazábal-Morón C, Espinosa-Giménez J, Gómez-Adrián MD. Radiographic Study of Transcrestal Sinus Floor Elevation Using Osseodensification Technique with Graft Material: A Pilot Study. Biomimetics (Basel) 2024; 9:276. [PMID: 38786485 PMCID: PMC11118885 DOI: 10.3390/biomimetics9050276] [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: 03/11/2024] [Revised: 04/26/2024] [Accepted: 04/27/2024] [Indexed: 05/25/2024] Open
Abstract
This pilot study aimed to evaluate the level of implant success after transcrestal sinus floor elevation (tSFE) using the osseodensification technique (OD) combined with beta-tricalcium phosphate (β-TCP) by analyzing clinical and radiographic results. Moreover, the increase in bone height was analyzed immediately after surgery, 3 months after, and before loading by taking standardized radiographic measurements. Thirteen patients, four males and nine females, with a mean age of 54.69 ± 5.86 years, requiring the placement of one implant in the upper posterior maxilla, with a residual bone height of <8 mm and a minimum bone width of 5 mm, participated in the study. The bone gain data was obtained using cone-beam computed tomography (CBCT) immediately after surgery and twelve months after the placement. The correlation between initial and final bone height with implant stability was also assessed. The results were analyzed using SPSS 23 software (p < 0.05). The results of the study indicated a 100% implant success rate after a follow-up period of twelve months. Preoperative main bone height was 5.70 ± 0.95 mm. The osseodensification technique allowed a significant increase of 6.65 ± 1.06 mm immediately after surgery. After a twelve-month follow-up, a graft material contraction of 0.90 ± 0.49 mm was observed. No correlation was observed between the bone height at the different times of the study and the primary stability of the implant. Considering the limitations of the size sample of this study, the osseodensification technique used for transcrestal sinus lift with the additional bone graft material (β-TCP) may provide a predictable elevation of the maxillary sinus floor, allowing simultaneous implant insertion with adequate stability irrespective of bone height limitations.
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Affiliation(s)
- Khrystyna Sulyhan-Sulyhan
- Department of Dentistry, Faculty of Medicine and Health Sciences, Catholic University of Valencia San Vicente Mártir, 46001 Valencia, Spain; (K.S.-S.); (C.L.-M.); (J.E.-G.); (M.D.G.-A.)
| | - Javier Barberá-Millán
- Department of Dentistry, Faculty of Medicine and Health Sciences, Catholic University of Valencia San Vicente Mártir, 46001 Valencia, Spain; (K.S.-S.); (C.L.-M.); (J.E.-G.); (M.D.G.-A.)
- Doctoral School, Catholic University of Valencia San Vicente Mártir, 46001 Valencia, Spain
| | - Carolina Larrazábal-Morón
- Department of Dentistry, Faculty of Medicine and Health Sciences, Catholic University of Valencia San Vicente Mártir, 46001 Valencia, Spain; (K.S.-S.); (C.L.-M.); (J.E.-G.); (M.D.G.-A.)
| | - Julián Espinosa-Giménez
- Department of Dentistry, Faculty of Medicine and Health Sciences, Catholic University of Valencia San Vicente Mártir, 46001 Valencia, Spain; (K.S.-S.); (C.L.-M.); (J.E.-G.); (M.D.G.-A.)
| | - María Dolores Gómez-Adrián
- Department of Dentistry, Faculty of Medicine and Health Sciences, Catholic University of Valencia San Vicente Mártir, 46001 Valencia, Spain; (K.S.-S.); (C.L.-M.); (J.E.-G.); (M.D.G.-A.)
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Deng C, Xiong C, Man Y, Qu Y. Combination of a surgical template and a collagen strip for guiding sinus floor elevation in the oblique sinus floor: A technical note. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101495. [PMID: 37169339 DOI: 10.1016/j.jormas.2023.101495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 05/08/2023] [Indexed: 05/13/2023]
Abstract
Sinus floor elevation (SFE) by transcrestal approach has been proven to be a predictable and minimally invasive treatment that augments posterior maxilla with insufficient bone height, allowing the prosthetic rehabilitation of this area with dental implants. However, precise and sufficient elevation of the Schneiderian membrane without perforation is challenging through this blind technique especially in the presence of anatomical restrictions. This note describes a novel technique combining a surgical template and an absorbable collagen sponge (ACS) strip for transcrestal SFE in the oblique sinus floor. A surgical template was used to locate the oblique sinus floor and a collagen strip was placed to orient membrane elevation, meanwhile, protect the sinus membrane. Within the limits of present observation, this technique may increase the manipuility while reducing the risk of complications.
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Affiliation(s)
- Chen Deng
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China; Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Chenyi Xiong
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Yi Man
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China; Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Yili Qu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China; Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.
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Epistatu D, Dinca OM, Vladan C, Padurariu C, Damian I, Hostiuc S. Radiological Study on the Evolution of the Biomaterial's Image (Shape, Density, Vertical Dimensions) after the Lateral Sinus Lift. Dent J (Basel) 2023; 11:273. [PMID: 38132411 PMCID: PMC10742771 DOI: 10.3390/dj11120273] [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: 07/31/2023] [Revised: 10/13/2023] [Accepted: 11/24/2023] [Indexed: 12/23/2023] Open
Abstract
The aim of this study is to evaluate the long-term changes of sinus lift material. Materials and methods: We included a total number of 35 patients (20 men and 15 women), between 32 and 80 years old, evaluated on a timeframe of up to 11.6 years. Diverse biomaterials were used (allograft, xenograft, alloplastic, combinations of them), with autologous bone in some cases. Results: The appearance of the top plane of the bone over time took a large dome shape (36% of cases), a linear shape (32% of cases), an irregular shape (23% of cases), or had micro domes above the implants (7%). No significant differences were found between the groups regarding age. The radiological density of the biomaterial tended to equalize that of the native bone. The final vertical dimensions seemed to be independent of the initial native bone height but seemed to be correlated with the amount of applied biomaterial. For the study group, the biomaterial contracted on average by 10% for the maximum height (H max) and 20% for the minimum height (H min), which can explain the tendency of the upper border of the biomaterial to curve. The annual H max contraction ranged from -0.09 to +0.18 with a mean value of 2.67% (SD = 0.04, CI: [0.011, 0.041]). The median value was 1.8%. The annual H min contraction ranged from -0.24 to +0.24, with a mean value of 4.33% (SD = 0.07, CI: [0.021, 0.065]). The median value was 3.59%. There were no statistically significant gender differences (Mann-Whitney U, p = 0.483, p = 0.642). The additional application of biomaterial together with the implants seemed to have a beneficial effect on the final vertical dimension of the bio-transformed material.
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Affiliation(s)
- Dragos Epistatu
- Department of Dental Radiology, Dental Medicine Faculty, “Carol Davila” University of Medicine and Pharmacy, 37 Dionisie Lupu Str., 020021 Bucharest, Romania
| | - Octavian-Marius Dinca
- Department Oral and Maxillofacial Surgery, “Dan Theodorescu Hospital”, “Carol Davila” University of Medicine and Pharmacy, 37 Dionisie Lupu Str., 020021 Bucharest, Romania; (O.-M.D.); (C.V.); (C.P.)
| | - Cristian Vladan
- Department Oral and Maxillofacial Surgery, “Dan Theodorescu Hospital”, “Carol Davila” University of Medicine and Pharmacy, 37 Dionisie Lupu Str., 020021 Bucharest, Romania; (O.-M.D.); (C.V.); (C.P.)
| | - Cristina Padurariu
- Department Oral and Maxillofacial Surgery, “Dan Theodorescu Hospital”, “Carol Davila” University of Medicine and Pharmacy, 37 Dionisie Lupu Str., 020021 Bucharest, Romania; (O.-M.D.); (C.V.); (C.P.)
| | - Iulian Damian
- Department of Oral Rehabilitation, Ovidius University, 124 Bd. Mamaia, Aleea Universitatii nr.1, 900527 Constanta, Romania;
| | - Sorin Hostiuc
- Department of Legal Medicine and Bioethics, “Carol Davila” University of Medicine and Pharmacy, 37 Dionisie Lupu Str., 020021 Bucharest, Romania;
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Kim JH, Min EJ, Ko Y, Kim DH, Park JB. Change in Maxillary Sinus Mucosal Thickness in Patients with Preoperative Maxillary Sinus Mucosal Thickening as Assessed by Otolaryngologists: A Retrospective Study. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1750. [PMID: 37893468 PMCID: PMC10608619 DOI: 10.3390/medicina59101750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 09/10/2023] [Accepted: 09/27/2023] [Indexed: 10/29/2023]
Abstract
Background and Objectives: Maxillary sinus pathologic conditions may increase the risk of complications during posterior maxillary sinus augmentation surgery. The purpose of this study was to evaluate the changes in participants with preoperative maxillary sinus mucosal thickening and to assess this factor as a preoperative risk indicator for sinusitis after maxillary dental implantation. Materials and Methods: We compared the preoperative and postoperative maxillary sinus mucosal thickness (MSMT), the distance between the maxillary sinus ostium and sinus floor (MOD), and the MSMT/MOD ratio. The participants were divided into three groups (sinus augmentation, bone grafting, and no grafting). Results: The mean preoperative MSMT was 4.3 ± 2.0 mm, and the mean MSMT/MOD ratio was 0.13 ± 0.05. No postoperative sinusitis was observed in these patients, including cases caused by anatomical variations. The mean postoperative MSMT was 4.5 ± 2.3 mm, and the mean postoperative MSMT/MOD ratio was 0.15 ± 0.06. There was no statistically significant difference between the groups at each time point (p > 0.05). Conclusions: The study found no significant change in MSMT at post-treatment evaluation, even when considering different subgroups. It underscores the importance of preoperative maxillary sinus radiographic assessments and collaboration between dentists and otolaryngologists for better outcomes in patients with preoperative maxillary sinus mucosal thickening.
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Affiliation(s)
- Jin-Hyeong Kim
- Department of Periodontics, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea; (J.-H.K.); (Y.K.)
| | - Eun Jeong Min
- Department of Medical Life Science, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea;
- Department of Biomedicine & Health Sciences, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Youngkyung Ko
- Department of Periodontics, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea; (J.-H.K.); (Y.K.)
- Dental Implantology, Graduate School of Clinical Dental Science, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Do Hyun Kim
- Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Jun-Beom Park
- Department of Periodontics, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea; (J.-H.K.); (Y.K.)
- Dental Implantology, Graduate School of Clinical Dental Science, The Catholic University of Korea, Seoul 06591, Republic of Korea
- Department of Medicine, Graduate School, The Catholic University of Korea, Seoul 06591, Republic of Korea
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Zhang Y, Zhang C. Crestal sinus augmentation in a head back position: Retrospective case series. J Indian Soc Periodontol 2023; 27:428-433. [PMID: 37593563 PMCID: PMC10431223 DOI: 10.4103/jisp.jisp_229_22] [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: 05/07/2022] [Revised: 01/11/2023] [Accepted: 01/15/2023] [Indexed: 08/19/2023] Open
Abstract
Objectives To evaluate the clinical efficacy of Crestal Sinus Augmentation (CSA) in a head back position (CSA-HBP) for maxillary sinus mucosa elevation. Materials and Methods We enrolled 209 patients, 246 maxillary sinuses, 348 sites in this study. Complications, maxillary sinus mucosal perforation rate and cumulative survival rate (CSR) data were collected to evaluate the clinical efficacy of CSA-HBP. Maxillary sinus mucosal elevation height (EH) and new bone height (NH) were measured by cone-beam computerized tomography and standard periapical radiographs. The implantation sites of residual bone height (RBH) ≤5 mm and RBH >5 mm were marked as Groups A (n = 81) and B (n = 267), respectively. The implantation sites of the second and third molar sites were marked as Group C (n = 134), and the remaining sites were marked as Group D (n = 214). Results The RBH before implant placement was 6.63 ± 2.10 mm (95% confidence interval [CI] 6.41- 6.85 mm). The mucosal EH was 4.04 ± 1.86 mm (95% CI 3.85 - 4.24 mm). The NH was 2.36 ± 1.20 mm (95% CI 3.85-4.24 mm). No other complications were found except three cases of postoperative swelling and one case of nasal blood secretions. The overall mucosal perforation rate was 1.44% (5/348, 95% CI 0.2%-2.7%) and the rate of RBH ≤ 5 mm (Group A) was 1.49% (2/134, 95% CI 0%-3.50%). The 8-year CSR was 99.71% (347/348, 95% CI 99.2%-100.0%). Mucosal EH and NH were higher in RBH ≤5 mm (Group A) than in RBH >5 mm (Group B) (P = 0.001 and P = 0.001, Mann-Whitney U-test). There were no significant differences in mucosal EH and perforation rate between second and third molar sites (Group C) and other sites (Group D) (P = 0.77, Mann-Whitney U-test, and P = 0.16, Yates' Chi-square independence test). Conclusions CSA-HBP is a minimally invasive and reliable technique.
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Affiliation(s)
- Yuhang Zhang
- Department of Stomatology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Chunyuan Zhang
- Department of Stomatology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
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Naqvi A, Mishra G, Shahi S, Shakarwal P, Singh A, Singh R. Comparison between Platelet-rich Fibrin and Saline Filling after Sinus Elevation without Adjunctive Bone Graft in Dental Implants Insertion Using CBCT. J Contemp Dent Pract 2023; 24:9-15. [PMID: 37189006 DOI: 10.5005/jp-journals-10024-3474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
AIM The goal of this research was to compare radiographically the outcomes of hydraulic transcrestal sinus lifting with platelet-rich fibrin (PRF) or normal saline filling on implant survival rates, negative outcomes, and variations in the height of residual alveolar ridge (HARB). MATERIALS AND METHODS There were 80 study participants included and 90 dental implants were placed. The study participants were divided into two categories: Category A and Category B. Each category consists of 40 study participants. Category A: Normal saline was placed in the maxillary sinus. Category B: PRF was placed in the maxillary sinus. Implant survival, complications, and HARB alterations were the outcome metrics. Radiographic images through Cone-beam computed tomography (CBCT) were retrieved and compared prior to surgery (T0), immediately following surgery (T1), three months later (T2), 6 months later (T3), and 12 months later (T4). RESULTS There are 90 implants having an average length of 10.5 ± 0.7 mm were inserted into the posterior portion of the maxilla of 80 patients with an average HARB of 6.9 ± 1.2 mm. At T1, elevation in HARB peaked, and the sinus membrane continued to droop but steadied while observed at T3. The steady increment of areas of radiopacities was noticed below the elevated membrane of the maxillary antrum. A radiographic intrasinus bone increase of 2.9 ± 1.4 mm was caused by the PRF filling, compared to 1.8 ± 1.1 mm by the saline filling at T4 (p < 0.05). Over the course of the one-year follow-up period, all of the implants were operating normally with no major issues. CONCLUSION Platelet-rich fibrin when used as a filling medium alone without bone graft can cause significant ascend in height of the residual alveolar bone (HRAB). CLINICAL SIGNIFICANCE The degradation of the alveolar bone under the maxillary sinus following tooth loss frequently restricts the placement of the implant in the edentulous region of posterior maxilla. Numerous sinus-lifting surgery procedures and tools have been developed to address these problems. It has been a topic of debate regarding the benefits of bone grafts placed at the apical region of the implant. The sharp protrusions of the granules of bone graft may also provide a danger of membrane puncture. Recently, it was shown that regular bone gain might occur inside the maxillary antrum without the use of any bone transplant material. Additionally, if there were substances that filled the gap between the floor of the sinus and the raised sinus membrane, then the membrane of the maxillary sinus could be raised greater and for a longer period of time during the phase of formation of new bone formation.
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Affiliation(s)
- Akbar Naqvi
- Department of Dentistry, HIMSR and HAHC Hospital, New Delhi, India
| | - Gaurav Mishra
- Faculty of Dental Sciences, King George's Medical University, Lucknow, Uttar Pradesh, India, Phone: +91 9651771144, e-mail:
| | - Siddharth Shahi
- Department of Conservative Dentistry and Endodontics, Sarjug Dental College and Hospital, Laheriasarai, Darbhanga, Bihar, India
| | - Parul Shakarwal
- Department of Conservative Dentistry and Endodontics, Sardar Patel Post Graduate Institute of Dental and Medical sciences, Lucknow, Uttar Pradesh, India
| | - Abhishek Singh
- Department of Conservative Dentistry and Endodontics, Sardar Patel Post Graduate Institute of Dental and Medical sciences, Lucknow, Uttar Pradesh, India
| | - Rohit Singh
- Department of Pedodontics and Preventive Dentistry, Vananchal Dental College and Hospital, Garhwa, Jharkhand, India
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Hsu YT, Rosen PS, Choksi K, Shih MC, Ninneman S, Lee CT. Complications of sinus floor elevation procedure and management strategies: A systematic review. Clin Implant Dent Relat Res 2022; 24:740-765. [PMID: 35737681 DOI: 10.1111/cid.13086] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 03/17/2022] [Accepted: 03/18/2022] [Indexed: 12/14/2022]
Abstract
AIM This systematic review aimed to investigates the types and incidences of complications following sinus floor elevations (SFE) along with their prevention and management strategies. MATERIALS AND METHODS Electronic database and hand search were conducted to screen the literature published from January 1960 to June 2021. The selected studies had to report well-described SFE techniques, complications during, and post-SFE. Data extraction included types of SFE techniques, complications, and their treatment strategies. RESULTS A total of 74 studies with 4411 SFE procedures met the inclusion criteria. Different SFE techniques demonstrated varying patterns for both complications and complication rates. Postoperative pain, swelling, and edema were widely reported. The most common complications that required intervention following Lateral SFE (LSFE) were sinus membrane perforation (SMP), wound dehiscence, graft exposure and failure, and sinusitis. LSFE had more SMPs and sinusitis cases compared with a transcrestal SFE (TSFE). The presence of benign paroxysmal positional vertigo following TSFE was significant in certain selected studies. CONCLUSION Given the inherent limitations, this systematic review showed distinct features of complications in SFE using varying techniques. Treatment planning for these procedures should incorporate strategies to avoid complication occurrence.
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Affiliation(s)
- Yung-Ting Hsu
- Department of Periodontics, University of Washington School of Dentistry, Seattle, Washington, USA
| | - Paul S Rosen
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, Maryland, USA
| | - Karishma Choksi
- Division of Clinical Dentistry, University of Detroit Mercy School of Dentistry, Detroit, Michigan, USA
| | - Ming-Chieh Shih
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Shale Ninneman
- Department of Periodontics, University of Washington School of Dentistry, Seattle, Washington, USA
| | - Chun-Teh Lee
- Department of Periodontics and Dental Hygiene, University of Texas Health Science Center at Houston, Houston, Texas, USA
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Lombardi T, Lamazza L, Bernardello F, Ziętek G, Stacchi C, Troiano G. Clinical and radiographic outcomes following transcrestal maxillary sinus floor elevation with injectable xenogenous bone substitute in gel form: a prospective multicenter study. Int J Implant Dent 2022; 8:32. [PMID: 35867239 PMCID: PMC9307698 DOI: 10.1186/s40729-022-00431-5] [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: 04/01/2022] [Accepted: 07/11/2022] [Indexed: 11/25/2022] Open
Abstract
Purpose To investigate clinical and radiographic outcomes of transcrestal maxillary sinus floor elevation performed with an injectable xenograft in gel form, analyzing general, local and surgical variables possibly influencing the results. Methods Patients with residual crestal height < 5 mm underwent transcrestal sinus floor elevation with xenograft in gel form to allow the placement of a single implant. Simultaneous implant placement was performed when primary stability was ≥ 15 Ncm. Graft height was measured immediately after surgery (T0) and after 6 months of healing (T1). Univariate and multivariate regression models were built to assess associations between clinical variables with implant survival and graft height at T1. Results 71 patients underwent transcrestal sinus floor elevation and 54 implants were simultaneously placed. Delayed implant placement (at T1) was possible in 5 cases out of 17 (29.4%), whereas in 12 patients (70.6%) implant insertion was not possible or required additional sinus grafting. Implant survival rate, with a follow-up varying from 12 to 32 months after loading, was 100%. Mean pre-operative bone height was 3.8 ± 1.0 mm, at T0 was 13.9 ± 2.2 mm and at T1 was 9.9 ± 2.8 mm. Bone height at T1 was negatively influenced by membrane perforation at surgery (p = 0.004) and positively influenced by immediate implant insertion (p < 0.001). Conclusions Transcrestal sinus floor elevation performed with injectable xenograft gel resulted in 100% implant survival rate. However, immediate implant insertion seems a crucial factor to preserve vertical bone gain: one-stage technique seems to be the most predictable approach to optimize clinical outcomes with this approach. Trial registration clinicaltrials.gov, NCT05305521. Registered 31 March 2022—Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT05305521.
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Affiliation(s)
- Teresa Lombardi
- Department of Health Sciences, Magna Græcia University, 88100, Catanzaro, Italy
| | - Luca Lamazza
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00161, Rome, Italy
| | - Fabio Bernardello
- Studio Bernardello, via Bonvicini, 42, Terranegra di Legnago (VR), 37045, Verona, Italy.
| | | | - Claudio Stacchi
- Department of Medical, Surgical and Health Sciences, University of Trieste, 34100, Trieste, Italy
| | - Giuseppe Troiano
- Department of Clinical and Experimental Medicine, University of Foggia, 71122, Foggia, Italy
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Lee JY, Kim S, Shin SY, Chung JH, Herr Y, Lim HC. Effectiveness of hydraulic pressure-assisted sinus augmentation in a rabbit sinus model: a preclinical study. Clin Oral Investig 2022; 26:1581-1591. [PMID: 34420085 DOI: 10.1007/s00784-021-04131-z] [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: 07/17/2021] [Accepted: 08/04/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To investigate the effectiveness of hydraulic pressure-assisted sinus augmentation (SA) in a rabbit sinus model in terms of radiographical and histological healing. MATERIALS AND METHODS Bilateral SA was performed in 12 rabbits. Each sinus was randomly assigned to either a hydraulic pressure-assisted SA (test) or a conventional SA (control) group. Healing periods of 2 and 4 weeks were applied (n = 6 for each week). Healing pattern including newly formed bone (NB) and residual bone substitute material (RM) was analyzed with microcomputed tomographically, histologically, and histomorphometrically. RESULTS No sinus membrane perforation was detected in either group. In the microcomputed tomographic analysis, the test group exhibited higher apico-coronal spread of RM compared to the control group (p < 0.05). Particularly, the test group exhibited several masses of NB out of the cluster of RM. Histologically, the test group showed an elongated shape of the augmented space, whereas the control group generally presented a dome shape. Histomorphometrically, the total augmented area and the area of NB (1.32 ± 0.56 vs. 0.84 ± 0.40 mm2 at 2 weeks, 2.24 ± 1.09 vs. 2.22 ± 0.85 mm2 at 4 weeks) were not significantly different between the test and the control groups at both healing periods (p > 0.05). CONCLUSION Hydraulic pressure-assisted SA led to new bone formation in the distant areas from the bony access hole, but similar histological healing pattern to conventional SA. CLINICAL RELEVANCE Hydraulic pressure-assisted SA is a promising option for treating pneumatized posterior maxilla.
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Affiliation(s)
- Ji-Yeong Lee
- Department of Periodontology, Graduate School, Kyung Hee University, 26 Kyungheedae‑ro, Dongdaemun‑gu, Seoul, 02447, Republic of Korea
| | - Sangyup Kim
- Department of Periodontology, Graduate School, Kyung Hee University, 26 Kyungheedae‑ro, Dongdaemun‑gu, Seoul, 02447, Republic of Korea
| | - Seung-Yun Shin
- Department of Periodontology, School of Dentistry, Periodontal-Implant Clinical Research Institute, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea
- Department of Periodontology, Dental Hospital, Kyung Hee University Medical Center, 23 Kyungheedae‑ro, Dongdaemun‑gu, Seoul, 02447, Republic of Korea
| | - Jong-Hyuk Chung
- Department of Periodontology, School of Dentistry, Periodontal-Implant Clinical Research Institute, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea
- Department of Periodontology, Dental Hospital, Kyung Hee University Medical Center, 23 Kyungheedae‑ro, Dongdaemun‑gu, Seoul, 02447, Republic of Korea
| | - Yeek Herr
- Department of Periodontology, School of Dentistry, Periodontal-Implant Clinical Research Institute, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea.
- Department of Periodontology, Dental Hospital, Kyung Hee University Medical Center, 23 Kyungheedae‑ro, Dongdaemun‑gu, Seoul, 02447, Republic of Korea.
| | - Hyun-Chang Lim
- Department of Periodontology, School of Dentistry, Periodontal-Implant Clinical Research Institute, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea.
- Department of Periodontology, Dental Hospital, Kyung Hee University Medical Center, 23 Kyungheedae‑ro, Dongdaemun‑gu, Seoul, 02447, Republic of Korea.
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Starch-Jensen T, Bruun NH. Patient's perception of recovery after osteotome-mediated sinus floor elevation with Bio-Oss collagen compared with no grafting material: a randomized single-blinded controlled trial. Int J Implant Dent 2021; 7:20. [PMID: 33748923 PMCID: PMC7982363 DOI: 10.1186/s40729-021-00302-5] [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: 11/03/2020] [Accepted: 02/11/2021] [Indexed: 01/23/2023] Open
Abstract
Background Osteotome-mediated sinus floor elevation with or without a grafting material is associated with high implant survival, intrasinus bone gain, and low frequency of complications. However, patient’s perception of recovery and satisfaction with the surgical intervention are rarely reported. The objective of the present randomized controlled trial was to assess patient’s perception of recovery after osteotome-mediated sinus floor elevation with Bio-Oss collagen compared with no grafting material. Forty healthy patients were randomly allocated to Bio-Oss collagen or no grafting material. Oral health-related quality of life was assessed by Oral Health Impact Profile-14 at enrollment. Patient’s perception of recovery was assessed by self-administrated questionnaires and visual analog scale evaluating pain, social and working isolation, physical appearance, duration and quality of life alterations, eating and speaking ability, diet variations, and sleep impairment after 1 week and 1 month, respectively. Descriptive statistics was expressed as mean percentage with standard deviation. Correlation between impaired oral health-related quality of life, age, gender, and recovery were assessed by T test. Level of significance was 0.05. Results Osteotome-mediated sinus floor elevation is associated with high patient satisfaction, limited postoperative discomfort, and willingness to undergo similar surgery. Influence on patient’s daily life activities seems to be minimal and limited to the first postoperative days. Most patients managed to return to work and their routine daily activities after 0-2 days. Impaired preoperative oral health-related quality of life, gender, or younger age seems not to predispose for delayed recovery. However, number of days with pain, eating difficulties, and sleep disturbances were significantly increased with Bio-Oss collagen compared with no grafting material (P<0.05). Conclusion Patient’s discomfort seems to be minimal and limited to the first postoperative days following osteotome-mediated sinus floor elevation with or without a grafting material. Impaired preoperative oral health-related quality of life, gender, or younger age seems not to predispose for delayed recovery.
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Affiliation(s)
- Thomas Starch-Jensen
- Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, 18-22 Hobrovej, DK-9000, Aalborg, Denmark. .,Department of Clinical Medicine, The Faculty of Medicine, Aalborg University, Aalborg, Denmark.
| | - Niels Henrik Bruun
- Unit of Clinical Biostatistics, Aalborg University Hospital, Aalborg, Denmark
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11
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Measurement of hydraulic pressure on the sinus membrane for safer control during transcrestal sinus lifting. Int J Oral Maxillofac Surg 2021; 50:1267-1270. [PMID: 33648817 DOI: 10.1016/j.ijom.2021.02.003] [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: 05/13/2020] [Revised: 11/03/2020] [Accepted: 02/02/2021] [Indexed: 11/23/2022]
Abstract
The aim of this study was to determine the hydraulic pressures necessary to separate and lift the sinus membrane from the sinus floor in order to ensure a more controlled and safer hydraulic transcrestal sinus lifting surgery and prevent sinus membrane perforation. A flow-regulating hydrodynamic device with a pressure sensor was used in nine patients. The hydraulic pressure was found to increase steadily up to a mean peak of 25.0±13.0kPa, which is comparable to the medium suction power of ordinary vacuum cleaners. Subsequently, there was a short plateau followed by a sharp decrease in the hydraulic pressure.
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12
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Lumbau AI, Meloni SM, Tallarico M, Melis L, Spano G, Baldoni E, Koshovari A, Pisano M. Implant Placement Following Crestal Sinus Lift with Sequential Drills and Osteotomes: Five Years after Final Loading Results from a Retrospective Study. J Funct Biomater 2021; 12:jfb12010010. [PMID: 33557297 PMCID: PMC7930954 DOI: 10.3390/jfb12010010] [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: 12/15/2020] [Revised: 01/24/2021] [Accepted: 01/29/2021] [Indexed: 11/16/2022] Open
Abstract
The aim of this retrospective study was to clinically evaluate the five-year outcomes of implants placed following a combined approach to the sinus, consisting of sequential drills and osteotomes. Medical records of patients with implants placed in combination with crestal sinus lift using sequential drills and osteotomes, with a residual alveolar bone crest between 4 to 8 mm, and a follow-up of at least five years after final loading, were evaluated. Outcomes were implant and prosthetic survival and success rates, any complication, and marginal bone loss. Data from 96 patients (53 women and 43 men; mean age 54.7 years; range 23-79 years) were collected. A total of 105 single implants were analyzed. After five years of function, two implants were lost and two prostheses failed. No major biological or prosthetic complications occurred. At the five-year examination, the marginal bone loss was 1.24 ± 0.28 mm. Within the limitations of this retrospective study it can be concluded that implants placed following a combined approach to the sinus consisting of sequential drills and osteotomes seem to be a viable option for the treatment of posterior atrophic edentulous maxilla.
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Affiliation(s)
- Aurea Immacolata Lumbau
- School of Dentistry, University of Sassari, 07100 Sassari, Italy; (A.I.L.); (S.M.M.); (G.S.); (E.B.)
| | - Silvio Mario Meloni
- School of Dentistry, University of Sassari, 07100 Sassari, Italy; (A.I.L.); (S.M.M.); (G.S.); (E.B.)
| | - Marco Tallarico
- School of Dentistry, University of Sassari, 07100 Sassari, Italy; (A.I.L.); (S.M.M.); (G.S.); (E.B.)
- Correspondence:
| | - Luca Melis
- Private Practice, 07100 Sardinia, Italy; (L.M.); (M.P.)
| | - Giovanni Spano
- School of Dentistry, University of Sassari, 07100 Sassari, Italy; (A.I.L.); (S.M.M.); (G.S.); (E.B.)
| | - Edoardo Baldoni
- School of Dentistry, University of Sassari, 07100 Sassari, Italy; (A.I.L.); (S.M.M.); (G.S.); (E.B.)
| | - Alba Koshovari
- Department of Implantology and Prosthetic Aspects, Aldent University, 1022 Tirana, Albania;
| | - Milena Pisano
- Private Practice, 07100 Sardinia, Italy; (L.M.); (M.P.)
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13
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Zhou Y, Shi Y, Si M, Wu M, Xie Z. The comparative evaluation of transcrestal and lateral sinus floor elevation in sites with residual bone height ≤6 mm: A two-year prospective randomized study. Clin Oral Implants Res 2020; 32:180-191. [PMID: 33220090 DOI: 10.1111/clr.13688] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 11/02/2020] [Accepted: 11/11/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To compare clinical and radiographic outcomes between transcrestal sinus floor elevation (TSFE) and lateral sinus floor elevation (LSFE) approaches of simultaneous implant placement in atrophic maxilla. MATERIALS AND METHODS Patients with a residual bone height (RBH) ≤6 mm were enrolled and randomly assigned to TSFE and LSFE groups. Patients in both groups simultaneously underwent sinus floor elevation with bovine-derived xenograft and implant placement. Clinical and radiographic results were evaluated immediately after surgery and after 6, 12, 18, and 24 months. The endo-sinus bone gain (ESBG), apical implant bone height (ABH), endo-sinus bone-implant contact rate (EBICR), and crestal bone level (CBL) were assessed using panoramic radiographs. RESULTS Forty-one implants (TSFE: 21, LSFE: 20) were placed in cases with a mean RBH of 3.77 ± 1.16 mm. All implants obtained clinical success and satisfactory ESBG at 24 months. No significant differences were found in ESBG and ABH between two groups immediately after surgery, but LSFE group showed significantly higher values than TSFE group thereafter. Grafts in TSFE group reached stability 6 months earlier than that in LSFE group. In both groups, EBICR was almost 100%, and CBL showed no detectable changes. CONCLUSIONS LSFE can achieve higher ESBG 2 years after surgery. Otherwise, TSFE could be an alternative to LSFE, when the access for lateral window preparation is limited. Both approaches were highly predictable for RBH ≤6 mm during 24-month observation period for the implants placed simultaneously.
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Affiliation(s)
- Yiqun Zhou
- 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, China
| | - Yang Shi
- 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, China
| | - Misi Si
- 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, China
| | - Mengjie Wu
- 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, China
| | - Zhijian Xie
- 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, China
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14
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Cho YS, Hwang KG, Jun SH, Tallarico M, Kwon AM, Park CJ. Radiologic comparative analysis between saline and platelet-rich fibrin filling after hydraulic transcrestal sinus lifting without adjunctive bone graft: A randomized controlled trial. Clin Oral Implants Res 2020; 31:1087-1093. [PMID: 32871620 DOI: 10.1111/clr.13655] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 07/30/2020] [Accepted: 08/13/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To evaluate implant survival rate, any complications, and changes in residual alveolar bone height (RABH) using saline or platelet-rich fibrin (PRF) filling after hydraulic transcrestal sinus lifting. METHODS Dental implants were placed after hydraulic transcrestal sinus lifting and the filling of saline (20 patients) or PRF (20 patients). Outcome measurements were implant survival, any complications, and RABH changes. Cone-beam computed tomography (CBCT) scans were taken and compared preoperatively (T0), immediately postoperatively (T1), at 3 months (T2), 6 months (T3), and 12 months postoperatively (T4), respectively. RESULTS In a total of 40 patients, 45 implants with a mean length of 10.4 ± 0.8 mm were placed in posterior maxilla of a mean RABH of 6.8 ± 1.1 mm. The increase in RABH peaked at T1, and continuous drooping of the sinus membrane was observed but stabilized at T3. Meanwhile, the gradual increase in the radiopacities was found below the lifted sinus membrane. The PRF filling induced the radiographic intrasinus bone gain of 2.6 ± 1.1 mm, which was significantly more than 1.7 ± 1.0 mm of saline filling at T4 (p < .05). All the implants were in function with no significant complications over the one-year follow-up period. CONCLUSIONS In this randomized case-control study, the feasibility of hydraulic transcrestal sinus lifting without bone graft was confirmed and PRF might be a better filler to support the elevated sinus membrane. However, adjunctive bone grafting should still be indicated for cases requiring more than 2-3 mm of intrasinus bone gain.
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Affiliation(s)
- Yong-Seok Cho
- Private Practice, Oral and Maxillofacial Surgery, Apsun Dental Hospital, Seoul, Korea
| | - Kyung-Gyun Hwang
- Division of Oral and Maxillofacial Surgery, Department of Dentistry, College of Medicine, Hanyang University, Seoul, Korea
| | - Sang Ho Jun
- Department of Oral and Maxillofacial Surgery, Korea University Anam Hospital, Seoul, Korea
| | - Marco Tallarico
- Department of Periodontology and Implantology, University of Sassari, Sassari, Italy
| | - Amy M Kwon
- Biostatistics Core, Medicine-Engineering-Bio (MEB) Global Development Research Center, Industry-University Cooperation Foundation, Hanyang University, Seoul, Korea
| | - Chang-Joo Park
- Division of Oral and Maxillofacial Surgery, Department of Dentistry, College of Medicine, Hanyang University, Seoul, Korea
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15
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Kim YK, Ku JK. Sinus membrane elevation and implant placement. J Korean Assoc Oral Maxillofac Surg 2020; 46:292-298. [PMID: 32855378 PMCID: PMC7469962 DOI: 10.5125/jkaoms.2020.46.4.292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 07/27/2020] [Indexed: 12/12/2022] Open
Abstract
Sinus Schneiderian membrane elevation surgery is widely performed for dental implant placement in the maxillary posterior region. With regard to sinus elevation surgery, various complications can occur and lead to implant failure. For successful implants in the maxillary posterior region, the clinician must be well acquainted with sinus anatomy and pathology, a variety of bone graft materials, the principles of sinus elevation surgery, and prevention and management of complications.
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Affiliation(s)
- Young-Kyun Kim
- Editor-in-Chief of J Korean Assoc Oral Maxillofac Surg, Seongnam, Korea.,Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Seongnam, Korea.,Department of Dentistry & Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Seongnam, Korea
| | - Jeong-Kui Ku
- Section Editor of J Korean Assoc Oral Maxillofac Surg, Seongnam, Korea.,Department of Oral and Maxillofacial Surgery, Section of Dentistry, Armed Forces Capital Hospital, Armed Forces Medical Command, Seongnam, Korea
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16
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Chaushu L, Chaushu G, Better H, Naishlos S, Kolerman R, Aragoneses JM, Calvo-Guirado JL, Nissan J. Sinus Augmentation with Simultaneous, Non-Submerged, Implant Placement Using a Minimally Invasive Hydraulic Technique. ACTA ACUST UNITED AC 2020; 56:medicina56020075. [PMID: 32069970 PMCID: PMC7074246 DOI: 10.3390/medicina56020075] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 02/10/2020] [Accepted: 02/11/2020] [Indexed: 12/14/2022]
Abstract
Background and objectives: To evaluate whether sinus augmentation, using a minimally invasive implant device, via a non-submerged surgical approach, might negatively influence the outcome. Materials and Methods: A retrospective cohort study was conducted by evaluating patients’ files, classifying them into two groups. Fifty patients (22 men 28 women) were included in the study, 25 in each group. The use of an implant device based on residual alveolar ridge height for sinus augmentation, radiographic evaluation, insertion torque, membrane perforation, post-operative healing, and a minimum of 12 months follow-up were evaluated. Results: The mean residual alveolar ridge height was 5.4 mm for the non-submerged group and 4.2 mm for the submerged group. There were no intraoperative or postoperative complications (including membrane perforations). The mean insertion torque was 45 N/cm for the study group and 20 N/cm for the control group. Complete soft tissue healing was observed within three weeks. Mean bone gain height was 8 mm for the study and 9.3 mm for the control group. All implants osseointegrated after 6–9 months of healing time. Mean follow-up was 17.5 months, range 12–36 months. Marginal bone loss at last follow-up was not statistically significantly different: 1 mm in the non-submerged vs. 1.2 mm in the submerged group. Conclusions: Submerged and non-submerged healing following maxillary sinus augmentation was comparable provided residual alveolar ridge height >5 mm and insertion torque >25 N/cm.
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Affiliation(s)
- Liat Chaushu
- Department of Periodontology and Implant Surgery, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 6997801, Israel;
- Correspondence:
| | - Gavriel Chaushu
- Department of Oral and Maxillofacial Surgery, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 6997801, Israel;
| | - Hadar Better
- Private practice in Oral and Maxillofacial Surgery, Tel Aviv 6997801, Israel;
| | - Sarit Naishlos
- Department of Pedodontics, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 6997801, Israel;
| | - Roni Kolerman
- Department of Periodontology and Implant Surgery, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 6997801, Israel;
| | - Juan Manuel Aragoneses
- Department of Dental Research in Universidad Federico Henriquez y Carvajal, Santo Domingo 10107, Dominican Republic;
| | - José Luis Calvo-Guirado
- Department of Oral and Implant Surgery, Faculty of Health Sciences, Universidad Católica de Murcia, Murcia 30107, Spain;
| | - Joseph Nissan
- Department of Oral and Maxillofacial Surgery, Rabin Medical Center, Petah Tiqwa, 4922297 Israel;
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
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17
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Tallarico M, Caneva M, Baldini N, Gatti F, Duvina M, Billi M, Iannello G, Piacentini G, Meloni SM, Cicciù M. Patient-centered rehabilitation of single, partial, and complete edentulism with cemented- or screw-retained fixed dental prosthesis: The First Osstem Advanced Dental Implant Research and Education Center Consensus Conference 2017. Eur J Dent 2019; 12:617-626. [PMID: 30369812 PMCID: PMC6178685 DOI: 10.4103/ejd.ejd_243_18] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
The aim of this consensus conference was to provide clinical guidelines, based on the available evidence and on the author's daily practice and experience, for general dentistry and dental practitioners to allow them to delivery long-term successful restorations. Three groups of expert clinicians and dental technicians were invited to evaluate all of the scientific literature from 1967 up to March 2017 to identify relevant studies on assigned topics and to prepare in advance narrative/systematic review, written according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, to fulfill the consensus statement criteria. The three topics assigned to the three groups were abutment/framework materials and customization (metal vs. metal-free restorations), abutment/framework protocols and designs, and abutment/framework retentions (cemented- vs. screw-retained implant-supported prostheses). All the expert clinicians presented their results, and the lectures were followed by discussions. No significant differences in clinical parameters (marginal bone loss, bleeding on probing, and pocket probing depth) between screw- or cemented-retained were found for single and multiple implant-supported restorations. There is moderate evidence that nonoriginal abutments provide worse mechanical behavior than originals and high evidence that different implant neck designs do not offer any clinical or radiographic advantage. All the participants agreed that it is desirable to connect and remove abutments as few times as possible. There is medium evidence that an adequate platform switching tends to enhance tissue volume and stability in the medium- and long-term follow-up. No statistically significant differences exist between metal and zirconia as a framework material. The authors discussed and all agreed that retrievability and patient's expectation (function and esthetics) should guide the choice of the most adequate technique, component, and material.
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Affiliation(s)
- Marco Tallarico
- Deparment of Medical Sciences, School of Dentistry, Aldent University, Tirana, Albania
| | - Marco Caneva
- ARDEC Academy, Ariminum Odontologica, Rimini, Italy
| | - Nicola Baldini
- Department of Periodontics and Implantology, University of Siena, Siena, Italy
| | - Fulvio Gatti
- Department of Biomedical, Surgical and Dental Sciences, Unit of Oral Surgery, San Carlo and San Paolo Hospital, University of Milan, Milan, Italy
| | - Marco Duvina
- Department of Oral Surgery and Implantology, University of Florence, Florence, Italy
| | | | - Gaetano Iannello
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, School of Dentistry, Policlinic "Gaetano Martino" University of Messina, Messina, Italy
| | | | - Silvio Mario Meloni
- Department of Surgical Microsurgical and Medical Science, University of Sassari, Sassari, Italy
| | - Marco Cicciù
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, Messina University, Messina, Italy
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18
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Zhou Z, Wang Y, Meng W, Yang X, Dao J. [Two-stage closed sinus lift for severe bone deficiency in the posterior maxilla imrpoves long-term clinical outcomes]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2019; 39:731-735. [PMID: 31270054 DOI: 10.12122/j.issn.1673-4254.2019.06.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To evaluate the long-term clinical outcomes of two-stage closed sinus lift for the maxillary sinus with residual bone height (RBH) of 1-3 mm in the posterior maxillary. METHODS Seventy-eight patients with maxillary posterior tooth loss (1 mm≤RBH≤3 mm and alveolar ridge width ≥5 mm) were treated with two-stage closed sinus lift at the Dental Implantation Center of our hospital between March, 2012 and December, 2014. Coral hydroxyapatite powder and 148 implants were implanted. The superstructure was fixed within 6 months after the operation and the patients were followed up for 1-5 years for assessing the patients' satisfaction, postoperative response, stability and survival rates of the implant, soft tissue condition, bone height of maxillary sinus floor elevation and the marginal bone loss. RESULTS Perforation of the maxillary sinus floor occurred in 3 (3.85%) of the cases. Twenty-three (30.67%) patients complained of mild pain, and 52 (69.33%) did not experience headache or fever or reported obvious pain or swelling after the operation. The overall response to the operation was favorable. The ISQ value was 58.39±1.39 immediately after the operation, and increased significantly to 81.88±1.22 at 6 months (P < 0.05). During the healing period and the follow-up, none of the implants fell off, and the implant survival rate was 100%. The peri-implant probing depth and modified sulcus bleeding index at 1 year after sinus lifting were similar to those at 5 years after the operation (P > 0.05), but the sinus floor elevation and marginal bone resorption at the two time points differed significantly (P < 0.05). CONCLUSIONS Compared with lateral wall lifting, two-stage close lifting of the maxillary sinus floor is associated with less trauma and less discomfort, and effectively solves the problem of severe alveolar bone height deficiency in the maxillary posterior region to achieve favorable long-term clinical outcomes.
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Affiliation(s)
- Zhen Zhou
- Stomatology Hospital, Southern Medical University, Guangzhou 510280, China
| | - Yamin Wang
- Stomatology Hospital, Southern Medical University, Guangzhou 510280, China
| | - Wenxia Meng
- Stomatology Hospital, Southern Medical University, Guangzhou 510280, China
| | - Xi Yang
- Stomatology Hospital, Southern Medical University, Guangzhou 510280, China
| | - Junfeng Dao
- Stomatology Hospital, Southern Medical University, Guangzhou 510280, China
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