Maxillary sinus lift augmentation: A randomized clinical trial with histological data comparing deproteinized bovine bone grafting vs graftless procedure with a 5-12-year follow-up.

INTRODUCTION: Different protocols and procedures for sinus lift and implant placement are available, generally involving the use of grafts to increase the tissue volume and/or prevent the Schneiderian membrane from collapsing. Among xenografts, deproteinised bovine bone graft (DBBP) is frequently used in sinus lift procedures. Leaving an ungrafted space following membrane elevation has proven to have a bony regenerative potential as well. This study aimed to compare the clinical and histological features of sinus lift surgery performed with or without biomaterials. METHODS: Patients with severe maxillary posterior atrophy (residual bone height 2-6 mm and residual crest thickness ≥4 mm), and in need of sinus lift surgery to allow the placement of three implants were enrolled and randomly divided into two groups. They underwent sinus lifts with DBBP (control) or with a graftless technique (test) and immediate placement of two implants (a mesial and distal one). After 6 months, a bone sample was retrieved from the area between the previously inserted fixtures, and a third, central implant was placed. The collected bone samples were analyzed morphologically and histomorphometrically. The patients were provided with prosthetic restorations after 6 months and followed up for 5-12 years. RESULTS: Ten patients were enrolled in the test and nine in the control group. The 6-month follow-up showed in the control group an average augmentation of 10.31 mm (±2.12), while in the test group it was 8.5 mm (±1.41) and a success rate of 96.3% in the control and 86.7% in the test group (p > 0.05). The histological analysis evidenced the presence of new bone tissue surrounded by immature osteoid matrix in the test group, and a variable number of DBBP particles surrounded by an immature woven bone matrix in the control group. CONCLUSION: The results of the present trial indicate that, with residual bone height of 2-6 mm and residual crest thickness ≥4 mm, sinus lift surgery with or without biomaterials followed by implant restoration, produces similar clinical and histological outcomes.

Mucoceles of the oral cavity: a large case series (1994-2008) and a literature review.

OBJECTIVES: Evaluating data of patients affected by oral mucoceles, examined at the Unit of Oral Medicine and Pathology of the University of Milan between January 1994 and December 2008. STUDY DESIGN: Concise review on oral mucoceles and analysis of the clinical files of patients who underwent excisional biopsy (patient age, medical history, diagnosis, date and site of the biopsy, histopathological diagnosis and recurrences if any). RESULTS: During the period June 1994-December 2008, 158 mucoceles were observed (93 males and 65 females), with the most frequent site being the lower lip (53%) (p=0.001 by Fisher's test). The mean age of the patients was 31.9 years, with a peak of occurrence in the first four decades of life (75%). CONCLUSIONS: Mucoceles are lesions commonly seen in an oral medicine service, mainly affecting young people and lower lips.

Immediate/early function with tapered implants supporting maxillary and mandibular posterior fixed partial dentures: preliminary results of a prospective multicenter study.

STATEMENT OF PROBLEM: While immediate loading in the interforaminal area of the mandible is a documented procedure, there are limited scientific data for immediate/early loading in premolar and molar areas where less bone density is often found and functional loading is high. PURPOSE: The purpose of this study was to evaluate if there is a difference between immediate and early loading in premolar and molar areas of the mandible and maxilla and compare data to historic data. MATERIAL AND METHODS: Fifty-one patients received 120 tapered implants in premolar and molar areas of the mandible and maxilla, for a total of 54 short-span (2 to 4 units) fixed partial dentures. Patients with noncontrolled diseases, periodontal pathology, bruxism, and heavy smokers (more than 10 cigarettes a day) were excluded. Patients were divided into 2 groups, with placement of provisional fixed partial prostheses occurring within 24 hours (n=33) or 6 weeks (n=21) after implant surgery. The provisional prostheses had narrow, flat occlusal surfaces to reduce lateral contacts. Surgery was performed with flap elevation, a surgical guide was used, and sites with bone with lower density were underprepared. Implant insertion torque values were between 35 and 45 Ncm. After 6 months, definitive metal-ceramic prostheses were placed. Patients were monitored clinically and radiographically for marginal bone remodeling at baseline, and 3, 6, and 12 months after loading. All patients were followed for 1 year. Data were analyzed with descriptive statistics. RESULTS: No implant failure occurred. Mean marginal bone resorption (SD) was 1.24 (0.88) mm for the immediate loading group and 1.19 (1.01) mm for the early loading group after 1 year. CONCLUSIONS: The preliminary results demonstrate that if accurate surgical and prosthetic protocols are followed, immediate and early function are predictable and safe approaches even in premolar and molar areas with low bone density.