A study of the septa in the maxillary sinuses and the subantral alveolar processes in 30 patients.

The objective of this paper is to study the incidence of septa in the maxillary sinus and measure the height of the underlying alveolar process using panoramic radiography and computerized tomography (CT scans). Thirty patients who were going to be treated with dental implants were submitted to panoramic radiographs and CT scans. Sixty maxillary sinuses were analysed and divided into 2 groups: group 1 (totally edentulous) and group 2 (partially edentulous). The sinuses were divided into 3 regions (anterior, middle, and posterior), the septa were analysed, and the heights of the alveolar processes were calculated in these 3 areas. Of the 30 patients, 36.5% had maxillary sinuses, and 25% of these sinuses had septa, and 11.8% of the panoramic radiographs were false-negatives. In the panoramic radiographs of 10 patients, 3 had bilateral septa, 5 had a septum in only one sinus, and 2 patients had 2 unilateral septa. In the CT scans of 11 patients, 4 patients had a bilateral septa, 5 had a septum in only 1 sinus, and 2 patients had 2 unilateral septa. Therefore, 2 more septa were observed in the CT scans. In the study of the height of the subantral alveolar process, the least amount of difference between both techniques occurred in the middle region of the sinus. The CT scan is more reliable than the panoramic radiograph in diagnosing maxillary septa because of its greater accuracy. In the panoramic radiograph, the middle portion of the alveolar process in the posterior subantral segment was the least distorted of the three portions measured.

Analysis of the use of expansion osteotomes for the creation of implant beds. Technical contributions and review of the literature.

Sometimes, the severe superior maxillary atrophy compromises and even impide oral implants treatment. The use of rotatory instruments (drills) produce heat and lost of bone, but the osteotomes in implantology avoid this and simplifies the surgical treatment allowing implant installation with an easier technique. We present an expansive maxillary technique review, describing the main indications, advantages and disadvantages of this surgical procedure.

Pain and inflammation in 41 patients following the placement of 131 dental implants.

AIMS: To study pain and swelling in the first week after dental implant placement. MATERIAL AND METHODS: A total of 131 implants were placed in 41 patients (17 males and 24 females) under local anesthesia. Pain was scored by means of a verbal and visual analog scale (VAS), while swelling was evaluated by a verbal scale. RESULTS: Most patients who experienced pain reported the latter to be slight, with a peak intensity 6 hours after the operation in 41.5% of cases. A significant relation was observed between pain and the number of implants placed. Swelling was moderate in most patients who reported pain -- peak intensity of inflammation being recorded after 48 hours in 48.8% of cases. A significant association was observed between swelling and older patients, the placement of more than four dental implants, and operations in which sinus lift or bone regeneration procedures were carried out. Swelling was greater in patients with implants positioned in the posterior sector versus those placed in the anterior zone, and in those located at free extreme or totally edentulous patients, versus those placed in interdental spaces. CONCLUSIONS: Following implant placement, pain tends to be mild, with moderate inflammation. The latter is seen to be greater in older patients, in subjects receiving a larger number of implants, and in interventions involving regenerative techniques.

Fixed rehabilitation of a patient with hypohidrotic ectodermal dysplasia using zygomatic implants.

We found few references in the dental literature on implant rehabilitation of patients with hypohidrotic ectodermal dysplasia and only 1 case on zygomatic fixations and maxillary prosthesis in a patient with hypohidrotic ectodermal dysplasia. Two zygomatic fixations were placed according to the sinus slot technique, together with 3 implants in the anterior maxillary region. After 6 months, an upper complete prosthesis was screwed onto the implants, and lower overdentures were placed over the remnant canines. After 18 months of follow-up the patient reported important improvement in oral function and self-esteem.

Implant-supported rehabilitation of the severely atrophic maxilla: a clinical report.

Implant-supported rehabilitation in the posterior maxillary region presents a series of challenges because of the possibility of increased pneumatization of the maxillary sinus after dental loss. In cases where significant maxillary bone resorption has occurred, efforts center on maximizing the use of the remaining bone to afford primary stability to the implants. This clinical report describes a patient with extreme maxillary atrophy for whom fixed rehabilitation supported on 8 implants was accomplished. A zygomatic implant, a pterygomaxillary implant, and 2 implants mesial and distal to both canine eminences were placed. This rehabilitation was accomplished with a less invasive technique and in a much shorter time period compared to a sinus lift procedure. One year after prosthetic loading, the clinical and radiological results remain satisfactory.