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1.
Cancer Radiother ; 28(2): 218-227, 2024 Apr.
Artigo em Francês | MEDLINE | ID: mdl-38599940

RESUMO

In this article, we propose a consensus delineation of postoperative clinical target volumes for the primary tumour in maxillary sinus and nasal cavity cancers. These guidelines are developed based on radioanatomy and the natural history of those cancers. They require the fusion of the planning CT with preoperative imaging for accurate positioning of the initial GTV and the combined use of the geometric and anatomical concepts for the delineation of clinical target volume for the primary tumour. This article does not discuss the indications of external radiotherapy (nor concurrent systemic treatment) but focuses on target volumes when there is an indication for radiotherapy.


Assuntos
Neoplasias Bucais , Neoplasias dos Seios Paranasais , Humanos , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/cirurgia , Seio Maxilar/patologia , Cavidade Nasal/diagnóstico por imagem , Planejamento da Radioterapia Assistida por Computador/métodos , Neoplasias Bucais/patologia
2.
BMC Oral Health ; 24(1): 440, 2024 Apr 10.
Artigo em Inglês | MEDLINE | ID: mdl-38600501

RESUMO

BACKGROUND: An oroantral fistula is a communication between the maxillary antrum and oral cavity. This pathological communication is formed mainly due to dental extraction of maxillary premolars and molars. Adequate management should include closing the oroantral fistula and eliminating sinus infections to prevent recurrence and sinusitis. PURPOSE: This study aimed to evaluate the effectiveness of using the pedicled buccal periosteal flap for closing an oroantral fistula without changing the native intraoral structure. PATIENTS & METHODS: Patients with oroantral fistulas were included in this study. The patients were examined clinically by Valsalva test and cheek-blowing test, the hole was probed, and the extent of the underlying bone defect was determined radiographically using computed tomography preoperatively. All patients underwent surgical closure of oroantral fistula using a pedicled buccal periosteal flap. RESULTS: All 10 patients obtained satisfactory results with marked improvement in the function of the maxillary sinus and complete healing of oroantral fistula with no recurrence except in Case No. 5, who had a recurrence of the oroantral fistula, also there was no statistically significant difference between the vestibular depth preoperatively and postoperatively. CONCLUSION: A pedicled buccal periosteal flap is a novel technique for oroantral fistula closure as it preserves vestibular depth with a tension-free closure flap and harbors the advantages of the regenerative potential of the periosteum. REGISTRATION DATE: 14/8/2023 REGISTRATION NUMBER: NCT05987943.


Assuntos
Fístula , Fístula Bucoantral , Humanos , Fístula Bucoantral/cirurgia , Tecido Adiposo , Retalhos Cirúrgicos/cirurgia , Seio Maxilar/cirurgia
3.
Shanghai Kou Qiang Yi Xue ; 33(1): 64-70, 2024 Feb.
Artigo em Chinês | MEDLINE | ID: mdl-38583027

RESUMO

PURPOSE: To analyze the bone remodeling around the implant 10 years after disk-up sinus reamer(DSR)-based internal sinus floor elevation with implantation and to investigate the influence of different factors on implant retention. METHODS: The clinical and imaging data of patients undergoing DSR-based sinus floor elevation with simultaneous implantation were collected from the Department of Dental Implantology, Affiliated Hospital of Qingdao University from January 2008 to December 2011. Panoramic film and CBCT were used to measure the changes of bone mass around implant in different periods. Kaplan-Meier and Log-rank tests were used to analyze the effects of different factors on implant retention with SPSS 26.0 software package. RESULTS: The study included 98 patients with a total of 128 implants. During the follow-up of 0-168 months, 7 implants failed, and the remaining formed good osseointegration and functioned, with a 10-year cumulative retention rate of 94.53%. The height of bone formation was (0.29±0.15) mm at the top and (2.74±0.66) mm in the sinus of 75 implant sites with complete imaging data obtained ten years after surgery. Kaplan-Meier and Log-rank tests showed that 8 factors including initial bone height, elevated bone height, mucosal perforation, implant length, implant torsion, diabetes, smoking and periodontitis had significant effects on implant retention. CONCLUSIONS: The DSR-based internal sinus floor elevation with implantation is a reliable and stable bone augmentation operation for vertical bone defect in maxillary posterior region, with a 10-year cumulative retention rate of no less than 94%. Initial bone height, elevated bone height, mucosal perforation, implant length, implant torsion, diabetes, smoking and periodontitis are the important factors affecting the long-term retention rate of implants.


Assuntos
Implantação Dentária Endóssea , Implantes Dentários , Levantamento do Assoalho do Seio Maxilar , Humanos , Implantação Dentária Endóssea/métodos , Diabetes Mellitus/cirurgia , Maxila/diagnóstico por imagem , Maxila/cirurgia , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/cirurgia , Periodontite , Resultado do Tratamento
4.
Vestn Otorinolaringol ; 89(1): 42-44, 2024.
Artigo em Russo | MEDLINE | ID: mdl-38506025

RESUMO

The article presents a case of chronic odontogenic maxillary sinusitis and the results of its surgical treatment. The cause of the sinusitis, confirmed by the results of X-ray and pathohistological studies, was an inflammatory process affecting the bone tissue around the implant, installed in the place of the upper first molar which was accompanied by the development of an oroantral fistula. During the surgical intervention, the communication between the oral cavity and the maxillary sinus was eliminated, and the implant with the abutment, which was entirely in its cavity, was also removed.


Assuntos
Implantes Dentários , Sinusite Maxilar , Humanos , Sinusite Maxilar/diagnóstico , Sinusite Maxilar/etiologia , Sinusite Maxilar/cirurgia , Implantes Dentários/efeitos adversos , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/cirurgia , Fístula Bucoantral/diagnóstico , Fístula Bucoantral/etiologia , Fístula Bucoantral/cirurgia , Doença Crônica
5.
Int J Implant Dent ; 10(1): 11, 2024 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-38472687

RESUMO

OBJECTIVE: This study analyzed and compared the biomechanical properties of maxillary sinus floor mucosa with implants at three different maxillary sinus angles during a modified internal sinus floor elevation procedure. METHODS: 3D reconstruction of the implant, maxillary sinus bone, and membrane were performed. The maxillary sinus model was set at three different angles. Two internal maxillary sinus elevation models were established, and finite element analysis was used to simulate the modified maxillary sinus elevation process. The implant was elevated to 10 mm at three maxillary sinus angles when the maxillary sinus floor membrane was separated by 0 and 4 mm. The stress of the maxillary sinus floor membrane was analyzed and compared. RESULTS: When the maxillary sinus floor membrane was separated by 0 mm and elevated to 10 mm, the peak stress values of the implant on the maxillary sinus floor membrane at three different angles were as follows: maxillary sinus I: 5.14-78.32 MPa; maxillary sinus II: 2.81-73.89 MPa; and maxillary sinus III: 2.82-51.87 MPa. When the maxillary sinus floor membrane was separated by 4 mm and elevated to 10 mm, the corresponding values were as follows: maxillary sinus I: 0.50-7.25 MPa; maxillary sinus II: 0.81-16.55 MPa; and maxillary sinus III: 0.49-22.74 MPa. CONCLUSION: The risk of sinus floor membrane rupture is greatly reduced after adequate dissection of the maxillary sinus floor membrane when performing modified internal sinus elevation in a narrow maxillary sinus. In a wide maxillary sinus, the risk of rupture or perforation of the wider maxillary sinus floor is reduced, regardless of whether traditional or modified internal sinus elevation is performed at the same height.


Assuntos
Implantes Dentários , Levantamento do Assoalho do Seio Maxilar , Implantação Dentária Endóssea/métodos , Levantamento do Assoalho do Seio Maxilar/métodos , Seio Maxilar/cirurgia , Membranas/cirurgia
6.
Medicina (Kaunas) ; 60(2)2024 Jan 27.
Artigo em Inglês | MEDLINE | ID: mdl-38399510

RESUMO

Background and Objectives: Chronic sinusitis is a commonly encountered diagnosis for otorhinolaryngologists. The profound negative effect of rhinosinusitis on patients' quality of life is frequently overlooked, and surgical lines of treatment are numerous. The aim of the study was to assess the comparative efficacy of endoscopic middle meatal antrostomy with the endoscopic prelacrimal recess approach, combined with middle meatal antrostomy in the treatment of unilateral chronic maxillary sinus lesion. Materials and Methods: Thirty patients with unilateral chronic maxillary sinus lesions enrolled in the study at Alahsa hospital. Patients were divided into two groups: 15 treated through a middle meatal antrostomy and 15 treated via a combined middle meatal antrostomy and prelacrimal recess approach. Demographic and clinical information of the patients, including the medical history, CT scan findings, diagnosis, recurrence, and complications, were gathered and analyzed. Pre- and postoperative clinical findings were graded utilizing the Lund-Kennedy Endoscopic Scoring System. Results: The enrolled patients varied in age from 18 to 56, with 60% being male and 40% being female. Antrochoanal polyp, maxillary sinus mucocele, and unilateral allergic fungal sinusitis were among the pathological diagnoses. The follow-up period averaged 14.3 months. Following surgery, two patients in Group II encountered nasal discomfort, which included synechia and epiphora. The success rate for preserving a patient's disease-free condition was 86.7%. A statistically significant difference in disease-free incidence was observed among the patients in group II. In group I, recurrence was identified in 26.7% of the patients. The postoperative symptoms diminished considerably, and the VAS score was reduced substantially. In Group II patients, however, there was no significant difference in scarring. Clinically significant differences were observed in the mean total Lund-Kennedy Endoscopic scores when compared to their preoperative values. Conclusions: Achieving endoscopic access to the sinus's anterior, lateral, inferior, and inferomedial regions is facilitated by operating via the prelacrimal recess, which is the most advantageous approach. This approach facilitates rapid mucosal healing by maintaining the integrity of the nasolacrimal duct and mucosal covering. The specific pathology, surgical objectives, surgeon expertise, and equipment accessibility influence the choice of endoscopic surgical technique.


Assuntos
Pólipos Nasais , Sinusite , Humanos , Masculino , Feminino , Seio Maxilar/cirurgia , Seio Maxilar/patologia , Qualidade de Vida , Pólipos Nasais/patologia , Sinusite/patologia , Endoscopia/métodos , Estudos Retrospectivos
7.
Medicina (Kaunas) ; 60(2)2024 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-38399630

RESUMO

Closing a recurrent oroantral fistula (OAF) that occurs at an infected sinus augmentation site is a challenge for clinicians. The recurrent OAF has a detrimental impact on bone regeneration and subsequent implant placement. This case report includes three cases in which sinus graft infection and OAF occurred after maxillary sinus augmentation (MSA). In these cases, treatments to control sinus infection were performed using an otolaryngologist; then, intraoral interventions comprising mucosal flap procedures, bone grafts, and barrier membrane applications were performed 2-5 times by oral surgeons. Nevertheless, OAF recurred persistently. The failure to stop OAF recurrence may be due to the inability to effectively block air pressure at the OAF site. Following a comprehensive debridement of the infected tissue at the previous sinus augmentation site, a pouch was created through sinus mucosal elevation. The perforated sinus mucosa at the OAF site was covered with a non-resorbable membrane in one case and with resorbable collagen membranes in the other two cases, followed by bone grafting within the pouch. Lastly, this procedure was completed by blocking the entrance of the pouch with a cortical bone shell graft and a resorbable collagen membrane. The cortical bone shell graft, obstructing the air pressure from the nasal cavity, facilitated bone formation, and, ultimately, allowed for implant placement. Within the limitations of the present case report, the application of a guided bone regeneration technique involving a cortical bone shell graft and a barrier membrane enabled the closure of the recurrent OAF and subsequent implant placement.


Assuntos
Procedimentos Cirúrgicos Pré-Protéticos Bucais , Fístula Bucoantral , Humanos , Fístula Bucoantral/etiologia , Fístula Bucoantral/cirurgia , Seio Maxilar/cirurgia , Transplante Ósseo/métodos , Procedimentos Cirúrgicos Pré-Protéticos Bucais/métodos , Colágeno/uso terapêutico
8.
Int J Oral Maxillofac Implants ; 39(1): 107-118, 2024 Feb 27.
Artigo em Inglês | MEDLINE | ID: mdl-38416004

RESUMO

PURPOSE: To evaluate the impact of different approaches to sinus membrane perforation (SMP) repair on bone formation, postoperative complications, and implant loss risk. MATERIALS AND METHODS: Electronic searches on PubMed, Web of Science, Scopus, Embase, and Cochrane Library databases were conducted for publications up to February 2021. All included articles reported SMPs submitted for repair. The proportion of implant loss in repaired SMP sites was calculated using a random-effects model meta-analysis. RESULTS: A total of 130 studies reporting SMP repair protocols were included in the systematic review, with 20 selected for meta-analysis. A total of 1,972 sinuses that were perforated and repaired during sinus elevation using different approaches were included in the qualitative analysis. The resorbable collagen membrane was the most commonly reported treatment. The presence of sinusitis was the most frequently described complication. Regarding bone parameters, the majority of studies described no differences between perforated and repaired sinuses and intact membranes. No difference in the implant loss proportion was observed between sites with repaired SMP compared to undetected SMP. The proportion of implant loss in repaired sinuses membrane sites (independent of the material or implant placement time) was 4% (95% CI: 2.0 to 8.0). In meta-regression analysis, no association was observed between the SMP size and implant loss proportion (P = .86). CONCLUSIONS: The materials and techniques indicated for SMP management seem to securely seal the maxillary sinus, without a negative effect on the ultimate survival of the implants placed in the affected sinuses.


Assuntos
Seio Maxilar , Complicações Pós-Operatórias , Humanos , Seio Maxilar/cirurgia , Membranas , Osteogênese
9.
J Appl Oral Sci ; 32: e20230406, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38359269

RESUMO

OBJECTIVE: The aim of this population-based retrospective study was to compare the osteogenic effect of newly formed bone after maxillary sinus floor elevation (MSFE) and simultaneous implantation with or without bone grafts by quantitatively analyzing trabecular bone parameters. METHODOLOGY: A total of 100 patients with missing posterior maxillary teeth who required MSFE and implantation were included in this study. Patients were divided into two groups: the non-graft group (n=50) and the graft group (n=50). Radiographic parameters were measured using cone beam computed tomography (CBCT), and the quality of newly formed bone was analyzed by assessing trabecular bone parameters using CTAn (CTAnalyzer, SkyScan, Antwerp, Belgium) software. RESULTS: In the selected regions of interest, the non-graft group showed greater bone volume/total volume (BV/TV), bone surface/total volume (BS/TV), trabecular number (Tb. N), and trabecular thickness (Tb. Th) than the graft group (p<0.001). The non-graft group showed lower trabecular separation (Tb. Sp) than the graft group (p<0.001). The incidence of perforation and bleeding was higher in the graft group than in the non-graft group (p<0.001), but infection did not significantly differ between groups (p>0.05). Compared to the graft group, the non-graft group showed lower postoperative bone height, gained bone height and apical bone height (p<0.001). CONCLUSION: MSFE with and without bone grafts can significantly improve bone formation. In MSFE, the use of bone grafts hinders the formation of good quality bone, whereas the absence of bone grafts can generate good bone quality and limited bone mass.


Assuntos
Levantamento do Assoalho do Seio Maxilar , Humanos , Levantamento do Assoalho do Seio Maxilar/métodos , Estudos Retrospectivos , Osteogênese , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/cirurgia , Osso Esponjoso
10.
Int J Implant Dent ; 10(1): 7, 2024 Feb 08.
Artigo em Inglês | MEDLINE | ID: mdl-38329586

RESUMO

PURPOSE: Maxillary molars have low alveolar bone height diameter due to the presence of the maxillary sinus; thus, a sinus lift may be required in some cases. Changes in the volume of bone substitutes can affect the success of implant therapy. Therefore, this study aimed to compare the changes in the volume of two different bone substitutes-one based on carbonate apatite and the other on octacalcium phosphate-used in maxillary sinus floor elevation. METHODS: Nineteen patients and 20 sites requiring maxillary sinus floor elevation were included in the study. Digital Imaging and Communications in Medicine data for each patient obtained preoperatively and immediately and 6 months postoperatively were used to measure the volume of the bone grafting material using a three-dimensional image analysis software. The immediate postoperative volume of octacalcium phosphate was 95.3775 mm3 per piece of grafting material used. It was multiplied by the number of pieces used and converted to mL to determine the immediate postoperative volume. RESULTS: The mean resorption values of carbonate apatite and octacalcium phosphate were 12.7 ± 3.6% and 17.3 ± 3.9%, respectively. A significant difference in the amount of resorption of the two bone replacement materials was observed (P = 0.04). CONCLUSIONS: The results of this study indicate that both bone substitute materials tend to resorb. The two bone grafting materials that are currently medically approved in Japan have not been in the market for a long time, and their long-term prognosis has not yet been reported. Further clinical data are warranted.


Assuntos
Substitutos Ósseos , Fosfatos de Cálcio , Levantamento do Assoalho do Seio Maxilar , Humanos , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/cirurgia , Substitutos Ósseos/uso terapêutico , Apatitas , Carbonatos
12.
Stomatologiia (Mosk) ; 103(1): 31-34, 2024.
Artigo em Russo | MEDLINE | ID: mdl-38372604

RESUMO

PURPOSE: Evaluation of the effectiveness of a new method of plasty of an extensive defect in the mucous membrane of the Schneiderian membrane, which occurs during the sinus lift operation, using an artificial collagen membrane and a developed method for fixing it. MATERIAL AND METHODS: A total of 188 patients took part in the study, all of these patients underwent an open sinus lift operation with simultaneous or delayed implantation. Operations were performed under balanced anesthesia. Six months after the operation, according to computed tomography, the height of the formed bone regenerate was estimated. In the area of each missing tooth, the initial bone height and the resulting bone grafting were assessed. Then we compared the average values before and after the operation, the average height difference before and after the operation. RESULTS: In 19 patients during the sinus lift there was an accidental extensive rupture of the mucous membrane of the maxillary sinus. Elimination of the mucosal defect was carried out according to our patented method. All 188 patients were diagnosed with partial loss of teeth with bone tissue deficiency in the distal maxillary sinus. The height of the alveolar process in the projection of missing teeth ranged from 0.5 mm to 5 mm. Delayed dental implantation was performed when the height of the alveolar bone was less than 3 mm, direct when the presence of 3-5 mm. After 6 months, dental implants were installed in the reconstruction zone, after another 6 months - rational prosthetics. CONCLUSIONS: The proposed method of plastic surgery has the following advantages. Firstly, it allows to eliminate the defect of the mucous membrane together with an increase in the height of the alveolar ridge. Secondly, after this method, the integrity of the mucous membrane will be restored. Thirdly, with an alveolar bone height of 3 mm or more, dental implants should also be installed.


Assuntos
Aumento do Rebordo Alveolar , Implantes Dentários , Levantamento do Assoalho do Seio Maxilar , Humanos , Implantação Dentária Endóssea/métodos , Mucosa Nasal/cirurgia , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/cirurgia , Aumento do Rebordo Alveolar/métodos , Levantamento do Assoalho do Seio Maxilar/métodos , Maxila/cirurgia
13.
BMC Oral Health ; 24(1): 227, 2024 Feb 13.
Artigo em Inglês | MEDLINE | ID: mdl-38350895

RESUMO

PURPOSE: This study aimed to introduce a graftless sinus lifting approach with simultaneous dental implant placement in the alveolus of the posterior maxilla and compare this approach's outcomes in freshly extracted sockets versus healed sockets. MATERIALS AND METHODS: A prospective study was conducted on 60 patients aged between 27 and 59 years old, requiring dental implants in the posterior maxilla, and diagnosed with reduced vertical bone height (30 with freshly extracted sockets (group A) and the remaining 30 with healed sockets (group B). Before the sinus lifting approach, a cone beam computed tomography (CBCT) was taken, followed by another CBCT at least one-year post-sinus lifting (range: 12-36 months). Biological and mechanical complications were assessed, and the primary implant stability was measured using the Implant Stability Quotient (ISQ). Parametric data were analyzed using an independent t-test for intergroup comparisons, with significance set at P < 0.05. RESULTS: No significant differences were found among groups concerning gender, placement side, and follow-up. All dental implants demonstrated high survival rates with no observed biological or mechanical complications. Moreover, the primary implant stability was satisfactory, and there was no statistically significant difference (P = 0.38). In terms of new intrasinus bone formation, both groups exhibited satisfactory and successful outcomes, with increased new bone formation in group A. However, there was no statistically significant difference (P = 0.26). Regarding the vertical sinus floor elevation without new bone formation, group B showed (0.11 ± 0.64) mm of intrasinus implant height without bone formation, while group A showed an increment of bone formation above the intrasinus implant (0.22 ± 0.33) mm, with no statistically significant difference between both groups (P = 0.30). CONCLUSION: Our approach proves to be predictable, low-cost, and efficient option for sinus lift procedures, demonstrating high survival rates with acceptable primary implant stability. Moreover, it yields satisfactory outcomes in terms of new intrasinus bone formation, both in freshly extracted and healed sockets. Consequently, our approach holds promise as a reliable procedure for sinus lifting with simultaneous dental implant placement.


Assuntos
Implantes Dentários , Levantamento do Assoalho do Seio Maxilar , Humanos , Adulto , Pessoa de Meia-Idade , Implantação Dentária Endóssea/métodos , Estudos Prospectivos , Levantamento do Assoalho do Seio Maxilar/métodos , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/cirurgia , Maxila/cirurgia , Resultado do Tratamento
14.
Int J Implant Dent ; 10(1): 9, 2024 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-38372934

RESUMO

PURPOSE: Tricalcium phosphate (TCP) has osteoconductive ability and reportedly offers similar clinical results as autogenous bone grafts in dental implant treatment. However, few reports quantify temporal changes in augmented bone volume after sinus augmentation. We aimed to establish a three-dimensional (3D) quantification method to assess bone volume after sinus augmentation and to evaluate biocompatibility of the TCP plate. METHODS: Maxillary sinus floor augmentation was performed employing the lateral window technique, and plate-shaped ß-TCP (TCP plate) was used instead of granular bone grafting materials. After lifting the sinus membrane, the TCP plate was inserted and supported by dental implants or micro-screws. The changes in bone volumes in the maxillary sinus before and after surgery were recorded using cone-beam computed tomography, saved as Digital Imaging and Communications in Medicine-formatted files, and transformed to Standard Triangle Language (STL)-formatted files. Pre- and post-operative STL data of bone volume were superimposed, and the augmented bone volume was calculated. Moreover, changes in bone volumes, TCP plate resorption rates, and bone heights surrounding the implants were three dimensionally quantified. RESULTS: Fifteen implants in nine subjects were included in this study. TCP plates secured long-term space making, with results similar to those of granular bone substitutes. Newly formed bone was identified around the implant without bone graft material. TCP plate was absorbed and gradually disappeared. CONCLUSIONS: A novel 3D quantification method was established to evaluate changes in bone volume. Clinical application of TCP plate in sinus augmentation could be a better procedure in terms of prognosis and safety.


Assuntos
Substitutos Ósseos , Fosfatos de Cálcio , Levantamento do Assoalho do Seio Maxilar , Humanos , Substitutos Ósseos/uso terapêutico , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/cirurgia , Placas Ósseas
15.
Clin Implant Dent Relat Res ; 26(2): 258-265, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38225873

RESUMO

INTRODUCTION: Oro-control communication is one of the complications associated with dental extraction and oral surgeries. This case report presents a minimally invasive surgical approach for bone regeneration at the site of oro-antral communication utilizing a prefabricated computer-aided design and computer-aided manufacturing (CAD-CAM) allogenic bone block. METHODS: A 20-year-old healthy female, nonsmoker, with a badly destructed upper right first molar was referred for dental implant placement after extraction. Cone beam computerized tomography images revealed the presence of a large bone defect associated with oro-antral communication with the maxillary sinus and insufficient bone for dental implant placement. A prefabricated CAD-CAM allogenic bone scaffold was fabricated. After surgical exposure, the scaffold was secured in place and covered with a non-resorbable membrane. A dental implant was placed after 5 months, and a trephining biopsy was processed for histological evaluation. RESULTS: Closure of the oro-antral communication was clinically observed. The average width of the alveolar bone was 12 mm, and the average height was 11 mm. Histological analysis at 5-month intervals showed thin newly formed bone trabeculae encircling remnants of graft material surrounded by osteoid tissue. The newly formed bone percentages were 32 ± 18% and 28 ± 17% volume remained after the biodegradation of the scaffold. Specific immune-histochemical staining by anti-vascular epithelial growth factor expression index value was 32.06%. CONCLUSIONS: A prefabricated CAD-CAM scaffold was successfully used to seal a large oro-antral communication and regenerate sufficient bone to place a dental implant.


Assuntos
Implantes Dentários , Adulto , Feminino , Humanos , Adulto Jovem , Desenho Assistido por Computador , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/cirurgia , Fístula Bucoantral/etiologia , Fístula Bucoantral/cirurgia
16.
J Clin Periodontol ; 51(5): 652-664, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38246602

RESUMO

AIM: To evaluate the 3- to 8-year outcomes of dental implants placed with lateral sinus floor augmentation (LSFA) and to identify factors affecting implant survival. MATERIALS AND METHODS: This retrospective study was performed by screening all implants placed with LSFA procedures, which were conducted between January 2012 and December 2016. Subantral bone gain (SABG) and apical bone height (ABH) were assessed using panoramic radiographs. The cumulative survival rate of implants was analysed using life-table analysis and Kaplan-Meier survival curves. The influential risk factors affecting survival were assessed using univariate log-rank tests and multivariable mixture cure rate model. Implant complications were recorded. RESULTS: Based on the established criteria, a total of 449 patients (760 implants) were included in this study. In the 3- to 8-year follow-up (mean ± SD, 5.81 ± 1.33 years), 15 implants in 14 patients failed, with a CRS of 96.81% on an implant basis and 95.07% on a patient basis. A history of periodontitis and poor compliance with supportive periodontal treatment was associated with a significantly higher risk of implant failure at both implant and patient levels. Significant decreases in ABH occurred during each yearly interval except for 3 years. A similar trend has been observed for SABG at 1, 2, 6 and 8 years. The total complication rate was 31.84% on implant basis, with peri-implant mucositis (21.58%) being the most frequent biologic complication and porcelain cracking (5.00%) being the most common technical complication. CONCLUSIONS: Implant with LSFA is a reliable treatment option in atrophic maxilla. A history of periodontitis without regular supportive periodontal treatment was identified as a predictor for implant failure. Slight but significant shrinkage of vertically augmented bone can be observed after implant placement.


Assuntos
Implantes Dentários , Periodontite , Levantamento do Assoalho do Seio Maxilar , Humanos , Levantamento do Assoalho do Seio Maxilar/efeitos adversos , Levantamento do Assoalho do Seio Maxilar/métodos , Implantes Dentários/efeitos adversos , Implantação Dentária Endóssea/efeitos adversos , Implantação Dentária Endóssea/métodos , Estudos Retrospectivos , Transplante Ósseo/métodos , Maxila/cirurgia , Fatores de Risco , Seio Maxilar/cirurgia , Falha de Restauração Dentária , Resultado do Tratamento , Seguimentos
18.
Compend Contin Educ Dent ; 45(1): 40-43, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38289634

RESUMO

Maxillary sinus window design is an important factor in sinus augmentation procedures, playing a key role in managing maxillary sinus elevation complications, avoiding the sinus septum, and providing lateral support for the graft material. A less-invasive window design in comparison to conventional maxillary sinus windows was introduced with an "I"-shaped window for single implant placement. However, drawbacks of this window design have included limited instrument accessibility to the anterior sinus and incomplete membrane elevation. The purpose of this case report is to demonstrate a step-by-step surgical procedure for lateral wall maxillary sinus augmentation with a novel "J"-shaped window design for single implants.


Assuntos
Implantes Dentários , Seio Maxilar , Humanos , Seio Maxilar/cirurgia
19.
Sci Rep ; 14(1): 2483, 2024 01 30.
Artigo em Inglês | MEDLINE | ID: mdl-38291074

RESUMO

Fungus ball is the most common form of non-invasive fungal sinusitis, and maxillary sinus is the most commonly involved site. Maxillary sinus fungus ball (MFB) accounts for a considerable proportion of unilateral maxillary sinusitis. The prevalence of MFB has recently increased; however, its contributing factors are unclear. This study analyzed the association between MFB and dental implants. One hundred one patients who underwent unilateral maxillary sinus surgery were divided into two groups based on surgical biopsy results: unilateral bacterial sinusitis (UBS, n = 45) and MFB (n = 56). Stratified random sampling of 30 patients from each group was performed to adjust for age. The number of dental implants on maxillary teeth and degree of penetration into the maxillary sinus was radiologically evaluated. The number of patients with dental implants was greater (P = 0.085) and the number of implants was significantly higher (P = 0.031) in the MFB group. Dental implant can be a potential risk factor for MFB development. Therefore, dental implant surgeons should take caution in penetrating the maxillary sinus floor during implant insertion and otolaryngologists should consider the possibility of fungus ball when assessing patients with sinusitis who have dental implants.


Assuntos
Implantes Dentários , Levantamento do Assoalho do Seio Maxilar , Sinusite , Humanos , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/cirurgia , Implantes Dentários/efeitos adversos , Fatores de Risco , Fungos
20.
BMC Oral Health ; 24(1): 142, 2024 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-38287339

RESUMO

PURPOSE: The purpose of this study was to evaluate the suitability, accuracy, and reliability of a non-invasive 3-Tesla magnetic resonance imaging technique (3 T-MRI) for the visualization of maxillary sinus grafts in comparison to conventional, X-ray-based, established standard imaging techniques. METHODS: A total of eight patients with alveolar bone atrophy who required surgical sinus floor augmentation in the course of dental implantation were included in this pilot study. Alongside pre-operative cone-beam computed tomography (CBCT), 3 T-MRI was performed before and 6 months after sinus floor augmentation. Two investigators measured the maxillary sinus volume preoperatively and after bone augmentation. RESULTS: In all cases, MRI demonstrated accurately the volumes of the maxillary sinus grafts. Following surgery, the bony structures suitable for an implant placement increased at an average of 4.89 cm3, corresponding with the decrease of the intrasinusidal volumes. In general, interexaminer discrepancies were low and without statistical significance. CONCLUSION: In this preliminary study, we could demonstrate the feasibility of MRI bone volume measurement as a radiation-free alternative with comparable accuracy to CT/CBCT before procedures like sinus floor augmentation. Nevertheless, costs and artifacts, also present in MRI, have to be taken into account. Larger studies will be necessary to justify the practicability of MRI bone volume evaluation.


Assuntos
Implantes Dentários , Levantamento do Assoalho do Seio Maxilar , Humanos , Implantação Dentária Endóssea/métodos , Levantamento do Assoalho do Seio Maxilar/métodos , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/cirurgia , Projetos Piloto , Reprodutibilidade dos Testes , Transplante Ósseo/métodos , Tomografia Computadorizada de Feixe Cônico/métodos , Imageamento por Ressonância Magnética , Maxila/cirurgia
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