The "dome phenomenon" associated with maxillary sinus augmentation.

AIM: This case series is aimed to report a new phenomenon, the "dome phenomenon," which was observed in infected augmented sinuses over several years. METHODS: Five patients are presented in whom sinus lift augmentation resulted in postoperative infection with inflammation and suppuration. The patients received aggressive anti-inflammatory treatment and surgical debridement of the inflamed tissue, including some grafted material performed through the lateral window of the primary procedure. RESULTS: The inflammatory condition was reversed, and the site healed clinically. Radiographically, a dome-shaped, radio-opaque tissue was observed at the superior most aspect of the grafted sinus. This "dome phenomenon" was further confirmed during dental implant placement, which indicates healing potential adjacent to the maxillary sinus membrane. CONCLUSIONS: The current report, as well as other studies and case series, suggests that there is great potential for healing and bone formation in the maxillary sinus membrane. The precise mechanism is not known. Further clinical and histologic studies are needed to understand the regenerative potential of the Schneiderian membrane.

Dental implants placed in previously failed sites: survival rate and factors affecting the outcome.

OBJECTIVES: The purpose of the present study was to evaluate the survival rate of dental implants in previously failed implant sites. In addition, factors that might affect the outcome of these redo procedures were also explored. MATERIAL AND METHODS: Patients that had failed dental implants, which were replaced with the same implant type at the same site, were included. Data on the failed implants were collected. The same parameters, along with the interval between retrieval and re-implantation, were collected for the second set of implants. Descriptive statistics were used to describe the patients and implants. Life table analysis of these implants was tabulated for both implant sets. The effect of systemic, environmental and local factors on the survival of the redo dental implants was evaluated. RESULTS: Fifty-six patients with a total of 79 redo implants were included in this study. Implants were followed for 7-78 months (mean 29.9+/-2). Thirteen implants failed that resulted in an overall survival rate of 83.5%. Successful implants had greater diameter (4.05+/-0.52 mm) than failed implants (3.72+/-0.56 mm); however, these differences were only marginal (P=0.06). Conversely, smoking habits, implants length and location, mode of placement and spontaneous exposure did not have a significant effect on the outcome of this procedure. CONCLUSION: Redo of dental implants has a lesser survival rate compared with previous reports for implants in pristine sites. These results were not associated with most implant- and/or patient-related factors. Thus, a possible negative effect that is associated with the specific implant's site might account for this phenomenon.

The effect of menstrual cycle on periodontal health.

BACKGROUND: Fluctuation in estrogen/progesterone levels has been shown to affect the periodontium. The effects of pregnancy, prepuberty, and oral contraceptives on gingival health has been studied extensively, with gingival scores reported to be higher, in most instances, than in controls. Fluctuation in steroid sex hormone is also noticeable through women's menstrual cycle. Many women report an increase in gingival inflammation and discomfort associated with their menstrual cycle, most commonly around the menses period. However, this well-known phenomenon has never been studied. The purpose of this longitudinal, prospective study was to compare the periodontal status of premenopausal women at different times during their menstrual cycle. METHODS: Eighteen premenopausal women, enrolled in our maintenance program, were recruited. Clinical examination was performed before the recall visit at three different time points in their menstrual cycle: ovulation (OV), premenstruation (PM), and menstruation (M). Plaque index (PI), gingival index (GI), probing depth (PD), and clinical attachment level (CAL) were examined around the Ramfjord index teeth. Analysis of variance, with Scheffe modification, was used to determine differences between the menstrual time points. RESULTS: Several women in this study reported appreciable oral symptoms just before or during menses. Mean PI (0.85 +/- 0.06) was almost identical at all time points. Despite this, GI was significantly higher (P = 0.0245) in OV (0.54 +/- 0.07) and in PM (0.5 +/- 0.08) than in M (0.38 +/- 0.07). Mean patient's PD (2.22 +/- 0.08 mm) and CAL (2.92 +/- 0.15 mm) was not significantly different between examinations. CONCLUSIONS: We observed changes in gingival scores during the menstrual cycles of periodontally healthy women. These changes need to be addressed when analyzing data from epidemiological and treatment studies in premenopausal women.