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1.
Stomatologiia (Mosk) ; 99(4): 76-80, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32692525

RESUMO

INTRODUCTION: The lack of the available bone in the posterior maxilla is determined by the range of anatomical and topographical factors. Lateral sinus floor elevation is the procedure for vertical augmentation in this region. Several complications may occur while performing a lateral sinus lift and bleeding due to alveolar antral artery (AAA) damage is one of them.The aim of the study is to analysis the different literature on AAA topographical features on cadaver species and on radiographic methods. MATERIALS AND METHODS: A search of the English language literature was performed by three independent readers in the PubMed electronic database. Articles published between 2013 and 2018 on cadaver and radiographic studies were included. RESULTS: The analysis included 9 articles. AAA prevalence in cadavers was 100% but AAA bone signs in CBCT studies varied between 32% and 93%. The diameter varied from 0.91 mm to 3.6 mm, and the distances from AAA to the sinus floor and to the alveolar ridge crest were 7.38-9.97 and 14.6-18.66 mm respectively. CONCLUSION: Our literature analysis showed the difference between AAA prevalence in cadavers and in CBCT scans. The results show that even proper pre-operative planning of the lateral sinus lift with CBCT cannot guarantee avoiding AAA damage while performing the surgery.


Assuntos
Seio Maxilar , Levantamento do Assoalho do Seio Maxilar , Artérias , Tomografia Computadorizada de Feixe Cônico , Humanos , Prevalência
2.
Quintessence Int ; 51(7): 578-584, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32500865

RESUMO

An edentulous posterior maxilla can present a challenge for placement of dental implants due to the proximity of the maxillary sinus. Sinus augmentation is a surgical bone grafting procedure aimed to increase the bone height for implant support. A number of sinus augmentation techniques have been presented and the outcomes show good implant success rates. In order to achieve the desirable outcomes, it is important to gain knowledge of the maxillary sinus anatomy and complete a thorough preoperative evaluation. Being aware of the location of vasculature, nerves, and the presence of septa will help reduce the risk of intraoperative and postoperative complications. This review provides a narrative clinical overview related to the anatomy, preoperative evaluation, contraindications, techniques, postoperative care, outcome measures, and complications of sinus augmentation procedures.


Assuntos
Implantes Dentários , Levantamento do Assoalho do Seio Maxilar , Implantação Dentária Endo-Óssea , Falha de Restauração Dentária , Maxila , Seio Maxilar , Resultado do Tratamento
3.
Compend Contin Educ Dent ; 41(6): 331-335, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32551715

RESUMO

This case series demonstrates internal maxillary sinus elevation and placement of 37 posterior implants in 34 private practice patients using sequential motorized expander burs exclusively to infracture the sinus border and embed bone graft material (allograft or xenograft) for vertical augmentation. With this technique, manual osteotome/malleting was completely avoided, improving surgical control and the patient experience. Sinus borders were lifted by a mean of 3.92 mm in ridges that had an average residual height of 7.52 mm. All implants achieved high insertion torque values (≥90 Ncm), obtained primary stability, and were successfully restored without complications. Anecdotally, the type of bone graft used did not appear to influence the outcome.


Assuntos
Implantes Dentários , Levantamento do Assoalho do Seio Maxilar , Transplante Ósseo , Implantação Dentária Endo-Óssea , Humanos , Maxila/cirurgia , Seio Maxilar/cirurgia , Osteotomia , Torque
4.
Int J Oral Implantol (Berl) ; 13(2): 109-121, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32424379

RESUMO

AIMS: To evaluate whether piezoelectric bone surgery (PBS) for lateral maxillary sinus floor elevation reduces risk of intraoperative complications, requires prolonged surgical time and improves the survival rate of dental implants in comparison with conventional rotary instruments. MATERIALS AND METHODS: This meta-analysis followed PRISMA guidelines and was registered in the PROSPERO database (CRD42019122972). The PubMed, Embase, Scopus and Open Grey databases were screened for articles published from 1 January 1990 to 31 December 2018. The selection criteria included randomised controlled trials (RCTs) and case-control studies (CCTs) comparing PBS with rotary instruments in lateral sinus augmentation and reporting intraoperative and postoperative outcomes (e.g. sinus membrane perforations, surgical time and implant failure rate). The risk of bias assessment was performed using the Cochrane Collaboration's tool for RCTs. A meta-analysis was performed, and the power of the meta-analytic findings was assessed via trial sequential analysis (TSA). RESULTS: Four RCTs met the inclusion criteria and were included in the review. The meta-analysis showed that, although a lower incidence of membrane tearing occurred when using PBS, the difference between the two groups was not significant. However, the power of evidence for this outcome, as determined by the TSA, was weak. Moreover, there was moderate evidence suggesting that PBS prolongs the surgery duration (mean difference of 3.43 minutes), whilst insufficient data was present to assess if PBS improves the survival rate of implants inserted in augmented sinuses. CONCLUSIONS: The power of the evidence was too weak to confirm the above-mentioned findings and further well-designed randomised clinical trials are needed to draw definitive conclusions.


Assuntos
Implantes Dentários , Levantamento do Assoalho do Seio Maxilar , Seios Transversos , Humanos , Maxila , Seio Maxilar
5.
Compend Contin Educ Dent ; 41(5): 278-283, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32369385

RESUMO

Inadequate alveolar bone height/volume and sinus anatomy can complicate the predictable placement of conventional implants and subsequent restoration in posterior maxillary sites. A variety of sinus lift and vertical bone height augmentation materials and techniques have been utilized for this purpose; however, generally they are clinically challenging, demand well-trained surgical proficiency, and require the use of multiple armamentaria. Simultaneously, clinicians must meticulously handle the sinus membrane to achieve elevation without perforation, attain successful bone grafting, and ensure predictable implant osseointegration. The hydraulic sinus condensing (HSC) technique via the osteotomy site is designed to be less invasive than conventional sinus lift techniques, reduce trauma to patients, improve implant osseointegration into grafted alveolar bone, prevent sinus membrane perforation, and enhance the overall efficiency of the associated surgical process. This article briefly reviews the evolution of sinus lift and posterior maxillary implant insertion procedures and presents a case in which the HSC technique and a uniquely designed sinus implant were used.


Assuntos
Implantes Dentários , Levantamento do Assoalho do Seio Maxilar , Implantação Dentária Endo-Óssea , Humanos , Maxila , Seio Maxilar , Osseointegração
6.
Cient. dent. (Ed. impr.) ; 17(1): 19-26, ene.-abr. 2020. ilus, graf
Artigo em Espanhol | IBECS | ID: ibc-189745

RESUMO

La pérdida ósea vertical en los sectores posteriores maxilares es un hecho frecuente tras la extracción dental. En muchas ocasiones para rehabilitar estas zonas podemos emplear técnicas de regeneración u optar por un abordaje más conservador con implantes cortos. En el presente caso clínico mostramos un caso rehabilitado bilateralmente con dos técnicas diferentes: elevación de seno y la inserción de implantes cortos, con un seguimiento de ocho años donde ambas técnicas han logrado resultados igualmente predecibles


Vertical bone loss in the posterior maxillary sectors is a frequent occurrence after tooth extraction. These areas can often be rehabilitated using regeneration techniques or by opting for a more conservative approach with short implants. The present clinical case shows bilateral rehabilitation with two different techniques: sinus lift and the insertion of short implants, with a follow-up of 8 years where both techniques have achieved equally predictable results


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Atrofia , Maxila/cirurgia , Levantamento do Assoalho do Seio Maxilar/métodos , Implantes Dentários , Maxila/patologia , Dente Molar/patologia , Radiografia Panorâmica
7.
Cient. dent. (Ed. impr.) ; 17(1): 35-40, ene.-abr. 2020. ilus
Artigo em Espanhol | IBECS | ID: ibc-189747

RESUMO

Los implantes dentales constituyen una alternativa predecible para la rehabilitación de los maxilares edéntulos, sin embargo, el éxito del tratamiento puede ver-se comprometido cuando existen graves atrofias maxilares. Para el tratamiento de estos casos complejos, se han desarrolla-do técnicas de regeneración ósea, entre las que destacan la regeneración ósea guiada y los injertos en bloque. Dentro de estos últimos, cabe destacar la técnica de Khoury. Se trata de un procedimiento indicado para regenerar defectos horizontales y verticales, mediante la obtención de finas láminas de hueso autógeno procedentes de la línea oblicua externa mandibular. Se presenta un caso clínico de un gran defecto mandibular reconstruido con la técnica de Khoury, secundario a un fracaso implantológico que además ocasionó patología nerviosa


Dental implants constitute a predictable alternative for the rehabilitation of edentulous jaws. However, the success of the treatment can be limited when severe atrophic alveolar ridges are present. For the treatment of these complex cases, several regeneration techniques have been developed, such as guided bone regeneration and block grafts. Within the last, it should be noted the Khoury technique. It is a procedure indicated for the regeneration of horizontal and vertical defects, through the obtention of autologous graft in form of thin plates, derived from mandibular external oblique line.A clinical case is presented, that consists in a great mandibular defect which was reconstructed by the Khoury technique. The defect was secondary to an implant failure, which was also related with nervous pathology


Assuntos
Humanos , Masculino , Idoso , Regeneração Óssea , Atrofia/cirurgia , Hipestesia/cirurgia , Falha de Restauração Dentária , Maxila/cirurgia , Levantamento do Assoalho do Seio Maxilar/métodos , Procedimentos Cirúrgicos Reconstrutivos/métodos , Implantes Dentários , Reabsorção Óssea/patologia , Boca Edêntula/cirurgia
8.
J Oral Sci ; 62(2): 242-244, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32224576

RESUMO

When the sinus is enlarged, it may be necessary to elevate the floor of the maxillary sinus using the crestal or lateral approach. This report presents a case where sinus floor elevation was performed using tricalcium phosphate (TCP) plates supported by implant bodies, and only the blood clot was present around the implant bodies. Cone-beam computed tomography images, taken one year after the lateral approach, revealed the presence of a TCP-like radio-opacity, which almost disappeared after two years. About seven years after the surgery, the patient's superstructure and occlusion were stable. Furthermore, the grafted TCP was completely absorbed, and the implant body appeared to be in good condition, with no signs of bone resorption around the implant.


Assuntos
Implantes Dentários , Levantamento do Assoalho do Seio Maxilar , Fosfatos de Cálcio , Tomografia Computadorizada de Feixe Cônico , Humanos , Seio Maxilar
9.
Artigo em Inglês | MEDLINE | ID: mdl-32233183

RESUMO

Alveolar bone resorption and maxillary sinus pneumatization occurring after dental extraction in the posterior region of the maxilla may be problematic when planning implant-supported rehabilitation. Various regenerative options are available, including guided bone regeneration, bone block grafts, and lateral sinus augmentation. These procedures are associated with significant complication rates, high morbidity, increased therapy duration, and high cost. Less invasive approaches, such as transcrestal sinus floor elevation, and using short implants have been proposed in an attempt to reduce these drawbacks. The aim of this study is to analyze available evidence to suggest predictable options and identify minimally invasive management of implant-supported rehabilitation in the posterior maxilla. This article concerns biologic mechanisms regulating new bone formation after maxillary sinus augmentation and examines characteristics of available implants and grafting materials to help the clinician select the most rational and convenient surgical approach according to specific situations.


Assuntos
Produtos Biológicos , Implantes Dentários , Levantamento do Assoalho do Seio Maxilar , Implantação Dentária Endo-Óssea , Maxila , Seio Maxilar
10.
Int J Periodontics Restorative Dent ; 40(3): e95-e102, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32233185

RESUMO

Insufficient crestal bone is a common feature encountered in the edentulous posterior maxilla due to atrophy of the alveolar ridge and maxillary sinus pneumatization. Numerous surgical techniques, grafting materials, and timing protocols have been proposed for implant-supported rehabilitation of posterior maxillae with limited bone height. In the majority of potential implant sites, residual bone height is less than 8 mm and the clinician has to select either a lateral or transcrestal sinus-elevation technique or placing short implants as the correct surgical option. Nevertheless, guidelines for selecting the best option remains mostly based on the personal experience and skills of the surgeon. The role of sinus anatomy in healing and graft remodeling after sinus floor augmentation is crucial. In addition to the evaluation of residual bone height, the clinician should consider that histologic and clinical outcomes are also influenced by the buccal-palatal bone wall distance. Therefore, three main clinical scenarios may be identified and treated with either a lateral or transcrestal sinus-elevation technique or short implants. This article introduces a new decision tree for a minimally invasive approach based on current evidence to help the clinician safely and predictably manage implant-supported treatment of the atrophic posterior maxilla.


Assuntos
Aumento do Rebordo Alveolar , Implantes Dentários , Levantamento do Assoalho do Seio Maxilar , Árvores de Decisões , Implantação Dentária Endo-Óssea , Maxila , Seio Maxilar
11.
Artigo em Inglês | MEDLINE | ID: mdl-32233190

RESUMO

Maxillary sinus augmentation is a procedure commonly performed in patients in need of maxillary posterior implants with loss of vertical ridge height and sinus pneumatization. Previous studies have identified some factors associated with sinus membrane perforation during lateral-wall sinus elevation procedures. Although membrane perforation does not directly link to future implant failure, it has been shown to have an association with postoperative complications. In order to promote more predictable results and reduce complications during the sinus elevation procedure, especially for the lateral window approach, articles published in peer-reviewed journals were reviewed to support the proposal of a new risk-evaluation system prior to the sinus surgery. This article reviews anatomical and patient-related factors that might affect the risk of perforation during the surgery and also aims to provide a risk assessment table to enable clinicians to analyze these factors prior to the lateral sinus augmentation surgery.


Assuntos
Seio Maxilar , Levantamento do Assoalho do Seio Maxilar , Implantação Dentária Endo-Óssea , Humanos , Maxila , Medição de Risco
12.
Rev. Odontol. Araçatuba (Impr.) ; 41(1): 24-29, jan.-abr. 2020. ilus
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-1102366

RESUMO

O levantamento de seio maxilar é realizado como forma de obtenção de volume ósseo adequado para a instalação de implantes dentários, por vezes imediatos, em região posterior de maxila. A perfuração da membrana sinusal é um dos acidentes mais comuns associados a este procedimento. Objetivo: Relatar o uso da Fibrina Rica em Plaquetas ­ PRF como uma técnica simples e de baixo custo, que permite a obtenção de coágulos de fibrina e membranas enriquecidas com plaquetas, simulando o processo fisiológico de reparo tecidual, podendo servir como único material de enxertia na elevação sinusal, além de proporcionar o reparo de uma membrana eventualmente perfurada durante o ato cirúrgico. Relato de Caso: Paciente do gênero feminino, faioderma, 57 anos de idade, que por meio de tomografia computadorizada apresentava áreas de pneumatização em região 14 e região 15, exigindo elevação sinusal previamente à instalação de implantes. A perfuração da membrana foi observada durante o descolamento da mesma. O pós-operatório sob exame clínico regular ocorreu sem complicações. Após um período de cicatrização de quatro meses, os implantes foram reabertos para a confecção das coroas. A avaliação da tomografia cone beam pós-cirúrgica comparada à inicial demonstrou que o osso peri-implantar era estável e compacto ao redor dos implantes. Conclusão: Os achados deste relato de caso sugerem que a membrana PRF pode ser uma consideração viável para o reparo da membrana do seio perfurada(AU)


The maxillary sinus lift is performed as a way to obtain adequate bone volume for the installation of dental implants, sometimes immediate, in posterior maxilla. Sinus membrane perforation is one of the most common accidents associated with this procedure. Objective: To report the use of Plateletrich Fibrin ­ PRF as a simple and low cost technique, which allows the allows to obtain fibrin clots and membranes enriched with platelets, simulating the physiological process of tissue repair and can serve as the only grafting material for sinus elevation, besides providing repair of a membrane that may have been perforated during the surgical procedure. Case Report: Female patient, faioderm, 57 years old who, through imaging examinations, had areas of pneumatization in region 14 and region 15, requiring sinusal elevation prior to implant installation. The perforation of the membrane was observed during its detachment. The postoperative period under regular clinical examination occurred without complications. After a healing period of four months, the implants were reopened to make the crowns. The evaluation of the postoperative cone beam tomography compared to the initial one demonstrated that the periimplant bone was stable and compact around the implants. Conclusion: The findings of this case report suggest that the PRF membrane may be a viable consideration for the repair of perforated sinus membrane(AU)


Assuntos
Implantes Dentários , Levantamento do Assoalho do Seio Maxilar , Fibrina Rica em Plaquetas , Seio Maxilar
13.
Compend Contin Educ Dent ; 41(3): 156-163, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32125168

RESUMO

The anatomic proximity of the maxillary sinus to the apices of molar and premolar teeth is a significant factor when considering implant therapy to replace maxillary posterior teeth. An emerging field within tissue engineering is the application of xenografts capable of stimulating de novo bone regeneration. This article presents a technique using a crestal approach to sinus grafting utilizing a novel bone graft material composed of porcine, ribose cross-linked collagen seeded with a nanocrystalline hydroxyapatite mineral. This highly cohesive biomaterial is able to minimize graft migration, which is particularly important in case of undetected Schneiderian membrane perforations. The material also has been demonstrated in animal studies to be capable of osteoconduction, resulting in increased bone volume in ridge augmentation procedures.


Assuntos
Implantes Dentários , Levantamento do Assoalho do Seio Maxilar , Animais , Transplante Ósseo , Colágeno , Implantação Dentária Endo-Óssea , Humanos , Seio Maxilar , Ribose , Suínos
14.
Niger J Clin Pract ; 23(3): 275-283, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32134023

RESUMO

We aimed to assess the complications of minimally invasive balloon-assisted maxillary sinus floor augmentation, compared with the conventional sinus floor augmentation procedures done before placing a dental implant. A structured question was formulated and an electronic search was conducted in three databases (MEDLINE via PubMed, Google Scholar, and Scopus). A separate search of gray literature and a hand search for missing articles were also conducted. Apart from animal studies, in-vitro studies, and case reports, all other types of studies where maxillary sinus floor augmentation was done using a balloon were considered for review. Our review was registered in International Prospective Registration of Systematic Reviews (PROSPERO) under number CRD42018086770. Our search produced 73 articles. However, only eight articles were found eligible to be included in our review (seven case series and one case-control study). Quality check was done using Methodological Index for Non-Randomized Studies (MINORS). Results suggest that balloon-assisted augmentation is associated with low rates of membrane tears (9 out of 272 sinus augmentation attempts), and high follow-up bone gain levels (mean 212.91%, 95% confidence interval 158.07%-267.75%, I2 = 97.62%). Balloon-assisted augmentation seems to be safe. More clinical trials are needed to assess the advantages and disadvantages of balloon-assisted maxillary sinus floor augmentation compared with other procedures.


Assuntos
Implantação Dentária Endo-Óssea/métodos , Implantes Dentários , Seio Maxilar/cirurgia , Levantamento do Assoalho do Seio Maxilar/métodos , Humanos
15.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 38(1): 86-89, 2020 Feb 01.
Artigo em Chinês | MEDLINE | ID: mdl-32037772

RESUMO

Vertical bone insufficiency in the maxillary posterior teeth is a common clinical situation. At present, the bone insufficiency in the maxillary posterior teeth is mainly overcome by bone grafting through maxillary sinus floor elevation. Compared with traditional axial implantation, tilted implantation can better avoid bone grafting, reduce complications, shorten the treatment cycle, reduce the treatment cost for patients, and gradually be promoted in clinical settings. This article reviews the concept, biomechanics, clinical evaluation, and digital trend of tilted implants of maxillary posterior teeth.


Assuntos
Implantes Dentários , Levantamento do Assoalho do Seio Maxilar , Implantação Dentária Endo-Óssea , Planejamento de Prótese Dentária , Humanos , Maxila , Seio Maxilar
16.
Int J Oral Maxillofac Surg ; 49(7): 960-965, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32061430

RESUMO

This study was performed to test a protocol for trans-implant treatment of chronic recurrent maxillary sinusitis (CRS), via implants with an internal removable sealing screw. The appropriate indications for treatment, optimal number of treatment sessions, and general schedule of treatment and follow-up were assessed. This was a retrospective study of 31 patients with CRS who were managed with trans-implant lavage. Of these patients, 28 (referred for a sinus elevation procedure) underwent a simultaneous implantation procedure and treatment of the sinusitis. Three patients received treatment for sinusitis via an already existing implant. The suggested sinusitis treatment protocol includes the drainage of pus through the punctured sinus floor and three sessions of antral irrigation/lavage, four cone beam computed tomography scans, and four transnasal endoscopic observations. The suggested combined protocol includes the simultaneous evaluation of the implant status and the sinusitis treatment results on days 30 and 60 after surgery. Of the 31 patients, 28 (90%) had complete relief of most of their symptoms (nasal obstruction/discharge, anosmia/hyposmia) up to day 30 postoperative. Follow-up nasal endoscopy demonstrated no evidence of active sinus disease. Twenty-seven implants were well-osseointegrated and were still in use for prosthetic purposes. In one case, the implantation failed because of poor bone quality. For the remaining 30 cases, both clinical and radiological results showed stability of the implants and no CRS recurrence during the whole follow-up period. The dental implant with an internal central port and an integral sealing screw may be used for drainage, irrigation, observation, and further treatment of the maxillary sinus in cases of CRS.


Assuntos
Implantes Dentários , Sinusite Maxilar , Levantamento do Assoalho do Seio Maxilar , Sinusite , Implantação Dentária Endo-Óssea , Humanos , Seio Maxilar/cirurgia , Estudos Retrospectivos
18.
Oral Maxillofac Surg ; 24(2): 151-156, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32002693

RESUMO

PURPOSE: In cases of highly atrophic alveolar ridges, augmentation procedures became a frequent procedure to gain optimal conditions for dental implants. Especially in the maxilla sinus floor elevation procedures represent the gold standard pre-prosthetic and mainly successful procedure. The perforation of the Schneiderian is one of the most common complications. The aim of this study was to evaluate whether the intraoperative perforation of the Schneiderian membrane has an impact on long-term implant success. METHODS: Thirty-four patients from a former study collective of the years 2005 and 2006 with a total of 41 perforations were invited for a follow-up examination to determine the long-term success rates after sinus floor elevation and subsequent implantation. RESULTS: Twenty-one patients with 25 perforations were subsequently re-evaluated. One implant was lost due to a of periimplant infection after 232 days, resulting in an implant survival rate of 98% within a mean follow-up period of 8.9 years (± 1.5 years). CONCLUSION: Regarding the long-term success, there was no increased risk for implant failure or other persisting complications, e.g., sinusitis, after intraoperative perforation during sinus floor elevation in this study.


Assuntos
Implantes Dentários , Levantamento do Assoalho do Seio Maxilar , Implantação Dentária Endo-Óssea , Falha de Restauração Dentária , Humanos , Maxila , Seio Maxilar , Mucosa Nasal , Fatores de Risco
19.
Med Oral Patol Oral Cir Bucal ; 25(2): e168-e179, 2020 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-32040465

RESUMO

BACKGROUND: One of the greatest challenges that dentists face today is to rehabilitate severe atrophied alveolar ridges in partially and completely edentulous patients with implants. Despite the high survival rate of implants placed next to sinus elevation, this technique presents complications that can be avoided by placing short implants, an option that also presents high survival rates. For this reason, the aim of this study is to compare the survival rate, marginal bone loss and complications associated with short implants (<8 mm) versus longer implants (≥8mm) placed with lateral sinus floor elevation in posterior atrophic maxillae. MATERIAL AND METHODS: A literature search was conducted by two independent reviewers in the PubMed/Medline (National Library of Medicine, Washington, DC) electronic database for articles published from January 2007 to July 2018. Seven qualified articles were selected for the meta-analysis. RESULTS: The test for overall effect did not find statistical significance in the survival rates, overall complications, intra-operative complications, post-operative complications and prosthetic complications. However, the test showed statistically significant differences in biological complications in favor of standard implants, and marginal bone loss between control and test groups in favor of short implants (<8mm) was found. CONCLUSIONS: Within the limitations of the present study, prosthetic rehabilitations with short implants (<8mm) in posterior maxilla is a reliable treatment option as an alternative to lateral wall sinus floor augmentation.


Assuntos
Implantes Dentários , Levantamento do Assoalho do Seio Maxilar , Implantação Dentária Endo-Óssea , Planejamento de Prótese Dentária , Falha de Restauração Dentária , Humanos , Maxila , Resultado do Tratamento
20.
Clin Oral Implants Res ; 31(6): 536-548, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32072685

RESUMO

OBJECTIVES: To analyze a modified biphasic phycogenic biomaterial in comparison with anorganic bovine bone in maxillary sinus floor elevation in humans. MATERIAL AND METHODS: Eight male patients in need of bilateral two-stage sinus floor elevation were consecutively recruited for this randomized split-mouth study. A combination of autogenous cortical bone (ACB, 20%) and anorganic bovine bone (ABB, 80%) (ACB + ABB group) or ACB (20%) and modified biphasic phycogenic material (BP, 80%) (ACB + BP group) were randomly assigned to graft each sinus. Patients were followed up for 6 months post-surgery when bone samples were collected for analysis. RESULTS: Radiographically, bone height gain was statistically higher in the ACB + ABB versus the ACB + BP group. While the analysis of the biological compartments showed differences in non-mineralized tissue (39.15 ± 20.97% vs. 65.87 ± 28.59%, ACB + ABB vs. ACB + BP respectively; p = .018) and remnant biomaterial particles (22.62 ± 17.01% vs. 7.96 ± 8.57%, respectively; p = .028), the percentage of mineralized tissue (38.23 ± 17.55% vs. 24.14 ± 24.66%, respectively; p = .398) showed no statistically significant difference. In contrast, ACB + ABB biopsies showed higher Musashi-1-positive cells per mm2 compared to ACB + BP biopsies (811.49 ± 875.30 vs. 236.90 ± 280.81; p < .018), where the fusiform cells corresponded mainly with fibroblasts, as demonstrated by ultrastructural analysis. CONCLUSION: Both combinations of materials exhibited bone formation after 6 months of healing in the maxillary sinus cavity. However, the combination with biphasic phycogenic biomaterial induced a higher radiographical vertical resorption and graft collapse in comparison with the combination with anorganic bovine bone, possibly due to a higher remodeling of the graft.


Assuntos
Substitutos Ósseos , Levantamento do Assoalho do Seio Maxilar , Animais , Materiais Biocompatíveis , Transplante Ósseo , Bovinos , Durapatita , Humanos , Masculino , Seio Maxilar , Boca
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