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1.
Compend Contin Educ Dent ; 42(9): e5-e8, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34606294

RESUMO

The displacement or invasion of a foreign object (eg, amalgam, dental bur, dental cement, dental implant) into the maxillary sinus can lead to various negative sequelae. Several techniques have been described for the removal of such objects, but although all of them require correct diagnosis and accurate determination of the exact size and location of the foreign object before the removal procedure is performed, high postoperative complication rates often result from these invasive procedures. The authors propose the categorization of two different types of maxillary sinus areas that can be invaded by dental implants and/or foreign objects; diagnosis and treatment are predicated on differentiating and/or identifying these two spaces. The clinical implications of these classifications include the ability to select from and execute appropriate and minimally invasive removal techniques, which are described and demonstrated in three presented case reports.


Assuntos
Implantes Dentários , Corpos Estranhos , Implantes Dentários/efeitos adversos , Corpos Estranhos/diagnóstico por imagem , Corpos Estranhos/cirurgia , Humanos , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/cirurgia , Complicações Pós-Operatórias
2.
Artigo em Chinês | MEDLINE | ID: mdl-34521170

RESUMO

Objective: To analyze the clinical features of patients with odontogenic sinusitis (OS) treated by endoscopic sinus surgery (ESS). Methods: A retrospective investigation was carried out in our 27 (16 males and 11 females) cases with OS aged (49.74±14.42) years old. Subjects were hospitalized between January 2018 and November 2020 from Department of Otorhinolaryngology Head and Neck Surgery, Beijing Chaoyang Hospital. The medical history, symptoms, result of nasal endoscopy and paranasal sinus computed tomography (CT) were analyzed statistically by SPSS 19.0. Results: OS mainly occured on unilateral sinuses, with a duration of (8.56±11.79) months. Seventy point four percent (19/27) of the patients had a course within six-month, only 11% was over 12 months (3/27). Symptoms mostly showed as nasal obstruction (88.9%; 24/27), runny nose (81.5%; 22/27), nasal stinks (16/19) and postnasal drip (10/10). Sixty-three percent (17/27) of the OS patients had a dental history. Nasal endoscopic examination revealed a swelling of the ostiomeatal complex (77.8%; 21/27), medial wall interhal displacement of maxillary sinus (55.6%; 15/27), white emulsion-like purulent secretion in the middle meatus (70.4%; 19/27) and nasal polyps (59.3%; 16/27). Etiology of OS included implant-related problems (14.8%; 4/27) and periodontal disease (85.2%; 23/27). Conclusions: OS is usually unilateral sinusitis with a short history. Its clinical features show nasal stinks, white emulsion-like purulent secretion in the middle meatus and imaging findings of unilateral maxillary sinusitis with tooth-related lesions.


Assuntos
Sinusite Maxilar , Sinusite , Adulto , Doença Crônica , Endoscopia , Feminino , Humanos , Masculino , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/cirurgia , Sinusite Maxilar/diagnóstico por imagem , Sinusite Maxilar/cirurgia , Pessoa de Meia-Idade , Estudos Retrospectivos
4.
Niger J Clin Pract ; 24(9): 1366-1372, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34531351

RESUMO

Objective: We aimed to investigate the effectiveness of the liquid PRF-DBBM mixture on new bone formation in maxillary sinus augmentation. Material and Methods: Seven patients requiring two-stage bilateral maxillary sinus augmentation were included in the study. The patients were selected according to the criteria of having an alveolar bone height of at least 2 mm in the atrophic region. The elevated sinus cavities were randomly grafted with DBBM + liquid PRF (test) or DBBM alone (control) in a split-mouth design. Bone samples were collected during implant surgery with a trephine bur for histomorphometric evaluation after 4 months. Results: In the control group, the newly formed bone was 39.49%, the mature bone was 15.66%, the residual graft was 15.62%, and the fibrous tissue ratio 28.59%, while in the test group, the newly formed bone (NFB) was 45.95%, the mature bone was 14.40%, the residual graft was 10.32%, and the fibrous tissue was 29.31%. No statistically significant difference was found between the groups in terms of the parameters studied (p > 0.05). The mean osteocalcin score in the control group was 2.70 ± 0.39, while it was 2.81 ± 0.36 in the test group. There was no statistically significant difference between the averages of osteocalcin scores of the groups (p > 0.05). Conclusion: The results of our study showed that DBBM is a reliable graft material for maxillary sinus augmentation even in the early period. Combining of DBBM with liquid-PRF contributed to new bone formation over a four-month period, but this contribution was not statistically significant.


Assuntos
Substitutos Ósseos , Fibrina Rica em Plaquetas , Levantamento do Assoalho do Seio Maxilar , Animais , Bovinos , Humanos , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/cirurgia , Minerais , Boca , Osteogênese
5.
Vestn Otorinolaringol ; 86(4): 111-115, 2021.
Artigo em Russo | MEDLINE | ID: mdl-34499458

RESUMO

The article presents a clinical example of the course of posttraumatic acute purulent sinusitis with reactive soft tissue phenomena due to the previous injury of the orbit by a foreign body, the introduction of the latter into orbit and the maxillary sinus result in a fracture of the lower wall of the orbit. A feature of the injury is the penetration of a foreign body through the conjunctiva of the lower eyelid and lower conjunctival fornix, without damaging the skin. This case is professionally interesting for both young doctors and experienced specialists in otolaryngology, ophthalmology, maxillofacial surgery and neurosurgery. Experts, analyzing this clinical example, will be able to correctly diagnose, effectively eliminate the inflammatory process in the maxillary sinus.


Assuntos
Corpos Estranhos , Sinusite Maxilar , Corpos Estranhos/complicações , Corpos Estranhos/diagnóstico , Corpos Estranhos/cirurgia , Humanos , Seio Maxilar/cirurgia , Sinusite Maxilar/diagnóstico , Sinusite Maxilar/etiologia , Sinusite Maxilar/cirurgia , Procedimentos Neurocirúrgicos , Órbita/diagnóstico por imagem
6.
BMC Oral Health ; 21(1): 448, 2021 09 16.
Artigo em Inglês | MEDLINE | ID: mdl-34530808

RESUMO

BACKGROUND: The present study examined the effectiveness of high-purity macro/microporous beta-tricalcium phosphate (HPMM ß-TCP) as a bone grafting material for maxillary sinus floor elevation by morphometric, histopathological, and histomorphometric evaluations. METHODS: Ten unilateral maxillary sinus floor elevation procedures using 100% HPMM ß-TCP were performed in 10 patients. Morphometric evaluation was carried out by computed tomography (CT) imaging immediately after augmentation and prior to dental implant placement 7 months later. Histopathological and histomorphometric evaluations were carried out by bone biopsy retrieval at the time of dental implant placement 7 months after sinus floor elevation. RESULTS: All 10 sinus floor elevations were successful. Morphometric evaluation by CT showed that the vertical height and volume gained by sinus floor elevation decreased 7 months after surgery. Histopathological evaluation of bone biopsy retrieval specimens showed no signs of inflammation at the newly formed bone area and the native alveolar bone area. New bone formation was observed at the cranial side from the native alveolar bone. The newly formed bone had a trabecular structure and was in intimate contact with the HPMM ß-TCP material. Histomorphometric evaluation of bone biopsy retrieval specimens showed an average new bone volume of 33.97% ± 2.79% and an average residual HPMM ß-TCP volume of 15.81% ± 4.52%. CONCLUSIONS: In this study, HPMM ß-TCP showed osteoconductive properties for vertical augmentation of the atrophied maxilla by means of a maxillary sinus floor elevation procedure allowing subsequent dental implant placement after a 7-month healing period.


Assuntos
Substitutos Ósseos , Levantamento do Assoalho do Seio Maxilar , Substitutos Ósseos/uso terapêutico , Transplante Ósseo , Fosfatos de Cálcio , Implantação Dentária Endo-Óssea , Humanos , Maxila/diagnóstico por imagem , Maxila/cirurgia , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/cirurgia , Estudos Retrospectivos
7.
Int J Oral Maxillofac Implants ; 36(4): 660-668, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34411205

RESUMO

PURPOSE: To examine the reaction of mucosa over time to a close contact with biomaterial after sinus elevation performed with deproteinized bovine bone mineral (DBBM) granules of two different sizes. MATERIALS AND METHODS: Bilateral sinus mucosa elevation was performed in 18 New Zealand rabbits through access on the nasal dorsum. DBBM with granule dimensions of either 1 to 2 mm (large group) or 0.250 to 1.0 mm (small group) were used to randomly fill the subantral hollow spaces. Biopsy specimens of the experimental sites from six animals in each group were obtained 2, 4, and 8 weeks after the surgery. RESULTS: The integrity of the sinus mucosa was clinically evaluated during surgery using a ×2.5 magnifying visual device. The sinus mucosa in contact with the biomaterial granules was found to be thinned compared with the pristine mucosa in all periods examined. Three hundred fifty-two thinned zones were found considering all 36 sinuses treated. Perforations of the sinus mucosa with extrusion of granules toward the sinus were observed, increasing in number over time. In the 8-week healing period, five perforations in three sinuses and eight perforations in four sinuses were found in the large and small groups, respectively. No differences were seen between the large and small groups. The differences between 2 and 8 weeks were statistically significant for the thinned mucosa width in both the large and the small groups and for the number of sinuses and perforations for the small group. CONCLUSION: Thinning zones and perforations of the sinus mucosa were seen increasing in number over time in regions in contact with graft granules in both the large and small groups.


Assuntos
Substitutos Ósseos , Levantamento do Assoalho do Seio Maxilar , Animais , Substitutos Ósseos/uso terapêutico , Transplante Ósseo , Bovinos , Incidência , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/cirurgia , Minerais , Coelhos , Levantamento do Assoalho do Seio Maxilar/efeitos adversos , Cicatrização
8.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 39(4): 377-385, 2021 Aug 01.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-34409792

RESUMO

The tilted implantation technique is characterized by placing the implant at an angle of more than 15° and less than 45° from the horizontal plane. This technique can avoid damaging the maxillary sinus, inferior alveolar nerve, nasal base, and other anatomical structures when the height of the upper and lower jaw available bone is insufficient, to maximize the use of available bone and avoid a large range of bone increment. The tilted implantation technique can reduce the trauma of the surgery, increase the possibility of immediate restoration and shorten the treatment cycle, which has been widely used clinically. In this review, the scope of application, design elements, design scheme and complications of the tilted implantation technique for edentulous patients will be described.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Arcada Edêntula , Boca Edêntula , Implantação Dentária Endo-Óssea , Planejamento de Prótese Dentária , Prótese Dentária Fixada por Implante , Seguimentos , Humanos , Arcada Edêntula/cirurgia , Mandíbula , Maxila/cirurgia , Seio Maxilar/cirurgia , Boca Edêntula/cirurgia
9.
Medicina (Kaunas) ; 57(6)2021 Jun 16.
Artigo em Inglês | MEDLINE | ID: mdl-34208644

RESUMO

Oro-antral communication (OAC) acts as a pathway for bacteria between the maxillary sinus and oral cavity, and is a common complication after the removal of a dental implant or extraction of a tooth from the maxillary posterior area. In the case of an untreated OAC, oro-antral fistula develops and becomes epithelialized. We aimed to introduce a treatment for OAC closure via a sinus bone grafting procedure using bone tacks and a collagen membrane with an allograft. The procedure was performed by applying an absorbable membrane made in pouch form. This membrane acted as a barrier for closing the large sinus membrane perforation. Bone tacks were used to fix the membranes. Subsequently, the maxillary sinus was filled with the allograft, and the absorbable membrane was reapplied. Primary closure was achieved by performing a periosteum-releasing incision for a tension-free suture. After 6 months, sufficient bone dimensions were gained without any occurrence of maxillary sinusitis or recurrence of OAC. Additional bone grafts and implantation could be performed to rehabilitate the maxillary posterior area. We conclude that this technique might be a useful treatment for reconstructing the maxillary posterior area with simultaneous sinus bone graft and OAC closure.


Assuntos
Transplante Ósseo , Fístula Bucoantral , Colágeno , Humanos , Seio Maxilar/cirurgia , Fístula Bucoantral/etiologia , Fístula Bucoantral/cirurgia , Extração Dentária/efeitos adversos
10.
J Biol Regul Homeost Agents ; 35(2 Suppl. 1): 9-19, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34281299

RESUMO

The aim of the present study is to describe a new technique through which it is possible to complete the maxillary sinus lift procedure even in case of severe damage or complete removal of the sinus mucosa using the PRGF-Endoret® platelet concentrate. Eighteen patients (ratio F:M=4:5; average age: 58.2 years; DS: 8.85 years) with severe perforation (more than 10 millimetres of diameter) of the sinus mucosa during the maxillary sinus lift procedure were selected. Normally the procedure is interrupted due to impossible stabilization of the graft material inside the subantral cavity. On the contrary, our protocol foreseen the sealing of the perforation using the PRGF autologous gel membranes or the creation of a new sinus pseudomembrane through which the graft material was covered. The PRGF-Endoret were obtained according to the protocol developed by BTI (Biotechnology Institute - Vitoria, Spain). In 14 cases out of 18 implant fixtures were concurrently inserted while in 4 cases the fixture insertion was postponed after 6 months: 37 fixtures were inserted (27 at the same time and 10 after 6 months). 2 months after surgery the CBCT showed a correct pneumatization of the maxillary sinus in 16 patients out of 18 (89% of cases), while after 12 months the radiological normalization of the maxillary sinus was present in 17 patients out of 18, bringing the healing rate to 94% of cases. Regarding implant healing, 2 out of 37 implants inserted were lost in the first month after the surgical phase, whereas 12 months after prosthesis application the other 35 implants were perfectly osteointegrated with a healing rate equal to 94.6% of the fixtures. 36 months after the surgery all the fixtures were osteointegrated (35 of 37 implants with a percentage of 94.6% of success). We may conclude that the use of PRGF allowed to complete the sinus lift even in case of severe perforation of the sinus mucosa or its total removal thanks to its capability to stabilize the graft, its antibacterial and antifungal activity and its anabolic effect and favouring bone regeneration.


Assuntos
Implantes Dentários , Seio Maxilar , Regeneração Óssea , Humanos , Maxila/diagnóstico por imagem , Maxila/cirurgia , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/cirurgia , Pessoa de Meia-Idade , Membrana Mucosa , Cicatrização
11.
J Oral Sci ; 63(3): 295-297, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34193779

RESUMO

The aim of this study was to clarify whether hydroxyapatite/collagen composite material (HAp/Col) could be useful as a graft material for maxillary sinus floor augmentation (MSFA). MSFA and implant placement were performed simultaneously. When the lateral approach was employed, 3 out of 19 implants failed in 3 maxillary sinuses (success rate; 84.2%), and in these cases the alveolar bone heights, cortical bone thicknesses and values of the implant stability quotient were smaller. If alveolar the bone height, cortical bone thickness, and healing period are optimized, HAp/Col can be a useful graft material for MSFA.


Assuntos
Implantes Dentários , Levantamento do Assoalho do Seio Maxilar , Transplante Ósseo , Colágeno , Durapatita , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/cirurgia
12.
Indian J Dent Res ; 32(1): 61-68, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34269239

RESUMO

Aim: To assess osteotome-mediated sinus floor elevation (OMSFE) with simultaneous implant placement using an in situ hardening biphasic calcium phosphate (BCP) compared to xenograft as a control. Methods: Patient in need for sinus floor augmentation in one or both sinuses were selected for this randomised controlled clinical trial. Sites presenting a residual sinus floor height of 3-6 mm and eligible for OMSFE were randomly assigned to receive either BCP (test) or xenograft particles (control). CBCT scans were performed before and at the time of implant loading (180 days). The difference in sinus floor height gain between the two groups was set as the primary endpoint parameter for equivalence testing. The implant insertion torque (ITV) was recorded and Implant stability quotients (ISQ) was assessed upon implant placement, abutment connection (160 days) and implant loading (180 days). Results: A total of 54 sinus lifts were performed in 42 patients including 12 bilateral cases. Four implants failed (two in each group) and a total of six patients were lost to follow-up. Statistical analysis of sinus floor height revealed no significant differences (p < 0.05) between groups at baseline nor at 180 days after augmentation. There was no statistical difference in sinus floor height gain between the two groups as supported by the 90% confidence intervals of the difference between groups. Good primary implant stability was confirmed in both treatment groups by ITV and ISQ measurements. Conclusions: Within the limits of this study, it can be concluded that OMSFE using in situ hardening BCP particles results in equivalent sinus floor height gain than using xenograft particles but offers an easier application.


Assuntos
Substitutos Ósseos , Implantes Dentários , Levantamento do Assoalho do Seio Maxilar , Substitutos Ósseos/uso terapêutico , Implantação Dentária Endo-Óssea , Xenoenxertos , Humanos , Hidroxiapatitas/uso terapêutico , Maxila/cirurgia , Seio Maxilar/cirurgia
13.
Artigo em Inglês | MEDLINE | ID: mdl-34328471

RESUMO

Minimally invasive microsurgery performed using an operating microscope (OM) has shown accelerated and improved wound healing for periodontal plastic and regenerative procedures. This case series aims to demonstrate the potential usefulness of OM for maxillary sinus augmentation in a private practice setting. Twelve vertical sinus augmentations (VSAs) and 8 lateral sinus augmentations (LSAs) were performed with the assistance of OM. Flap reflection, osteotomy, sinus membrane elevation, membrane integrity evaluation, implant placement (if indicated), and wound approximation with sutures were performed under OM. After a minimum healing period of 6 months, radiographic bone height gain was assessed. One sinus membrane perforation was observed during VSA surgery. The mean vertical bone gain was 4.82 ± 1.31 mm and 8.36 ± 1.45 mm for VSA and LSA, respectively, with 100% implant success rate. OM-assisted maxillary sinus augmentation provides favorable clinical visualization, thus facilitating delicate hard and soft tissue manipulation.


Assuntos
Seio Maxilar , Levantamento do Assoalho do Seio Maxilar , Implantação Dentária Endo-Óssea , Humanos , Maxila/diagnóstico por imagem , Maxila/cirurgia , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/cirurgia , Osteotomia
14.
Artigo em Inglês | MEDLINE | ID: mdl-34328479

RESUMO

The aim of this histomorphometric study was to compare the outcome of sinus floor augmentation procedures using bovine bone mineral and a xenograft enriched with gelatin and a polymer. In 20 patients a single sinus floor elevation procedure with a lateral window approach was performed. In half of the patients, sinuses were grafted with a deproteinized bovine bone mineral-DBBM (control group)-while in the remaining 10, a xenograft enriched by polymer and gelatin-NBS (test group)-was applied. In the DBBM group, histomorphometric analysis revealed 23.14 ± 10.62% of lamellar bone, 19.43% ± 9.18% of woven bone, 23.35% ± 6.04% of osteoid, 17.16% ± 6.13% of biomaterial particles, and 16.93% ± 9.78% of medullary spaces. In the NBS group, histomorphometric analysis found 39.64% ± 12.02% of lamellar bone, 16.28% ± 7.75% of woven bone, 17.51% ± 4.87% of osteoid, 12.72% ± 5.36% of biomaterial particles, and 13.84% ± 6.53% of medullary spaces. Differences between groups for proportion of lamellar bone (P = .004) and osteoid (P = .0287) were statistically significant. Inflammatory infiltration was appreciated only in the NBS group. The enriched xenograft showed a statistically significant higher proportion of lamellar bone and osteoid; however, this was accompanied by an accentuated inflammatory infiltrate.


Assuntos
Substitutos Ósseos , Levantamento do Assoalho do Seio Maxilar , Animais , Bovinos , Gelatina , Humanos , Seio Maxilar/cirurgia , Minerais , Polímeros
16.
J Craniofac Surg ; 32(6): e600-e602, 2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34224463

RESUMO

ABSTRACT: Cholesterol granuloma is commonly found in the mastoid air cells but is rare in the paranasal sinuses. The most commonly affected sinuses are the frontal sinus, followed by the maxillary sinus. Cholesterol granuloma can be difficult to diagnose because clinical manifestations and radiologic findings are similar to those of other sinonasal disorders. The authors observed 4 cases of cholesterol granuloma that were preoperatively suspected to be nasal polyps or mucoceles. Here, the authors report on their clinical presentation and their successful treatment using the endoscopic sinus approach. These cases expand the current literature on cholesterol granuloma in the paranasal sinuses.


Assuntos
Mucocele , Pólipos Nasais , Doenças dos Seios Paranasais , Colesterol , Erros de Diagnóstico , Endoscopia , Granuloma/diagnóstico , Granuloma/patologia , Granuloma/cirurgia , Humanos , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/patologia , Seio Maxilar/cirurgia , Mucocele/diagnóstico por imagem , Mucocele/cirurgia , Pólipos Nasais/diagnóstico , Pólipos Nasais/patologia , Pólipos Nasais/cirurgia , Doenças dos Seios Paranasais/diagnóstico por imagem , Doenças dos Seios Paranasais/cirurgia
17.
J Biol Regul Homeost Agents ; 35(3 Suppl. 1): 139-145, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34289673

RESUMO

The sinus lift with lateral approach is a regenerative technique nowadays considered predictable to increase the height of bone in the atrophic posterior maxilla. Knowledge of sinus anatomy and evaluation of risk factors are the basis of regenerative and rehabilitative surgical success. The positioning and size of the lateral antrostomy represent critical factors in the execution of regenerative surgery, due to the difficulty in transferring radiological information to the lateral wall of the maxillary sinus even for skilled surgeons. The knowhow of guided implant surgery in recent years is also finding use in planning and precisely delineating the lateral access to the maxillary sinus using CBCT imaging and dimensional reconstruction software, through the realization of surgical guides with 3D printing, as shown in the presented case.


Assuntos
Implantes Dentários , Levantamento do Assoalho do Seio Maxilar , Atrofia , Humanos , Maxila/diagnóstico por imagem , Maxila/cirurgia , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/cirurgia , Impressão Tridimensional
18.
Rev. Soc. Odontol. La Plata ; 31(60): 23-26, jul. 2021. ilus
Artigo em Espanhol | LILACS | ID: biblio-1284468

RESUMO

Las neoplasias malignas de la cavidad oral en gran medida (90%) consisten en carcinoma de células escamosas que surgen de la mucosa de revestimiento. El 10% restantes de neoplasias malignas orales de un grupo heterogéneo de tumores de diferente etiología. Presentamos dos casos de patología oncohematológica: Mieloma Múltiple (AU)


Malignant neoplasms of the oral cavity largely (90%) consist of squamous cell carcinoma arising from the lining mucosa. e remaining 10% of oral malignancies from a heterogeneous group of tumors of different etiology. We present two cases of oncohematological pathology: Multiple Myeloma (AU)


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Plasmocitoma/diagnóstico , Plasmocitoma/patologia , Plasmocitoma/diagnóstico por imagem , Neoplasias Bucais/diagnóstico , Radioterapia , Biópsia/métodos , Tomografia Computadorizada por Raios X , Procedimentos Cirúrgicos Bucais/métodos , Difosfonatos/uso terapêutico , Seio Maxilar/cirurgia , Mieloma Múltiplo
19.
Br J Oral Maxillofac Surg ; 59(7): 742-751, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34120778

RESUMO

A systematic review and network meta-analysis was conducted to compare different commercially available xenograft materials used in maxillary sinus floor elevation surgery (MSFES). Embase, PubMed, the Cochrane Library, Web of Science, Scopus, LILACS, and grey literature were searched up to 13 July 2020. Only randomised controlled trials (RCTs) were included. A frequentist network meta-analysis using a random effects model compared different commercially available xenograft materials. The primary outcomes were the percentage of newly-formed bone and residual bone-substitute rate. Both were measured by histomorphometric analysis from bone biopsies obtained during preparation of the implant site. Of the 659 studies initially identified, 11 involving 242 MSFES were included in the quantitative analyses. A total of six bone-substitute materials were analysed (Bio-Oss® (Geistlich Pharma), InduCera® Dual Coat, Lumina-Bone Porous® (Critéria), Osseous® (SIN - Sistema de Implantes Nacional), THE Graft® (Purgo Biologics), and Osteoplant Osteoxenon® (Bioteck)). The P-score estimation showed that Osteoplant Osteoxenon® produced the most newly-formed bone and reabsorbed faster than other xenograft materials after six months. The combination of Bio-Oss® plus bone marrow aspirate concentrate (BMAC) significantly increased the percentage of newly-formed bone compared with Bio-Oss® alone. In contrast, the addition of Emdogain® (Straumann) and leucocyte and platelet-rich fibrin (L-PRF) to Bio-Oss® did not significantly improve the amount of regenerated bone. Study-level data indicated that the percentage of newly-formed bone differs among commercially available xenograft materials. Osteoplant Osteoxenon® seems to result in the highest amount of new bone in MSFES.


Assuntos
Substitutos Ósseos , Levantamento do Assoalho do Seio Maxilar , Substitutos Ósseos/uso terapêutico , Transplante Ósseo , Implantação Dentária Endo-Óssea , Xenoenxertos , Humanos , Seio Maxilar/cirurgia , Minerais/uso terapêutico , Metanálise em Rede
20.
Clin Implant Dent Relat Res ; 23(4): 520-529, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34101342

RESUMO

BACKGROUND: The ability to restore missing teeth with dental implants is dictated by the available bone and by the presence of anatomical structures. The potential to insert ultrashort implants avoids additional surgical procedures and its inherent complications. The last European Association of Dental Implantologists consensus in 2016 defined ultrashort implants and standard-length dental implants as <6 and >8 mm, respectively. PURPOSE: The present study aimed to investigate whether single standing ultrashort dental implants (US) could provide a viable therapeutic alternative to osteotome mediated sinus floor elevation in combination with standard-length dental implants (SL) 10 mm in posterior maxillary rehabilitation with reduced bone height. MATERIALS AND METHODS: The study was conducted as a prospective parallel group controlled clinical trial with a 12 month follow-up, where 48 implants were randomized into two groups; US-group (5.5 mm) and SL-group (10 mm) implants placed with osteotome-mediated sinus floor elevation. Crestal bone loss (CBL) was defined as the study's primary outcome, while implant survival, buccal bone thickness, implant stability, probing depth, gingival recession, and adverse effects were assessed as secondary outcomes. RESULTS: Mesial CBL was 1.13 ± 0.52 mm in SL- and 0.72 ± 0.52 mm in US-group (P = .021), while distal CBL was 1.44 ± 0.72 mm in SL- and 0.91 ± 0.69 mm in US-group at 12 months (P = .0179). Regarding implant stability, probing depth, and gingival recession there was no statistically significant difference between the two groups. Regarding implants' survival, three implants were lost in the US-while only one implant was lost in the SL-group (P = .6085; Fisher's exact test). Nevertheless, the ultrashort implants were associated with a tripling of the failure rate and uncertainty where the true failure rate is uncertain (relative risk 3.0; confidence interval 0.3-26.8). CONCLUSIONS: Within the current trial's limitations, US-appear appear promising as they are associated less postoperative discomfort, minimal invasiveness and less CBL. However, larger sample size is required to determine whether the ultrashort have an acceptable survival rate.


Assuntos
Implantes Dentários , Levantamento do Assoalho do Seio Maxilar , Implantação Dentária Endo-Óssea , Planejamento de Prótese Dentária , Falha de Restauração Dentária , Maxila/cirurgia , Seio Maxilar/cirurgia , Estudos Prospectivos , Resultado do Tratamento
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