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1.
Artículo en Inglés | MEDLINE | ID: mdl-33819333

RESUMEN

This study aimed to rehabilitate shortened maxillary dental arch with splinted crowns by connecting ultra-short implants with longer ones. In the posterior maxilla of 11 patients, one 10-mm (n = 11) and one or two ultra-short 4-mm (n = 17) dental implants were inserted. The insertion torque was lower than 20 Ncm in 55% of the 10-mm implants and in 94% of the 4-mm implants (P > .05). Median (range) implant stability quotients at the time of insertion and after 6 months were 61 (14 to 72) and 68 (51 to 79), respectively, for 4-mm implants, and 66 (52 to 78) and 78 (60 to 83), respectively, for 10-mm implants (P < .05). One 4-mm implant failed to integrate. All patients were restored with splinted metal-ceramic crowns connecting 4- and 10-mm implants. Median (range) clinical crown/implant ratios of 4-mm and 10-mm implants were 2.79 (1 to 3.66) and 1.06 (0.85 to 1.46), respectively (P < .05). Six months after prosthetic rehabilitation, the median (range) crestal bone loss was 0.3 mm (-0.7 to 1.7 mm) for 4-mm implants and was 0.5 mm (-0.8 to 3.5 mm) for 10-mm implants (P > .05). Splinted crowns combining 4- and 10-mm implants may contribute to a better force distribution in the treatment with ultra-short implant-supported prosthesis in the posterior maxilla.


Asunto(s)
Implantes Dentales , Maxilar , Coronas , Implantación Dental Endoósea , Diseño de Prótesis Dental , Prótesis Dental de Soporte Implantado , Fracaso de la Restauración Dental , Humanos , Maxilar/diagnóstico por imagen , Maxilar/cirugía , Seno Maxilar/cirugía
2.
J Oral Implantol ; 47(1): 25-29, 2021 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-33706369

RESUMEN

The most commonly reported complication during the sinus elevation surgical procedure is the perforation of the Schneiderian membrane. The aim of this retrospective study was to compare the rate of sinus membrane perforation during lateral window augmentation using either conventional sinus curettes or medical-grade polyurethane sponges. This retrospective study included patients who received a lateral window approach for sinus floor elevation. The sinus elevation procedures using medical-grade polyurethane sponges (test) or conventional curettes (control) were recorded and analyzed. All subjects' demographic data and preexisting conditions were evaluated. A total of 38 procedures met inclusion criteria, and those data were evaluated for analysis. There were no statistically significant differences in demographic data or preexisting conditions including age, sex, treatment location, presence and absence of septum, Schneiderian membrane thickness, and residual bone height between test and control groups. The membrane perforation rate was 7% in the test group and 43% in the control group; however, this difference did not reach statistical significance (P = .064). Within the limitations of this study, although there was no statistically significant reduction of sinus membrane perforation with the use of medical-grade polyurethane sponges, the decreased incidence of perforation might be of clinical significance.


Asunto(s)
Poliuretanos , Elevación del Piso del Seno Maxilar , Implantación Dental Endoósea , Humanos , Seno Maxilar/cirugía , Mucosa Nasal , Estudios Retrospectivos , Elevación del Piso del Seno Maxilar/efectos adversos
3.
Int J Oral Maxillofac Implants ; 36(1): 126-130, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33600533

RESUMEN

PURPOSE: To present a case series treated by inferior meatal antrostomy as a prophylactic maneuver after the placement of zygomatic implants to decrease the risk of sinusitis. MATERIALS AND METHODS: All patients undergoing zygomatic implant placement using the lower meatal antrostomy protocol between June 2011 and March 2019 at the Department of Oral and Maxillofacial Surgery, Universidad El Bosque, were included. Patients were evaluated after 12 months of the procedure using clinical and radiologic criteria described by Kuriyama and Reiskin. RESULTS: Forty-eight patients were included, in whom 184 implants were placed. Complications were as follows: paresthesia (6.2%), orosinusal fistula (4.1%), skin infection (2.1%), and loss of the implant (1.6%). There were no cases of sinusitis. CONCLUSION: This study provides evidence that the technique is effective and should be considered because of its simplicity. The inferior meatal antrostomy has been proven to be a simple, effective, and reliable technique to decrease the risk of sinusitis associated with the placement of zygomatic implants.


Asunto(s)
Implantes Dentales , Sinusitis Maxilar , Sinusitis , Implantación Dental Endoósea/efectos adversos , Humanos , Seno Maxilar/cirugía , Sinusitis Maxilar/etiología , Sinusitis Maxilar/prevención & control , Sinusitis Maxilar/cirugía , Cigoma/diagnóstico por imagen , Cigoma/cirugía
4.
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
5.
Clin Implant Dent Relat Res ; 23(1): 31-42, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33595906

RESUMEN

BACKGROUND: The overlying maxillary sinus frequently restrains the height of the posterior maxillary bones. PURPOSE: Evaluating the effect of downsizing the antrostomy side-window on the stability of the installed implants and vertical bone gain, after employing a graftless antral membrane balloon elevation (AMBE). MATERIALS AND METHODS: The study is a randomized controlled clinical trial conducted on 20 patients with 30 deficient maxillary alveolar ridges underwent graftless (AMBE) after being allocated into a (5 mm) entry antrostomy group (the test group) and a (10 mm) entry antrostomy group (the control group) implementing a radiographic linear bone height and implant stability quotations (ISQ) comparison among both groups immediately after the placement of 38 Implants and 6 months after. RESULTS: Radiographic bone gain of the test group (5.55 ± 0.93 mm) was significantly higher than the control group (2.86 ± 0.60 mm) (p <0.001). There was no significant difference in primary stability between the test (65 ± 5.32) and control groups (62.67 ± 4.46) (p = 0.202); while the test group (73.43 ± 4.39) showed significantly higher secondary stability than the control group (64.83 ± 6.05) (p <0.001). ISQ values recorded at 6 months were significantly higher than those recorded at insertion in the test group (p <0.001), while they were insignificant in the control group (p = 0.148). CONCLUSION: Undersizing the antrostomy window deemed beneficial concerning the vertical bone gain and the simultaneously placed root form dental implants' secondary stability.


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
6.
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
7.
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
8.
Artículo en Inglés | MEDLINE | ID: mdl-33513756

RESUMEN

According to classic Hirschfeld studies, the first teeth to be lost are the first and second maxillary molars. After the teeth are extracted and the alveolar process is developed, the maxillary sinus is reabsorbed and pneumatized with a decrease in bone availability in the posterior sector of the maxilla. This process often creates the need to perform regeneration techniques for the placement of implants in this area due to the low availability of bone. The most frequently used and documented technique for the elevation of the sinus maxillary floor is elevation by the side window, as proposed by Tatum. In 1994, Summers proposed a technique that allowed the elevation of the sinus floor from a crestal access using an instrument called an osteotome, as well as the placement of the implant in the same surgical act. The aimed of the study was to evaluate the survival of 32 implants placed in posterior maxilla with bone availability less than 5 mm performing a sinus lift augmentation technique with osteotome without biomaterials. The results of this study show a survival rate of 100% for 32 implants placed in situations with an initial bone availability of 2 to 5 mm without the use of graft material. The infra-drilling technique used offers an increase in the primary stability of implants that allows adequate osteointegration Implants placed were charged at 12 weeks. In all cases, spontaneous bone formation was observed, even in cases where a positive Valsalva maneuver was observed. This proposed technique reduces treatment time and the need for more invasive maxillary sinus augmentation techniques.


Asunto(s)
Elevación del Piso del Seno Maxilar , Materiales Biocompatibles , Maxilar/cirugía , Seno Maxilar/diagnóstico por imagen , Seno Maxilar/cirugía , Osteotomía
9.
Clin Oral Implants Res ; 32(4): 448-459, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33455002

RESUMEN

OBJECTIVE: To investigate the early bone formation in beagles with mini-lateral window sinus floor elevation and simultaneous implant placement. MATERIAL AND METHODS: Six beagles were selected for the split-mouth design procedures. In each animal, one maxillary recess received a 5 mm-diameter mini-round lateral osteotomy (test group), and the contralateral maxillary recess received a large rectangular osteotomy (10 mm long and 8 mm wide), (control group). Simultaneous implant installation was executed on bilateral maxillary recesses. Tetracycline and calcein dyes were administered on the 14th, 13th days and the 4th, 3rd days prior to sacrifice, respectively. After 8 weeks of healing, the beagles were euthanized for fluorescent labeling and histomorphometric analyses. RESULTS: In both groups, new bone formation initiated from the circumferential native bone of the maxillary recesses and extended toward the central sub-recess cavities. The maxillary recesses with the mini-window procedures exhibited superior mineral apposition rate, bone formation rate, and the percentage of new bone area to those of the group exposed to large osteotomy procedure (p < .05). While there was no significant difference in the value of bone-to-implant contact, the mini-window group displayed a tendency for an increase in this aspect (p > .05). Bone formation rate and new bone amount were not statistically correlated with bone-to-implant contact (p > .05). CONCLUSION: The hypothesis that mini-lateral window sinus floor elevation with simultaneous implant placement would improve early new bone formation in augmented sinus compared with large lateral window procedure is accepted.


Asunto(s)
Implantes Dentales , Elevación del Piso del Seno Maxilar , Animales , Trasplante Óseo , Implantación Dental Endoósea , Perros , Seno Maxilar/diagnóstico por imagen , Seno Maxilar/cirugía , Osteogénesis
10.
J Oral Maxillofac Surg ; 79(4): 787-798.e2, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33434518

RESUMEN

PURPOSE: The gold standard for bone regeneration of bone deficiencies is still an autologous bone graft, which has considerable disadvantages; namely, the need for a second major surgery and the limited volume of bone available for harvesting. BonoFill (BF) is a novel, tissue-engineered, bone graft with intrinsic osteoinductive, osteoconductive, and osteogenic properties, consisting of the patient's own adipose tissue-derived mesenchymal stem cells, attached to hydroxyapatite particles. Here, we present the safety and efficacy results of BF first-in-human clinical study for maxillofacial bone tissue regeneration. MATERIALS AND METHODS: Eleven eligible male and female subjects, aged 49-65 years, were enrolled into the clinical study in 2 clinical indications: Bone augmentation and bone void grafting in the jaws. Clinical follow-up was performed throughout a period of 6 months after BF treatment and included clinical examination, blood tests, CT scans, and biopsies collected from the transplantation site to assess chronic bone infection, changes in complete blood count, and adequate bone augmentation for implant placement. RESULTS: The study results demonstrated that BF promoted adequate bone tissue regeneration without complications. Per our evaluation, there were no incidents of chronic bone infection, or significant changes in complete blood count, and the patients reported overall good health for the duration of the study. At trial end, in the sinus augmentation indication, the BF treated sites residual bone was augmented at an average of 6.36 mm (Δ new bone, n = 10) and the total bone height at the treated area was on average 11.44 mm (n = 10). In the indication of filling of bone voids, the patient's average residual bone height of 2.91 mm was 15.76 mm (n = 1) at trial end. CONCLUSIONS: BF treatment was shown to be safe and resulted in newly generated bone, which provided adequate bone height for placement of dental implants. Thus, BF is a promising novel autologous bone graft for bone tissue repair.


Asunto(s)
Aumento de la Cresta Alveolar , Implantes Dentales , Elevación del Piso del Seno Maxilar , Anciano , Regeneración Ósea , Trasplante Óseo , Implantación Dental Endoósea , Femenino , Humanos , Masculino , Mandíbula/diagnóstico por imagen , Mandíbula/cirugía , Seno Maxilar/cirugía , Persona de Mediana Edad
11.
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
12.
Dent Clin North Am ; 65(1): 197-210, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33213709

RESUMEN

Implant stability is critical to implant success, and the amount of available bone is vital to achieving that end. Because of low-lying maxillary sinuses, adequate alveolar height on the posterior maxilla is often lacking in many patients in need of implant replacement. This chapter reviews both the traditional lateral sinus lift maxillary approach to achieve vertical augmentation as well as the transcrestal osteotome intraoral approach. A discussion of osseodensification will also be mentioned as an alternative approach.


Asunto(s)
Seno Maxilar , Elevación del Piso del Seno Maxilar , Implantación Dental Endoósea , Humanos , Maxilar/cirugía , Seno Maxilar/diagnóstico por imagen , Seno Maxilar/cirugía , Osteotomía
13.
Clin Oral Implants Res ; 32(3): 274-284, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33314302

RESUMEN

OBJECTIVES: This retrospective study aimed to evaluate the influence of anatomical, patient and surgical factors on the occurrence of membrane perforation (MP) during lateral window sinus floor elevation (LWSFE). MATERIAL AND METHODS: A review of LWSFE patient records between 2014 and 2019 accounted for MP occurrence, window surface area (WSA), intravenous sedation use, osteotomy instrument type and clinician experience. Preoperative cone beam computed tomography (CBCT) scans were analyzed for lateral wall thickness (LWT), LFM and LAM angles formed between lateral and medial walls at the floor and anterior wall, respectively, sinus width at 5-, 10- and 15-mm (LM-5, LM-10 and LM-15) from the floor, residual bone height (RBH), sinus pathologies, septa and arterial anastomoses. The generalized estimating equation (GEE) approach with a sandwich variance-covariance estimator was used to evaluate the associations with MP. RESULTS: MP occurred in 25.74% of 202 LWSFE procedures (166 patients). Mean 1.6 mm-LWT, 3.2 mm-RBH, 95°-LFM, 75.5°-LAM, 12 mm-LM-5, 20.79% septa, 16.83% arterial anastomosis, 37.62% sinus pathology and 29.21% intravenous sedations, 85.24% WSA ≥ 40 mm2 and 57% >10 procedures/clinician were reported. Greater MP rates were encountered as follows: 38.3% (LWT ≥ 1.5 mm), 38% (LFM < 90°), 59.6% (LAM < 70°), 45.4% (LM-5 < 10 mm) and 36.4% (WSA ranged > 80 mm2 ), with statistically significant associations with all these outcomes (p < .05). The presence of pathologies was also associated with MP (p = .013). Associations between MP and the presence of septa and arterial anastomoses, age/gender, right/left sinus, RBH, clinician's experience, instrument type and intravenous sedation use could not be demonstrated. CONCLUSIONS: MP is significantly associated with thicker lateral walls, narrower sinuses, larger windows and existing sinus pathology.


Asunto(s)
Elevación del Piso del Seno Maxilar , Tomografía Computarizada de Haz Cónico , Humanos , Seno Maxilar/diagnóstico por imagen , Seno Maxilar/cirugía , Mucosa Nasal , Estudios Retrospectivos , Elevación del Piso del Seno Maxilar/efectos adversos
15.
Int. j. odontostomatol. (Print) ; 14(4): 586-589, dic. 2020. graf
Artículo en Inglés | LILACS | ID: biblio-1134543

RESUMEN

ABSTRACT: Our objective was report an extremely rare case of isolated meningitis and suppurative dacrioadenitis as consequences of odontogenic sinusitis. We describe the diagnostic tools including imaging and culture, as well as surgical treatment and follow-up. Our final diagnosis was odontogenic sinusitis caused by Streptococcus Anginosus complicated by isolated meningitis and lacrimal gland abscess. Urgent surgical treatment to restore the paranasal sinuses and drainage of the lacrimal gland was performed. Culture from purulent material collected from maxillary sinus indicated the targeted therapy. Clinical assessment and imaging obtained 20 days after surgery demonstrated successful results. This case emphasizes the importance of evaluating intracranial complications of rinosinusitis, the need to search for a dental infection when a maxillary sinusitis is encountered, the key role of a thorough diagnostic workup in order to plan a comprehensive and effective surgical treatment, as well as targeted medical therapy.


RESUMEN: En este estudio se informa un caso extremadamente raro de meningitis aislada y dacrioadenitis supurativa, como consecuencia de sinusitis odontogénica. Describimos las herramientas de diagnóstico que incluyen imágenes y cultivo, como también el tratamiento quirúrgico y el seguimiento. El diagnóstico final fue de sinusitis odontogénica causada por estreptococo anginoso complicado por una meningitis aislada y el absceso de la glándula lagrimal. Se realizó un tratamiento quirúrgico de urgencia para restaurar los senos paranasales y drenar la glándula lagrimal. Se determinó el tratamiento de acuerdo a los resultados de cultivo del seno maxilar. La evaluación clínica y las imágenes obtenidas 20 días después de la cirugía demostraron resultados exitosos. Es importante la evaluación de las complicaciones intracraneales de la rinosinusitis además de la necesidad de considerar una infección dental frente a una sinusitis maxilar. Por otra parte, es clave una evaluación exhaustiva de diagnóstico para planificar un tratamiento quirúrgico completo y efectivo, así como el tratamiento médico.


Asunto(s)
Humanos , Masculino , Adolescente , Infecciones Estreptocócicas , Sinusitis Maxilar/diagnóstico por imagen , Streptococcus anginosus , Absceso/microbiología , Tomografía Computarizada por Rayos X/métodos , Sinusitis Maxilar/cirugía , Dacriocistitis/microbiología , Infección Focal Dental/complicaciones , Infección Focal Dental/terapia , Seno Maxilar/cirugía , Seno Maxilar/diagnóstico por imagen , Meningitis
16.
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
17.
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
18.
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
19.
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
20.
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
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