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1.
Int J Oral Maxillofac Implants ; 36(1): 137-145, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33600535

RESUMEN

PURPOSE: To evaluate the clinical and radiographic outcomes of endoscope-assisted maxillary sinus floor elevation with platelet-rich fibrin grafting and simultaneous implant placement (PESS) in atrophic maxillae. MATERIALS AND METHODS: Twenty-three implants were placed to rehabilitate atrophic maxillae. Patient satisfaction was measured with a visual analog scale (VASpain). CBCT was taken to assess the bone changes for the elevated sites. RESULTS: Twenty-two of 23 implants fulfilling the survival criteria represented a 1-year survival rate of 95.65%. The VASpain score decreased with time. The residual bone height was 4.45 ± 1.44 mm. The elevation height was 6.72 ± 1.84 mm. The definitive restoration was completed in the 4th month postsurgery. The peri-implant bone level value was 6.04 ± 2.30 mm, 6.32 ± 2.25 mm, and 6.71 ± 1.97 mm at the 3rd, 9th, and 15th month postsurgery. The crestal bone level value decreased by 0.22 ± 0.56 mm from the 3rd month to the 15th month postsurgery (P > .05). Bone mineral density increased with time at the neck, middle, and root site of implant. CONCLUSION: PESS in the maxilla resulted in predictable peri-implant bone formation. This strategy is a relatively safe and effective approach with less invasion, which provides new insights into the choice of implant treatment plans.


Asunto(s)
Implantes Dentales , Fibrina Rica en Plaquetas , Elevación del Piso del Seno Maxilar , Implantación Dental Endoósea , Endoscopios , Humanos , Maxilar/diagnóstico por imagen , Maxilar/cirugía , Seno Maxilar/diagnóstico por imagen , Seno Maxilar/cirugía , Estudios Prospectivos , Resultado del Tratamiento
2.
Int J Oral Maxillofac Implants ; 36(1): 59-67, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33600524

RESUMEN

PURPOSE: Short dental implants serve as a valuable alternative for patients with limited bone height. Immediate or early provisionalization facilitates a more physiologic environment for the gingival tissues to be modeled. The purpose of this meta-analysis was to systematically review and evaluate the implant survival and marginal bone loss with immediate and early loading protocols of short dental implants (≤ 6 mm). MATERIALS AND METHODS: A literature search (electronic and manual) was conducted to identify studies with a focused PICO question: "In patients with short dental implants, does loading time affect treatment outcomes?" Studies using an immediate or early loading protocol for restoration of short implants with a mean follow-up of at least 1 year, and refraining from the use of advanced surgical procedures (sinus floor elevation, bone augmentation), were included. After evaluating patient selection and outcome reporting biases, a meta-analysis was conducted to assess implant survival and bone loss for studies fulfilling the inclusion criteria. Bone loss differences between immediate and early loading protocols were evaluated by Student t test, and Spearman correlation analysis was used to analyze the trends between crown-to-implant (C/I) ratio and bone loss. RESULTS: A total of 396 studies with patients receiving short implants (≤ 6 mm) with immediate or early prosthetic loading protocols were identified. For the 7 included studies, the pooled implant survival rate for 322 implants with a follow-up ranging from 1 to 10 years (5 years) was 91.63% (95% CI: 88% to 94%), with a mean bone loss effect estimate of 0.52 ± 0.1 mm (z = 3.07, P < .002). The differences observed in the mean bone loss for studies using immediate loading as opposed to early loading were not statistically significant. A moderate but significant positive correlation was observed between the C/I ratio and mean bone loss levels (r = 0.67, P = .02). CONCLUSION: Short implants with immediate or early loading protocols have satisfactory long-term treatment prospects with satisfactory implant survival rates and minimal bone loss.


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales , Carga Inmediata del Implante Dental , Elevación del Piso del Seno Maxilar , Pérdida de Hueso Alveolar/diagnóstico por imagen , Pérdida de Hueso Alveolar/cirugía , Implantación Dental Endoósea , Prótesis Dental de Soporte Implantado , Fracaso de la Restauración Dental , Estudios de Seguimiento , Humanos , Resultado del Tratamiento
3.
Int J Oral Maxillofac Implants ; 36(1): 154-164, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33600537

RESUMEN

PURPOSE: Using panoramic radiograph and CBCT to compare the measurement errors of the residual bone height in the same site before implant placement in the posterior maxilla and endo-sinus bone gain after osteotome sinus floor elevation without grafting, and to evaluate endo-sinus bone augmentation before stage-two surgery with CBCT. Also, some related factors of new bone formation in the sinus were analyzed, such as small bone block elevated by osteotome at the implant apex intraoperatively. MATERIALS AND METHODS: Patients were enrolled in the retrospective study; dental implants were placed in the maxillary posterior region using osteotome sinus floor elevation without grafting. The panoramic radiograph and CBCT were taken preoperatively, immediate postoperatively, and before the stage-two surgery. Endo-sinus bone augmentation was evaluated. A generalized linear model was made to explore the related factors of endo-sinus bone gain. Also, some clinical indexes, such as sinus membrane perforation rate, implant success, and failure criteria were assessed. RESULTS: One hundred two dental implants were inserted in 91 patients. Preoperatively, the mean residual bone height was 8.53 ± 1.76 mm and 7.87 ± 1.45 mm measured using a panoramic radiograph and CBCT, respectively, with significant statistical differences (P < .05). Endo-sinus bone gains of 1.31 °æ 1.05 mm by panoramic radiograph and 1.80 ± 1.72 mm by CBCT were observed, with statistically significant differences (P < .05). The final endosinus bone gain was positively correlated with the implant protrusion length at baseline without any other relevant factors, such as elevated small bone block. CONCLUSION: Measurement errors could be relatively minimized when using CBCT. Using the osteotome sinus floor elevation technique without grafting, approximately 2 mm of endo-sinus bone could be acquired. The final endo-sinus bone gain was positively correlated with implant protrusion length at baseline. Small bone block elevated intraoperatively did not gain more endo-sinus bone.


Asunto(s)
Implantes Dentales , Elevación del Piso del Seno Maxilar , Implantación Dental Endoósea , Humanos , Maxilar/diagnóstico por imagen , Maxilar/cirugía , Seno Maxilar/diagnóstico por imagen , Seno Maxilar/cirugía , Osteotomía , Estudios Retrospectivos , Resultado del Tratamiento
4.
Quintessence Int ; 0(0): 0, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33491394

RESUMEN

Objective: This study analyzed two xenogenous biomaterials based on deproteinized bovine bone mineral applied for maxillary sinus elevation. Method and materials: Fourteen patients were submitted to maxillary sinus augmentation with one of the following biomaterials: Criteria Lumina Bone Porous (test group) or Geistlich Bio-Oss (control group), both of large granules (1 to 2 mm). After 6 months, trephine biopsies were collected at the time of implant placement: 27 samples (11 patients) in the test group; 7 samples (3 patients) in the control group. Biopsies were analyzed by descriptive histology and histomorphometry, in which the percentages of newly formed bone, residual biomaterial particles, and connective tissue were evaluated. Results: Histomorphometry showed means for test and control groups, respectively, of 32.41% ± 9.42% and 26.59% ± 4.88% for newly formed bone, 22.89% ± 4.58% and 25.00% ± 4.81% for residual biomaterial, and 44.70% ± 9.54% and 48.41% ± 3.36% for connective tissue. There were no differences between groups (P > .05). Conclusion: This study concluded that Criteria Lumina Bone Porous presented similar histologic and histomorphometric characteristics to Geistlich Bio-Oss 6 months after sinus elevation surgery, identifying the tested biomaterial as an interesting alternative for bone augmentation in the maxillary sinus.


Asunto(s)
Sustitutos de Huesos , Elevación del Piso del Seno Maxilar , Animales , Materiales Biocompatibles , Trasplante Óseo , Bovinos , Implantación Dental Endoósea , Humanos , Maxilar , Seno Maxilar/cirugía , Minerales
5.
J Biol Regul Homeost Agents ; 35(1 Suppl. 1): 37-46, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33463141

RESUMEN

Reconstructive surgery (RS) is necessary before implant placement to regenerate bone defects. Success rate of implants is related to RS and to the correct position of implants in residual crest. The most popular surgical procedures of RS are bone grafts, guided bone regeneration. Bone graft is the gold standard technique to achieve RS of edentulous crests. RS is a surgical technique that uses barrier membranes to promote osteoblast cells proliferation. RS is often combined with bone grafting procedures. Sinus floor elevation procedures are elective treatments when there is insufficient bone height for implant insertion in maxilla. Bone osteogenesis distraction is the process of RS between two bone segments in response to tensile stress. The aim of this short review is to analyze the different methods of RS: bone grafts, guided bone regeneration, maxillary sinus floor elevation, and bone osteogenesis distraction.


Asunto(s)
Regeneración Ósea , Trasplante Óseo , Implantes Dentales , Maxilar/cirugía , Seno Maxilar , Elevación del Piso del Seno Maxilar , Resultado del Tratamiento
6.
Trials ; 22(1): 101, 2021 Jan 28.
Artículo en Inglés | MEDLINE | ID: mdl-33509257

RESUMEN

BACKGROUND: The volume of residual alveolar bone is critical to the survival of dental implants. When the volume of alveolar bone in the posterior maxillary region is less than 4 mm, maxillary sinus floor elevation (MSFE) with the lateral approach is an effective option. Traditionally, this standard approach is usually conducted at 4-6 months after tooth extraction (standard MSFE). However, defective dentition due to extraction can impair mastication during the period of bone remodeling, especially if the molars on both sides are severely compromised and must be extracted. MSFE before extraction (modified MSFE) can take full advantage of residual tooth strength. However, the effectiveness and practicability of the modified MSFE procedure remain unknown. Therefore, the aim of this study was to compare the clinical outcomes of modified vs. standard MSFE, in order to provide references to periodontists. METHODS/DESIGN: The study cohort included 25 adult patients (50 surgery sites) recruited from Peking University Hospital and School of Stomatology who met the inclusion criteria. The two sides of each patient will be randomly divided into two groups: a test group-modified MSFE or a control group-standard MSFE. The surgical duration and patient-reported outcomes (visual analog scale for discomfort) will be documented. Clinical indicators, including implant survival rates, mucosal conditions, and complications, will be recorded every 6 months during the 5-year follow-up period. The volume of the alveolar bone and marginal bone level will be assessed radiographically (cone-beam CT and periapical films) every 6 months. Histological analysis of biopsy samples retrieved from both sides will be performed to evaluate the biological features of the bone. DISCUSSION: The current study will explore the implant survival rates, safety, reliability, effectiveness, and practicability of the modified MSFE procedure. Moreover, the extent of osteogenesis on the sinus floor will also be assessed. The results of this trial will provide strategies for the modified MSFE procedure to achieve ideal clinical outcomes. TRIAL REGISTRATION: International Clinical Trials Registry Platform ChiCTR1900020648 . Registered on 1 January 2019.


Asunto(s)
Implantación Dental Endoósea/métodos , Seno Maxilar/cirugía , Diente Molar/cirugía , Elevación del Piso del Seno Maxilar/métodos , Extracción Dental/efectos adversos , Adulto , Tomografía Computarizada de Haz Cónico , Implantación Dental Endoósea/efectos adversos , Humanos , Seno Maxilar/diagnóstico por imagen , Seno Maxilar/patología , Osteogénesis , Cuidados Posoperatorios/efectos adversos , Cuidados Posoperatorios/métodos , Cuidados Preoperatorios/efectos adversos , Cuidados Preoperatorios/métodos , Ensayos Clínicos Controlados Aleatorios como Asunto , Reproducibilidad de los Resultados , Elevación del Piso del Seno Maxilar/efectos adversos , Resultado del Tratamiento
7.
J Appl Oral Sci ; 29: e20200568, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33331393

RESUMEN

OBJECTIVE: The aim of this study is to evaluate the new bone and connective tissue formation and the biomaterial remaining after maxillary sinus bone augmentation using 5 different bone substitutes. The osteocalcin immunolabeling was performed to demonstrate their calcification and the possibility of receiving dental implants. METHODOLOGY: 40 patients underwent maxillary sinus bone augmentation and were divided in 5 groups: Group 1 with 8 maxillary sinuses were grafted with autogenous bone graft (AB); Group 2 with 8 maxillary sinuses grafted with bioactive glass (BG); Group 3 with 8 maxillary sinuses grafted with bioactive glass added to autogenous bone graft (BG + AB) 1:1; Group 4 with 8 maxillary sinuses grafted with Bio-Oss (BO) and Group 5 with 8 maxillary sinuses grafted with Bio-Oss added to autogenous bone graft (BO + AB) 1:1. RESULTS: In group AB, 37.8% of bone was formed in the pristine bone region, 38.1% in the intermediate and 44.5% in the apical region. In group BG, 43.6% was formed in the pristine bone, 37% in the intermediate and 49.3% in the apical region. In group BG + AB 1:1, 39.0% was formed in the pristine bone region, 34.8% in the intermediate and 36.8% in apical region. In group BO, 33.4% was formed in the pristine bone, 32.5% in the intermediate and 34.3% in the apical region. In group BO + AB 1:1, 32.8% was formed in the pristine bone, 36.1% in intermediate and 27.8% in the apical regions. The immunolabeling for osteocalcin showed an intensive staining for all groups, which could demonstrate the calcification of the bone formed. CONCLUSION: This study showed that the groups evaluated formed a suitable lamellar bone in the maxillary sinus reconstruction after six months of bone healing, thus being indicated to receive dental implants.


Asunto(s)
Sustitutos de Huesos , Trasplante Óseo , Implantes Dentales , Osteogénesis , Elevación del Piso del Seno Maxilar , Implantación Dental Endoósea , Humanos , Seno Maxilar/diagnóstico por imagen , Seno Maxilar/cirugía
8.
Evid Based Dent ; 21(4): 126-127, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-33339970

RESUMEN

Data sources A search of electronic databases (Embase and PubMed) was carried out along with manual and grey searches of published and unpublished journals. Publication year was from first available until 23 August 2018.Study selection Titles and abstracts from the original search were reviewed by two authors. Studies were chosen for full-text analysis and data extraction after inter-reviewer agreement. Disagreement was resolved by discussion and Cohen's kappa was used to measure inter-reviewer agreement. An initial search gave 2,197 articles and, following screening, 18 publications were included in the study. Five articles were case series and ten were case reports describing one to nine cases. Three publications reported on comparatively large sample sizes, one prospectively and two retrospectively. None of the studies had control groups or blinding. The QUADAS-2 tool was used for quality assessment. Studies were deemed to have high, low or unclear levels of bias by two examiners. All were considered high risk of bias. Publications included fulfilled the following criteria: English language, human studies, endosseous osseointegrated dental implants, explantation technique described and reason for explantation clearly reported.Data extraction and synthesis Data extraction followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline process. Studies chosen for analysis were examined and the following data parameters were included: study design, number of patients, number of implants removed, implant system, reason for explantation, explantation technique and its success or failure, complications, flap access, socket grafting and immediate implant placement.Results The following five techniques for explantation of dental implants were identified: reverse torque, trephines, piezosurgery, burs and laser-assisted explantation. Reverse torque was the most commonly described technique (284 implants) with 87.7% success. Burs were used to remove 49 implants with 100% success, while trephines were used for explantation of 35 implants with 94% success. Piezosurgery and Er, Cr: YSGG laser removed 11 implants and one implant, respectively, with 100% success. One study reported perforation of the maxillary sinus floor following the use of a trephine technique, while another reported the fracture of three implants using reverse torque. The quality of the studies and lack of available data prevented further analysis. Results were presented in a narrative format.Conclusion The authors recommend reverse torque as the first choice for explantation. Despite its inferior success rate, it is the most conservative technique in terms of bone removal and flap access, meaning there is a greater opportunity for immediate implant placement.


Asunto(s)
Prótesis Anclada al Hueso , Implantes Dentales , Elevación del Piso del Seno Maxilar , Implantación Dental Endoósea , Humanos , Estudios Retrospectivos
9.
Rev. Odontol. Araçatuba (Impr.) ; 41(3): 33-39, set./dez. 2020. ilus
Artículo en Portugués | LILACS, BBO - Odontología | ID: biblio-1121742

RESUMEN

Este relato de caso clínico tem como objetivo descrever a utilização de osso alógeno na reconstrução de maxila atrófica para posterior reabilitação com prótese fixa metalocerâmica sobre implantes, fazer uma análise histológica do tecido ósseo enxertado e descrever o acompanhamento clínico e radiográfico por 8 anos. Uma paciente de 54 anos, com edentulismo parcial e atrofia moderada-a-severa na maxila, apresentou-se para tratamento demonstrando muito interesse em receber prótese sobre implantes. Após exame clínico e radiográfico, foi realizada montagem dos modelos de estudo em ASA para enceramento diagnóstico e obtenção de um guia multifuncional (tomográfico/ cirúrgico). A tomografia indicou a necessidade de reconstrução óssea maxilar. Procedeuse então à aposição de blocos de osso alógeno para aumento horizontal nas regiões anterior e posterior da maxila. Um dos blocos foi triturado e utilizado para levantamento do assoalho do seio maxilar no lado esquerdo. Dez meses depois, uma nova tomografia foi solicitada, utilizando o mesmo guia inicial, e os implantes instalados, utilizando o guia multifuncional como guia cirúrgico. Neste momento, material ósseo foi coletado na interface osso enxertado/osso nativo com uma broca trefina. Os resultados histológicos demonstraram viabilidade das células ósseas no enxerto, além da presença de vasos sanguíneos. Após o tempo necessário para osseointegração, procedeu-se com tratamento protético. Nenhuma complicação foi relatada até oito anos de controle. A sequência de tratamento proposta forneceu bons resultados estéticos e funcionais. Concluiu-se, então, que o emprego de osso alógeno é uma alternativa viável para a reconstrução de rebordos alveolares severamente reabsorvidos(AU)


This clinical case report aims to describe the use of allogeneic bone in the atrophic maxilla reconstruction for subsequent rehabilitation with a fixed metal-ceramic prosthesis on implants; to perform a histological analysis of the grafted bone tissue; and to describe the clinical and radiographic monitoring for 8 years. A 54-year-old patient, with partial edentulism and moderate-to-severe atrophy in the maxilla showed great interest in receiving implant prostheses. After c linical and radiographic examination, the ASA study models were assembled for diagnostic waxing and a multifunctional guide (tomographic / surgical) was obtained. Tomography indicated the need for maxillary bone reconstruction. Allogeneic bone blocks were then placed for horizontal enlargement in the anterior and posterior regions of the maxilla. One of the blocks was crushed and used to lift the floor of the maxillary sinus on the left side. Ten months later, a new tomography was requested, using the same initial guide, and the implants installed, using the multifunctional guide as a surgical guide. At this time, bone material was collected at the grafted bone / native bone interface with a trephine drill. Histological results demonstrated viability of bone cells in the graft, besides the presence of blood vessels. After the necessary time for osseointegration, a prosthetic treatment was performed. No complications were reported up to eight years of control. The propose treatment sequence provided good aesthetic and functional results. It was concluded, then, that the use of allogeneic bone is a viable alternative for the reconstruction of severely reabsorbed alveolar edges(AU)


Asunto(s)
Trasplante Óseo , Prótesis Dental de Soporte Implantado , Diseño de Prótesis Dental , Elevación del Piso del Seno Maxilar
10.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 38(6): 652-656, 2020 Dec 01.
Artículo en Chino | MEDLINE | ID: mdl-33377342

RESUMEN

OBJECTIVE: To investigate the effect of three anatomical parameters (maxillary sinus width, maxillary sinus angle, and residual bone height) on the outcomes of transcrestal sinus lift with simultaneous implant placement. METHODS: A total of 60 maxillary sinuses in 42 patients were included in this study. All patients were treated with transcrestal sinus lift procedure associated with simultaneous implant placement using a composite graft material of autogenous bone and Bio-Oss. For each patient, beam computed tomography (CBCT) scans were performed preoperatively, immediately after surgery, and 6 months after surgery. The parameters were measured on the preoperative and postoperative CBCT images. The correlation of three anatomical parameters with graft resorption was analyzed using Pearson's correlation test. RESULTS: The average residual bone height was (4.46±1.55) mm. The average width of maxillary sinus was (13.86±2.71) mm. The average sinus angle was 78.09°±10.27°. A significant positive correlation was observed between maxillary sinus width and graft resorption (P<0.01). A positive association was also found between sinus angle and graft resorption (P<0.01). CONCLUSIONS: The findings show that graft bone resorption in elevated sinus has a positive correlation with the sinus width and sinus angle.


Asunto(s)
Resorción Ósea , Implantes Dentales , Elevación del Piso del Seno Maxilar , Implantación Dental Endoósea , Humanos , Seno Maxilar/diagnóstico por imagen , Seno Maxilar/cirugía , Tomografía Computarizada por Rayos X
11.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 38(6): 667-671, 2020 Dec 01.
Artículo en Chino | MEDLINE | ID: mdl-33377345

RESUMEN

OBJECTIVE: To explore the changes in bone height of the maxillary sinus floor at different sinus ridge heights after transcrestal sinus floor elevation (tSFE) with the simultaneous implantation of short implants. METHODS: A total of 74 Bicon short implants were implanted into 37 patients during the same period of maxillary sinus elevation. The residual bone height (RBH)<4 mm group has 43 sites, and the RBH≥4 mm group has 31 sites. After 5 years of follow-up observation, the implant survival rate and the change in bone height achieved in the maxillary sinus over time were measured and analyzed via clinical examination and X-ray imaging. RESULTS: In the 74 implantation sites, the elevation height of the sinus floor was (6.64±1.32) mm and the bone height of the sinus floor was (3.35±1.29) mm 5 years after loading. No statistical difference was observed in the bone resorption of the implant neck between the RBH<4 mm and RBH≥4 mm groups. Meanwhile, a statistical difference was noted in the bone height obtained in the maxillary sinus between the two groups. CONCLUSIONS: When RBH in the maxillary posterior tooth area was <4 mm, the simultaneous implantation of Bicon short implants with tSFE can achieve a high implant survival rate and bone gain in the maxillary sinus, but does not increase the absorption of the alveolar ridge bone.


Asunto(s)
Implantes Dentales , Elevación del Piso del Seno Maxilar , Implantación Dental Endoósea , Humanos , Maxilar , Seno Maxilar/diagnóstico por imagen , Seno Maxilar/cirugía , Estudios Retrospectivos , Resultado del Tratamiento
12.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(11): 871-877, 2020 Nov 09.
Artículo en Chino | MEDLINE | ID: mdl-33171561

RESUMEN

Objective: To investigate the feasibility of two-stage crestal approach sinus elevation in severe atrophic maxilla. Methods: A total of 25 patients (male: 13 cases,female: 12 cases) who attended Department of Implant Center, Stomatological Hospital, Southern Medical University from May 2016 to May 2018 were included in this study. The age of the patients was 32-49 years old. The inclusion criteria were: single or multiple tooth loss in posterior maxilla with residual bone height ranged from 1.5 to 3.0 mm and vertical bone width≥6 mm, no pathological changes or septum were detected in the sinus. The elevated sides were divided into three groups according to different buccal-palatal sinus width (SW): wide (16 case, SW>15 mm), normal (12 case, 12 mm≤SW≤15 mm), narrow (5 case, SW<12 mm). Finally, 23 patients with 33 implants were placed by the two-stage crestal approach for sinus elevation. Six months after implant placement, final restorations were delivered. Implant survival rate, implant stability quotient (ISQ), immediate vertical bone height (VBH) after surgeries, changes of sinus elevation height (cSEH), marginal bone loss (MBL) at 1 year follow-up were examined. Results: Twenty-three patients were finally included in the study, including 12 males and 11 females, aged (41.2±7.6) years old. All implants healed uneventfully. ISQ (wide: 50.81±2.69; normal: 60.58±2.54; narrow: 63.12±3.58), immediate VBH after 1st surgery [wide: (7.99±1.13) mm; normal: (8.95±0.81) mm; narrow: (9.18±0.90) mm] and 2nd surgery [wide: (11.46±0.88) mm; normal: (12.77±0.49) mm; narrow: (12.57±0.55) mm], cSEH six months after 1st [wide: (3.87±0.43) mm; normal: (2.01±0.65) mm; narrow: (1.49±0.33) mm] and 2nd [wide: (1.16±0.29) mm; normal: (1.04±0.33) mm ; narrow: (0.97±0.41) mm] surgery, MBL [wide: (0.91±0.05) mm; normal: (0.79±0.10) mm; narrow: (0.74±0.07) mm] were significantly different among three groups (P<0.05). In all the three groups, cSEH was barely detected at 1-year follow-up (P>0.05). Conclusions: Two-stage crestal approach for sinus elevation might be an alternative protocol in severe atrophic posterior maxilla, especially in cases with narrow and normal buccal-palatal width. There is an urgent need for long time follow-up and more clinical cases.


Asunto(s)
Implantes Dentales , Elevación del Piso del Seno Maxilar , Adulto , Atrofia , Implantación Dental Endoósea , Femenino , Humanos , Masculino , Maxilar/cirugía , Seno Maxilar/cirugía , Persona de Mediana Edad , Resultado del Tratamiento
13.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(11): 897-901, 2020 Nov 09.
Artículo en Chino | MEDLINE | ID: mdl-33171565

RESUMEN

Objective: To observe the status of the sinus membrane using fiber optic endoscope during the lateral window approach sinus floor elevation to provide a reference for clinicians when evelvating the sinus mucoperiosteum. Methods: Sixty-six patients (72 sides) who underwent maxillary sinus floor elevation in Beijing Ruicheng Stomatology Hospital from September 2016 to December 2019 were selected, including 40 males and 26 females, aged 26-80 years old [(56.2±11.5) years]. And fiber optic endoscopy was used to observe the maxillary mucoperiosteum during the operation. Results: The status of maxillary sinus mucoperiosteal during lateral window approach sinus floor elevation can be divided into four categories: ① Class Ⅰ, complete periosteal, no damage to mucoperiosteum; ②Class Ⅱ, periosteal injury, unexposed laminae propria; ③Class Ⅲ, periosteal Rupture, exposed lamina propria; ④ Class Ⅳ, mucoperiosteum perforation, rupture of periosteum, lamina propria and epithelial layer. A total of 72 operations were performed, including 18 cases of class I, 28 cases of class Ⅱ, 4 cases of class Ⅲ, and 22 cases of class Ⅳ. Conclusions: The status of maxillary sinus mucoperiosteal during lateral window approach sinus floor elevation can be divided into four categories. Fiberoptic endoscopy as a clinical auxiliary examination method can improve the operator's control of the status of the maxillary sinus membrane and assist the peeling of the mucosa.


Asunto(s)
Seno Maxilar , Elevación del Piso del Seno Maxilar , Adulto , Anciano , Anciano de 80 o más Años , Endoscopios , Femenino , Humanos , Masculino , Maxilar , Seno Maxilar/cirugía , Persona de Mediana Edad , Mucosa Nasal
14.
Medicine (Baltimore) ; 99(46): e23180, 2020 Nov 13.
Artículo en Inglés | MEDLINE | ID: mdl-33181695

RESUMEN

This study compared implant outcomes following maxillary sinus floor augmentation (MSFA) in edentulous patients with a residual alveolar bone height ≤3 mm. Four techniques were evaluated: 1-stage bone-added osteotome sinus floor elevation procedure (BAOSFE) with simultaneous implant placement; 2-stage BAOSFE with delayed implant placement; 1-stage lateral window sinus floor elevation with simultaneous implant placement; and 2-stage lateral window sinus floor elevation with delayed implant placement. Patients were followed for 18 to 72 months (mean: 52.5 months) after prosthesis placement. Data were analyzed with cone-beam computed tomography. A total of 96 implants from 71 patients were analyzed; pretreatment, there were no significant differences between patients. Total implant survival was 98.9%. The mean residual bone height was significantly higher in the 1-stage BAOSFE group than the other groups (P < .01); 1 implant in this group failed at 3 months. There was no significant difference in total bone height gain between groups. However, the bone height gain of 1st sinus lifting with 2-stage BAOSFE was significantly lower than the 2-stage lateral window procedure (P < .01). There was no prosthesis failure. The favorable implant outcomes suggest these 1-stage and 2-stage MSFA procedures should be considered as alternative treatment options for patients with extremely atrophic posterior maxilla.


Asunto(s)
Huesos/cirugía , Senos Paranasales/cirugía , Prótesis e Implantes/tendencias , Elevación del Piso del Seno Maxilar/estadística & datos numéricos , Pesos y Medidas , Huesos/anomalías , Distribución de Chi-Cuadrado , Femenino , Humanos , Masculino , Persona de Mediana Edad , Procedimientos Quírurgicos Nasales/instrumentación , Procedimientos Quírurgicos Nasales/métodos , Osteotomía/métodos , Radiografía/métodos , Radiografía/estadística & datos numéricos , Elevación del Piso del Seno Maxilar/instrumentación , Elevación del Piso del Seno Maxilar/métodos , Estadísticas no Paramétricas , Resultado del Tratamiento
15.
Niger J Clin Pract ; 23(10): 1477-1482, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-33047709

RESUMEN

Background: To assess maxillary sinus findings using dental volumetric tomography before and after surgery in patients with dental implants in the maxillary posterior region with or without sinus floor elevation due to insufficient bone height. Materials and Methods: Cone-beam computerized tomography images taken for surgical planning before implantation and controlling after implantation were reviewed in 50 patients applied to the Department of Oral, Dental and Maxillofacial Surgery and Radiology of Dentistry Faculty at Ondokuz Mayis University. Maxillary sinus diseases (focal mucosal thickening, polyp, mucous retention cyst, sinusitis) were evaluated. The relationship between dental implant and sinus floor augmentation procedures and maxillary sinus findings was statistically evaluated using the Chi-square test and Wilcoxon rank test. Results: In this study, 26 female (52%) and 24 male (48%) patients were examined. The mean age of all patients was 53.82 years (± 8.63). Focal mucosal thickening was most frequently observed in the study. There was no statistically significant correlation between implant applications and sinus pathologies with both internal and external elevation procedures and implant applications (P > 0.05). Conclusions: Sinus floor augmentation and dental implant applications seemed not to increase the risk of maxillary sinüs pathologies. However, it is suggested to carry out similar studies with more samples.


Asunto(s)
Tomografía Computarizada de Haz Cónico/métodos , Implantes Dentales , Maxilar/cirugía , Seno Maxilar/diagnóstico por imagen , Elevación del Piso del Seno Maxilar , Adulto , Femenino , Humanos , Masculino , Seno Maxilar/cirugía , Persona de Mediana Edad
16.
Int J Oral Implantol (Berl) ; 13(3): 235-239, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32879928

RESUMEN

PURPOSE: Piezoelectric bone surgery was introduced into clinical practice almost 20 years ago as an alternative method for cutting bone in dental surgical procedures, in an attempt to reduce the disadvantages of using conventional rotary instruments. The aim of this Consensus Conference was to evaluate the current evidence concerning the use of piezoelectric surgery in oral surgery and implantology. MATERIALS AND METHODS: Three working groups conducted three meta-analyses with trial sequential analysis, focusing on the use of piezoelectric surgery in impacted mandibular third molar extraction, lateral sinus floor elevation and implant site preparation. The method of preparation of the systematic reviews, based on comprehensive search strategies and following preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines, was discussed and standardised. RESULTS: Moderate/low evidence suggests that piezoelectric surgery is significantly associated with a more favourable postoperative course (less pain, less trismus) after impacted mandibular third molar extraction than conventional rotary instruments. Moderate evidence suggests that implants inserted with piezoelectric surgery showed improved secondary stability during the early phases of healing compared with those inserted using a drilling technique. Strong/moderate evidence suggests that piezoelectric surgery prolongs the duration of surgery in impacted mandibular third molar extraction, sinus floor elevation and implant site preparation, but it is unclear whether the slight differences in duration of surgery, even if statistically significant, represent a real clinical advantage for either operator or patient. Weak evidence or insufficient data are present to draw definitive conclusions on the other investigated outcomes. CONCLUSIONS: Further well-designed trials are needed to fully evaluate the effects of piezoelectric surgery, especially in implant site preparation and sinus floor elevation.


Asunto(s)
Elevación del Piso del Seno Maxilar , Diente Impactado , Consenso , Humanos , Piezocirugía , Extracción Dental , Trismo
17.
Int J Oral Maxillofac Implants ; 35(5): 879-887, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32991637

RESUMEN

PURPOSE: To evaluate the influence on healing of the bony window elevated inward in the sinus cavity as a cortical bone graft. MATERIALS AND METHODS: Eighteen rabbits were included in the experiment. At the test sites (bony window), the antrostomy was prepared and the remaining bony window was elevated together with the sinus mucosa. At the control sites, the bony window was gently detached before the sinus mucosa elevation and discarded. The space obtained was grafted with deproteinized bovine bone mineral (DBBM). A collagen membrane was positioned on the antrostomy at both sides. The rabbits were euthanized after 2, 4, and 8 weeks in groups of six each. Histologic analyses in different regions of the elevated space were carried out, and a Wilcoxon test was used to estimate differences. Microcomputed tomography (microCT) analyses were also performed. RESULTS: After 2 weeks of healing, higher proportions of new bone were found in the test group compared with the control group due to the higher amount of bone formed in the region subjacent to the sinus mucosa. In this region, higher amounts of new bone were also found in the test group after 4 (P = .028) and 8 weeks of healing (P = .345). After 8 weeks of healing, the percentage of new bone was higher at the control sites compared with the test sites, with the proportions being 25.4% ± 3.2% and 21.3% ± 6.1%, respectively. In this period of evaluation, the bony window contributed with 20.1% ± 5.3% of vital bone in the test group. A fraction of 60.4% ± 10.8% of its surface was surrounded by new bone. In the microCT analysis, after 8 weeks of healing, fractions of 22.3% ± 1.6% and 22.2% ± 0.7% of bone were found in the test and control groups, respectively. CONCLUSION: The presence of the bony window positively influenced the healing in the elevated space, especially in the submucosa region. The bony window was vital and incorporated into newly formed bone.


Asunto(s)
Elevación del Piso del Seno Maxilar , Animales , Trasplante Óseo , Bovinos , Hueso Cortical/diagnóstico por imagen , Hueso Cortical/cirugía , Conejos , Cicatrización de Heridas , Microtomografía por Rayos X
18.
Int J Oral Maxillofac Implants ; 35(5): 1005-1012, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32991652

RESUMEN

PURPOSE: To clinically and histomorphometrically compare a biphasic calcium phosphate (BCP) and deproteinized bovine bone mineral (DBBM) for sinus floor elevation. MATERIALS AND METHODS: Sinus floor elevation procedures (lateral window) were performed randomly applying either BCP (test) or DBBM (control). At 6 months, bone biopsy specimens were harvested and dental implants were placed. The proportions of new bone, residual grafting material, and nonmineralized soft tissue were calculated. Four months after implant placement, the prosthetic reconstructions were inserted and the implant survival was assessed. RESULTS: Fifty-one patients were treated; 25 were randomly allocated to the BCP group and 26 to the DBBM group. After 6 months in 50 patients, bone biopsy specimens could be harvested, and a total of 121 implants could be placed subsequently. The histomorphometric analysis revealed a comparable percentage of new bone in both groups (BCP 35.9%, DBBM 35.4%; P > .05). The remaining grafting material was significantly lower with BCP (25.3%) compared with DBBM (45.9%; P < .001). Nonmineralized tissue was significantly higher for the BCP group (38.1%) compared with the DBBM group (18.2%; P < .001). The implant survival rate at loading was assessed at the level of the patients (96.0% for BCP and 88.8% for DBBM; P > .05) and at the level of the implants (96.9% for BCP and 94.7% for DBBM; P > .05). CONCLUSION: Grafting with DBBM or BCP showed similar percentages of new bone 6 months after sinus floor elevation. Implant survival presented no significant difference until loading.


Asunto(s)
Senos Paranasales , Elevación del Piso del Seno Maxilar , Animales , Bovinos , Humanos , Hidroxiapatitas , Minerales/uso terapéutico
19.
Rev. esp. cir. oral maxilofac ; 42(3): 107-118, jul.-sept. 2020. ilus, tab
Artículo en Español | IBECS | ID: ibc-196626

RESUMEN

OBJETIVOS: El objetivo es presentar el protocolo de trabajo, resultados clínicos y cambios en la vía aérea superior de una cohorte de 20 pacientes con síndrome de apnea/hipopnea obstructiva del sueño, intervenidos de avance maxilomandibular con rotación antihoraria. MATERIAL Y MÉTODOS: Un comité multidisciplinar determina la indicación quirúrgica, que los pacientes consienten. Se llevan a cabo tomografías computarizadas y polisomnografías antes y después de la cirugía, como protocolo habitual de trabajo. El comité ético de investigación clínica regional aprobó el estudio. Longitudes, volúmenes, área mínima, dimensión anteroposterior, dimensión transversal y otras medidas son determinadas en la vía aérea. El análisis estadístico es descriptivo y comparativo por pares con p < 0,05. RESULTADOS: Los movimientos planificados son 10,40 mm de avance y 2,11 mm de impactación anterior. El índice de apnea/hipopnea se reduce 30,50 puntos y la saturación de oxígeno capilar periférica mínima aumenta 5,00 puntos. Los resultados clínica y estadísticamente significativos son: 10,98 mm de acortamiento y 6,26 mm3 de incremento de volumen, especialmente en el compartimento retro-palatal; 91,45 mm2, 3,68 mm y 8,00 mm de aumento de área, dimensión antero-posterior y dimensión transversal respectivamente; el hioides avanza 1,92 mm. CONCLUSIONES: El avance maxilomandibular con rotación antihoraria en síndrome de apnea/hipopnea del sueño moderado-severo logra a corto plazo índice de apnea/hipopnea < 15 en el 80 % y saturación de oxígeno periférica capilar > 85 en el 75 % de nuestra serie. Los principales cambios en vía aérea son: acortamiento, incremento de volumen y áreas, forma elíptica y posicionamiento antero-superior del hioides


OBJECTIVES: To present the working protocol, clinical outcomes and upper airway changes of a 20-patient cohort with moderate-severe obstructive sleep apnea/hypopnea syndrome undergoing maxillo-mandibular advancement with counterclockwise rotation. MATERIAL AND METHODS: A multidisciplinary committee determines the surgical indication, which patients consent. Computed tomographies and polysomnographies are performed before and after surgery, as the usual clinical practice protocol. The clinical investigation ethics institutional review board approved the study. Lengths, volumes, minimum area, antero-posterior dimension, transverse dimension and other measurements are determined in the upper airway. Statistical analysis is descriptive and comparative by pairs with p < 0.05. RESULTS: Planned movements are 10.40 mm of advance and 2.11 mm of anterior impaction. Apnea/hypopnea index reduces by 30.50 points and minimum peripheral capillary oxygen saturation increases by 5.00 points. Clinically and statistical significant findings are: 10.98 mm of shortening and 6.26 mm3 of volume enlargement, especially in the retro-palatal compartment; 91.45 mm2, 3.68 mm and 8.00 mm of area, antero-posterior dimension and transverse dimension widening respectively; hyoid bone advances 1.92 mm. CONCLUSIONS: Maxillo-mandibular advancement with counterclockwise rotation in moderatesevere obstructive sleep apnea/hypopnea syndrome achieves in short-term follow-up apnea/hypopnea index < 15 in 80 % and minimum peripheral capillary oxygen saturation > 85 in 75 % of our series. Main upper airway changes are: shortening, volume and area increase, elliptical shape, and antero-superior hyoid bone movement


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Apnea Obstructiva del Sueño/cirugía , Elevación del Piso del Seno Maxilar/métodos , Anomalías Maxilomandibulares/cirugía , Sistema Respiratorio/anatomía & histología , Manejo de la Vía Aérea/métodos , Cuidados Posoperatorios/métodos , Procedimientos Quirúrgicos Ortognáticos/métodos , Polisomnografía/estadística & datos numéricos
20.
Indian J Dent Res ; 31(3): 449-456, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32769282

RESUMEN

Aims and Objectives: The aim of this prospective clinical study was to evaluate the success of one-stage direct (lateral) sinus lift procedure in severely atrophic posterior maxilla. Materials and Methods: One-stage direct (lateral) sinus lift procedure was carried out at 15 sites in 13 patients. All patients included in the study presented with partially edentulous posterior maxilla with one or more missing teeth and residual bone height less than 5 mm. Three months after surgery, patients were evaluated to access increase in residual bone height, density of new bone formed and implant stability. Patients were also evaluated after 3 months of prosthetic placement for the success of implant-supported prosthesis. Results: At 3 months post-operatively, increase in residual bone height was 8.31 ± 1.63 mm and the mean density of the newly formed bone around the implants was 417 ± 66.61 HU. All implants were stable and successfully osseointegrated, except one implant that was lost. The success rate of implant stability was 96.3% during the study period. Conclusion: Single-stage direct (lateral) maxillary sinus floor augmentation is a good treatment option with predictable outcome for patients with deficient alveolar bone in posterior maxilla.


Asunto(s)
Implantes Dentales , Elevación del Piso del Seno Maxilar , Implantación Dental Endoósea , Fracaso de la Restauración Dental , Humanos , Maxilar/cirugía , Seno Maxilar/cirugía , Estudios Prospectivos , Resultado del Tratamiento
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