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1.
Head Face Med ; 18(1): 34, 2022 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-36397046

RESUMO

BACKGROUND: The use of dental implants in the prosthetic rehabilitation of the posterior atrophic maxilla might be a challenge procedure because of low bone quantity and quality. This study aimed to report cases of implant displacement or migration into the maxillary sinus treated from 2008 to 2021. MATERIALS AND METHODS: All patients with unintentional insertion and/or displacement of dental implants into the maxillary sinus cavity that underwent surgical removal were included. Variables assessed included the patients' characteristics, past medical history, clinical and radiological findings at presentation, surgical approach (transoral, transnasal, combined), and outcome. RESULTS: A total of forty patients (23 male, 17 female) underwent surgical removal of dental implant displaced in the maxillary sinus. The mean age was 52,3 + 11,3 years. Seven patients presented with oro-antral fistula (OAF). In 15 cases, an ostium obstruction was diagnosed. Twenty-five patients underwent transoral surgery under local anesthesia. Eleven patients were treated solely via transnasal endoscopic approach, and four patients who had an associated OAF underwent surgery through a combined transnasal and transoral approach. All patients healed uneventfully without complications. CONCLUSION: These results and recent literature validate that transoral and transnasal approach, or a combination of these procedures, can be used safely to treat complications following displacement/migration of dental implants in the maxillary sinus. Early surgical removal minimizes sinus inflammation and prevents more invasive procedures. Each procedure presents specific indications that must be carefully evaluated prior to treatment choice to optimize intervention outcomes.


Assuntos
Implantes Dentários , Seio Maxilar , Humanos , Masculino , Feminino , Recém-Nascido , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/cirurgia , Implantes Dentários/efeitos adversos , Estudos Retrospectivos , Maxila/cirurgia , Endoscopia/métodos
2.
Shanghai Kou Qiang Yi Xue ; 31(3): 265-269, 2022 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-36204954

RESUMO

PURPOSE: To compare the clinical effects of two different hydroxyapatite bone graft materials in maxillary sinus lifting surgery with bone grafting and implantation at the same time. METHODS: Seventy-two patients with implantation in the maxillary posterior dental area and insufficient bone mass admitted to the First Affiliated Hospital of Bengbu Medical College were collected from March 2018 to April 2019, and they were divided into experimental group(n=36) and control group(n=36) by random number table. Patients in the control group used hydroxyapatite composite material, while patients in the experimental group used nano-hydroxyapatite composite material. The clinical effects, bone increment and bone density changes of the two groups of implants were compared, and postoperative implant stability and complications of the two groups were compared. Statistical analysis was performed with SPSS 18.0 software package. RESULTS: The survival rate of implants in the experimental group was significantly higher than that in the control group at 24 months (P<0.05). Alveolar bone resorption in the experimental group was significantly lower than the control group 6 months after surgery(P<0.05). The bone mineral density of implants in the experimental group was significantly higher than the control group 6 months and 12 months after operation(P<0.05). The implant stability coefficient value of the experimental group was significantly higher than the control group 12 months after operation(P<0.05). There was no significant difference in the total complication rate between the two groups(P>0.05). CONCLUSIONS: In maxillary sinus lift, the survival rate of nano-hydroxyapatite composite material implanted in the same period is high, which can improve postoperative bone metabolism and increase implant stability with good safety.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Transplante Ósseo/efeitos adversos , Implantação Dentária Endóssea , Implantes Dentários/efeitos adversos , Durapatita/uso terapêutico , Humanos , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/cirurgia
5.
Artigo em Inglês | MEDLINE | ID: mdl-36305935

RESUMO

Fourteen maxillary sinuses were reconstructed in 12 patients who presented with a previous sinus elevation failure. In all cases, large perforations of the sinus membrane occurred during removal of the failed graft from the sinus; the perforations were sealed with fibrin glue, then the site was grafted using homologous fibrin glue (HFG) mixed with a calcium phosphate scaffold (CPS). Histologic analyses revealed that the CPS-HFG graft was followed by an ossification process, with the formation of spongy bone similar to that of the normal skeleton. Twenty-four endosseous implants were successfully placed into the newly regenerated bone. All implants were successfully restored with ceramic crowns 6 months after placement. At the 3-year follow-up, no infections or implant failures were reported. The described technique offers several clinical advantages, as the removal of the failed graft, the sinus perforation repair, and the sinus elevation can be achieved in the same surgery without needing to postpone the regenerative surgery phase.


Assuntos
Implantes Dentários , Seio Maxilar , Humanos , Seio Maxilar/cirurgia , Seguimentos , Adesivo Tecidual de Fibrina , Implantação Dentária Endóssea/métodos , Transplante Ósseo/métodos , Falha de Restauração Dentária
6.
J Dent ; 126: 104318, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-36202279

RESUMO

BACKGROUND: There is growing evidence that minimally invasive sinus augmentation works without the use of filler materials. This study assessed the bone integration and sinus projection of single-unit implants in the maxilla, which were placed approximately 18 years ago using a modified filler-free osteotome technique. METHODS: Sixteen of the 24 treated patients of a former publication (treatment was performed between 2001 and 2004) were reassessed after a mean implant loading period of 17.5 years. The treated posterior areas were evaluated using cone-beam computed tomography (CBCT), and as a primary outcome parameter, sinus projection was determined in sectional views at the mesial, distal, buccal, and oral sites. Additionally, the percentage of alveolar bone contact was determined with respect to the implant length. Conventional radiographs were used to determine marginal bone levels. Additionally, plaque, bleeding on probing, and probing pocket depth were measured. The reconstructions were checked for chipping and other technical complications such as loss of retention, screw loosening, and screw fracture. RESULTS: The mean age of the included patients was 72.8 ± 8.5 years. Two implants were lost. Therefore, fourteen implants were available for CBCT evaluation. The highest sinus projection of 2.1 ± 1.7 mm was observed in the distal aspect, while it was 1.1 ± 1.5, 0.9 ± 1.2, and 0.9 ± 1.1 mm at the mesial, buccal, and oral sites, respectively. The maximal sinus projection in one case was 6.7 mm. The percentage calculation of osseous implant integration (in mm ± standard deviations) with respect to the selected implant length at the mesial, distal, buccal, and oral sites showed values ranging from, 87.9 ± 16.0, 78.4 ± 20.3, 91.0 ± 12.5, and 90.5 ± 11.1%, respectively. Five implants displayed probing pocket depths of more than 4 mm with bleeding; all implants had less than 1 mm of bone loss in the observation period, that is, implants had mucositis. Six of 14 crowns showed small chippings within the ceramic veneering. One case of screw loosening was reported in medical history. DISCUSSION: This study showed that implant placement in non-augmented sinuses resulted in good clinical results. The sinus projection, even if persistent and present, leads to no functional impairments. Given adequate maintenance, marginal bone levels remain constant and peri­implant health can be observed. Moreover, these results represent only a small cohort; and therefore, should be interpreted with caution. However, in view of the existing literature, these highly promising results are in line with other findings. CLINICAL SIGNIFICANCE: To the best of our knowledge, this dataset is the report with the longest follow-up. Overall, implants placed in the sinus without fillers represent a valuable alternative for tooth replacement in a minimally interventional manner.


Assuntos
Implantes Dentários , Levantamento do Assoalho do Seio Maxilar , Humanos , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/cirurgia , Levantamento do Assoalho do Seio Maxilar/métodos , Implantação Dentária Endóssea/métodos , Maxila/cirurgia , Osteotomia/métodos , Resultado do Tratamento
7.
J Craniofac Surg ; 33(7): e758-e761, 2022 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-36201693

RESUMO

Ectopic maxillary third molar teeth can often be located in the maxillary sinus, and the region necessarily requires a multidisciplinary approach due to its proximity to the oral cavity. Ectopic third molar tooth in the maxillary sinus was detected by oral and radiological examination in a 26-year-old male patient. The tooth was removed, and sinus augmentation was performed through the Caldwell-Luc procedure, and a dental implant was placed afterward. The treatment was ended by making a prosthetic metal-supported ceramic crown. Both removals of the ectopic tooth from the maxillary sinus, sinus augmentation, and implant operation can be achieved in a single operation of a single-window opened in the bone. As a result, because of the adjacency of the regions in operations related to the maxillary sinus, both the dental practitioner and the otolaryngologist should evaluate the operation, and multidisciplinary work should be done when necessary.


Assuntos
Implantes Dentários , Dente Supranumerário , Adulto , Odontólogos , Humanos , Masculino , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/cirurgia , Dente Serotino/diagnóstico por imagem , Dente Serotino/cirurgia , Papel Profissional
8.
Int J Clin Pract ; 2022: 1850012, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36249910

RESUMO

Maxillary sinus augmentation is critical to oral implantology, particularly in some cases. The morphology of the sinus floor reflects the lifting effect to a certain extent; however, there has been limited research on the morphology after sinus augmentation. The present study aims to investigate the relationship between residual bone height (RBH) and the morphology of the sinus floor and determine whether a correlation exists between the different evaluation classifications. Maxillary sinus floor augmentation procedures were performed in 56 patients and 68 teeth using the sinus crest approach (SCA). Imaging results obtained after one year of sinus augmentation were analyzed and simultaneously classified along the coronal plane, the sagittal plane, and the biplane (coronal-sagittal). The higher the RBH, the closer the result tends to be to A, A', or type 1 (more satisfactory). There was a significant correlation between the three different evaluation classifications (p < 0.05). The morphology of perforation cases was involved in types C, D, C', and D'. A more satisfactory post-lifting morphology (tent type and flat type) is probably related to an optimal preoperative bone height, and an unsatisfactory post-lifting morphology is related to a low preoperative sinus floor height. The sagittal plane evaluation correlates with the coronal plane and biplane evaluation and is thus more recommended.


Assuntos
Seio Maxilar , Levantamento do Assoalho do Seio Maxilar , Progressão da Doença , Humanos , Maxila , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/cirurgia , Estudos Retrospectivos , Levantamento do Assoalho do Seio Maxilar/métodos
9.
J Mater Sci Mater Med ; 33(11): 76, 2022 Oct 20.
Artigo em Inglês | MEDLINE | ID: mdl-36264396

RESUMO

Fractures of the paranasal sinuses often require surgical intervention. Persisting bone defects lead to permanent visible deformities of the facial contours. Bone substitutes for reconstruction of defects with simultaneous induction of new bone formation are not commercially available for the paranasal sinus. New materials are urgently needed and have to be tested in their future area of application. For this purpose critical size defect models for the paranasal sinus have to be developed. A ≥2.4 cm large bilateral circular defect was created in the anterior wall of the maxillary sinus in six sheep via an extraoral approach. The defect was filled with two types of an osteoconductive titanium scaffold (empty scaffold vs. scaffold filled with a calcium phosphate bone cement paste) or covered with a titanium mesh either. Sheep were euthanized after four months. All animals performed well, no postoperative complications occured. Meshes and scaffolds were safely covered with soft tissue at the end of the study. The initial defect size of ≥2.4 cm only shrunk minimally during the investigation period confirming a critical size defect. No ingrowth of bone into any of the scaffolds was observed. The anterior wall of the maxillary sinus is a region with low complication rate for performing critical size defect experiments in sheep. We recommend this region for experiments with future scaffold materials whose intended use is not only limited to the paranasal sinus, as the defect is challenging even for bone graft substitutes with proven osteoconductivity. Graphical abstract.


Assuntos
Substitutos Ósseos , Ovinos , Animais , Cimentos Ósseos , Titânio , Maxila/cirurgia , Fosfatos de Cálcio , Regeneração Óssea , Seio Maxilar/cirurgia
10.
Medicina (Kaunas) ; 58(9)2022 Aug 23.
Artigo em Inglês | MEDLINE | ID: mdl-36143818

RESUMO

Sarcomas in the head and neck area are rare diseases with an incidence of under 1% of all head and neck malignant tumours. Osteosarcomas or osteogenic sarcomas consist of neoplastic cells that produce osteoid bone or immature bone. Sarcomas develop more in the mandible than the maxilla. The exact diagnosis of different types of sarcomas is based on the immunohistochemical investigation. These rare tumours are of mesenchymal origin; osteosarcomas and chondrosarcomas are the most common types-Ewing's sarcomas. The use of proton beam radiotherapy in the treatment of osteosarcoma of the maxilla is rarely reported in the literature. We present a case of successfully treated (surgery and proton beam radiotherapy) poorly differentiated highly aggressive osteosarcoma in the ethmoids and maxillary sinus and morbidity after the treatment. We were presented with a case of a 65-year-old man with anaesthesia and palsy of the right face. The stomatology department performed the extraction of a tooth. One month later, the wound was still open. The histology showed an osteogenic sarcoma in the area of the wound. The oncologist and maxillofacial surgeons in a catchment hospital recommended a nonsurgical approach. Hence, we performed a radical maxillectomy and ethmoidectomy, after which we continued with proton bean radiotherapy. The patient is now five years after therapy without signs of sarcoma; however, he has blindness in the right eye and reduced vision in the left eye, as well as gliosis of the brain, vertigo, tinnitus, trismus, and ancylostomiases. Head and neck osteosarcomas treatment is considered a complex multidisciplinary task. It is currently argued that there is no clear therapeutic protocol for successful treatment. Innovations in treatment modalities such as proton beam radiotherapy appear to have potential, although their effects on long-term morbidity and survival outcomes are still undetermined. We present a rare case report of an osteosarcoma of the maxilla involving an innovative, successful treatment procedure combining surgical excision followed by proton beam radiotherapy. This treatment approach may enable maximum tumour control. This protocol has not been adequately described in the world literature for this diagnosis.


Assuntos
Neoplasias Ósseas , Neoplasias de Cabeça e Pescoço , Osteossarcoma , Sarcoma , Idoso , Humanos , Masculino , Seio Maxilar/patologia , Seio Maxilar/cirurgia , Osteossarcoma/patologia , Osteossarcoma/radioterapia , Osteossarcoma/cirurgia , Prótons
11.
Medicina (Kaunas) ; 58(9)2022 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-36143920

RESUMO

Background and Objectives: The accessory maxillary ostium (AMO) can interfere with ventilation and drainage of the maxillary sinus, and therefore the importance of evaluating the anatomical features of the AMO has been emphasized. This study aimed to evaluate anatomical characteristics of the AMO together with the natural ostium (NO) using three-dimensional (3D) analysis and to assess the relationship between the AMO and maxillary sinus pathologies. Materials and Methods: This retrospective study included 394 sinuses in 197 patients. Using 3D computed tomography images, the prevalence of the AMO and concurrent sinus pathologies were examined. For patients with an AMO, 3D spatial positions of the AMO and NO related to adjacent anatomic structures and dimensions of the AMO and NO were evaluated. Results: A total of 84 sinuses showed single or multiple AMO, with a prevalence of 21.3%. The AMO was located superiorly by 30.1 mm from the maxillary sinus floor, inferiorly by 1.3 mm from the orbital floor, and posteriorly by 22.4 mm from the anterior sinus wall. The AMO was located 5.4 mm posteriorly and 0.7 mm inferiorly from the NO. On the same coronal plane as the NO or AMO, height from the maxillary sinus floor to the NO and AMO ranged from 19.4 to 45.8 mm and 14.5 mm to 41.9 mm, respectively. The mean horizontal and vertical dimensions were 5.9 mm and 4.6 mm for the NO and 2.8 mm and 3.0 mm for the AMO. We detected a significant association between the presence of the AMO and the mucosal thickening (p = 0.029). Conclusions: The results of this study suggest that, although the AMO and NO are mostly located in positions that do not limit sinus-related surgeries, such as maxillary sinus floor augmentation, the AMO and NO are also found in lower positions, which may be a detriment to the postoperative physiological function of the maxillary sinus and affect treatment outcomes.


Assuntos
Levantamento do Assoalho do Seio Maxilar , Humanos , Maxila , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/cirurgia , Estudos Retrospectivos , Levantamento do Assoalho do Seio Maxilar/métodos , Resultado do Tratamento
12.
Medicina (Kaunas) ; 58(9)2022 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-36143978

RESUMO

The cause and pathogenicity of grafting voids following lateral maxillary sinus augmentation (MSA) have not yet been elucidated. The first purpose of this case series is to introduce an unusually large grafting void that radiologically resembles a surgical ciliated cyst (SCC) at the sinus augmented site; the second is to observe the histological findings of these grafting voids. In four patients, MSA was performed using the lateral window technique. An unusually large grafting void appeared on cone-beam-computed tomography (CBCT) taken one week after surgery and except for one patient, there were no clinical symptoms. On CBCT taken six months after surgery, the grafting voids were slightly smaller in size but showed radiographic findings similar to those of SCC. During uncovering, grafting voids were removed through the lateral window site. Histologically, the grafting void was empty or filled with dense connective tissue, and no ciliated columnar epithelium or inflammatory cells were observed. Within the limitations of this case series, the large grafting voids generated after MSA was not converted to SCCs. Rather, they remained scar tissue, which could infringe the sinus bone graft and affect the apical bone support of the implant.


Assuntos
Cistos , Seio Maxilar , Transplante Ósseo/métodos , Tomografia Computadorizada de Feixe Cônico/métodos , Cistos/cirurgia , Humanos , Maxila/cirurgia , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/cirurgia
13.
Int J Oral Maxillofac Implants ; 37(5): 869-878, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36170301

RESUMO

PURPOSE: To assess the effect of nongrafted and grafted materials on transalveolar sinus floor elevation (TSFE) with implant placement. MATERIALS AND METHODS: Relevant studies published between January 1, 1994, and July 31, 2021, were selected by searching Embase, PubMed/MEDLINE, Web of Science, and Cochrane Central Register of Controlled Trials. The study subjects were restricted to humans, and the language was limited to English. The study was confined to randomized controlled trials, controlled clinical trials, and observational studies (prospective and retrospective cohort) related to TSFE with and without bone-grafting materials. Two reviewers independently extracted study data and conducted quality assessments according to the Cochrane handbook and NOS scale. RevMan 5.3 and Stata 15.1 software were then used to analyze the research data that met the inclusion criteria. RESULTS: A total of nine articles were included, including 421 implants in the graft group and 502 implants in the nongraft group. Meta-analysis showed that there was no significant difference in the implant failure rate (RR = 1.03, 95% CI: 1.00, 1.06, P = .08) or marginal bone loss (SMD = 0.06, 95% CI: -0.23, -0.35, P = .69) between implants with and without graft materials after TSFE. The amount of endosinus bone gain in the nongraft group was significantly lower than that in the graft group (SMD = -1.07, 95% CI: -1.73: -0.41, P = .0001). CONCLUSION: TSFE in implants with or without grafting can achieve similar results, but there may be more bone gain in TSFE with grafting.


Assuntos
Implantes Dentários , Levantamento do Assoalho do Seio Maxilar , Implantação Dentária Endóssea/métodos , Humanos , Seio Maxilar/cirurgia , Prognóstico , Estudos Prospectivos , Estudos Retrospectivos , Levantamento do Assoalho do Seio Maxilar/métodos
14.
Int J Oral Maxillofac Implants ; 37(5): 905-912, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36170304

RESUMO

PURPOSE: To identify the impact of residual bone height on 5-year implant survival and prosthetic complication rates in patients who underwent maxillary sinus grafting. MATERIALS AND METHODS: A total of 87 consecutive patients were treated with 104 lateral approach maxillary sinus floor augmentation procedures with 100% deproteinized bovine bone and received 169 implants. The analysis considered patient age, sex, time of implant placement, and residual bone height. Patients with < 3 mm residual bone height were assigned to the study group; otherwise, they were placed in the control group. RESULTS: The mean follow-up was 68.2 months (0 to 103 months). The mean residual bone height was 1.8 mm in the study group and 4.1 mm in the control group. The 5-year implant survival and prosthetic complication rates were, respectively, 97.4% and 8.0% in the study group and 100% and 12.5% in the control group. Residual bone height, sex, age, and time of implant placement were not significant factors for the 5-year implant survival or prosthetic complication rate. The lateral bone wall was significantly thinner in the study group. The grafted bone height reduction was significantly different at 6 months and 2 years postoperation in both groups, but there was no difference in the change in grafted bone height reduction over time between the two groups. CONCLUSION: A residual bone height < 3 mm did not impact the survival rates of implants placed in grafted maxillary sinuses or the prosthetic complication rate after 5 years of functional loading.


Assuntos
Aumento do Rebordo Alveolar , Implantes Dentários , Levantamento do Assoalho do Seio Maxilar , Animais , Bovinos , Implantação Dentária Endóssea/métodos , Humanos , Seio Maxilar/cirurgia , Levantamento do Assoalho do Seio Maxilar/métodos , Taxa de Sobrevida
15.
Int J Oral Maxillofac Implants ; 37(5): 920-928, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36170306

RESUMO

PURPOSE: To examine the short-term outcomes of maxillary sinus augmentations consisting of laterally and apically displacing the palatal wall through a transcrestal approach. MATERIALS AND METHODS: The maxillary sinus floor was fractured in its palatal aspect by allowing a displacement in the buccal and apical direction with a magnetoelectric system. A medial displacement of the alveolar crest in its palatal bony plate was performed at the same time. Crestal bone change was investigated using superimposed preoperative and postsurgical computed tomography scans. Clinical and radiologic outcomes over 1 year were evaluated. RESULTS: A total of 18 implants were selected for retrospective volumetric and linear analyses. Sinus floor and alveolar bone augmentation surgery led to a significant increase in the bone volume (P = .0002) from 0.134 ± 0.060 cm3 to 0.639 ± 0.166 cm3, with an overall gain of +0.504 ± 0.139 cm3. No part of the implant apices appeared to protrude into the maxillary sinus at the 1-year follow-up. The width of the alveolar crest changed from 5.1 ± 0.5 mm to 6.5 ± 0.7 mm, with a significant increase of +1.4 ± 0.6 mm registered at 1 year. However, a marginal bone loss of 1.0 ± 0.8 mm was observed. When tooth positions were investigated, no significant differences between the two groups (premolars versus molars) were found. CONCLUSION: Significant and effective bone gains allowed proper placement of the dental implants but with a minimal loss of peri-implant bone volume.


Assuntos
Implantes Dentários , Levantamento do Assoalho do Seio Maxilar , Implantação Dentária Endóssea/métodos , Maxila/cirurgia , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/cirurgia , Estudos Retrospectivos , Levantamento do Assoalho do Seio Maxilar/métodos , Tomografia Computadorizada por Raios X
16.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 57(9): 953-957, 2022 Sep 09.
Artigo em Chinês | MEDLINE | ID: mdl-36097943

RESUMO

To explore the efficacy and value of personalized surgical schemes in the repair of maxillary sinus perforation and maxillary sinus fistula based on the size of the maxillary sinus perforation and maxillary sinus fistula. A total of 28 patients with maxillary sinus perforation and maxillary sinus fistula who were admitted to the Department of Oral and Maxillofacial Surgery, Stomatology Hospital of Kunming Medical University from July 2017 to May 2020 were included to conduct a prospective case clinical study. After the inflammation in the maxillary sinus was controlled, a proper surgical repair method was selected according to the size of the perforation and fistula based on the double-layer closure technique. The diameter of the perforation and fistula was measured with the assistance of cone-beam CT. After that, the platelet rich fibrin (PRF) repair was performed on the perforation and fistula with 3 mm≤diameter<7 mm in size in 14 patients. The PRF repair and buccal flap repair were performed on the perforation and fistula with 7 mm ≤diameter<15 mm in size in 7 patients. The adjacent buccal pad repair, palatine flap repair, and buccal flap repair were performed on the perforation and fistula with 15 mm≤ diameter<25 mm in size in 4 patients. The nasolabial axial flap repair and nasolabial free flap repair were performed on the perforation and fistula with a diameter ≥25 mm in size in 3 patients. The medical follow-up was conducted in all patients in the 1st, 2nd, and 4th week after surgery, with an overall success rate reaching 96.4% (27/28) after the initial intervention. The relapse of disease occurred in one patient (4.6%) with diabetes and a smoking history in the 2nd week after surgery. Identifying a proper surgical repair method according to the size of the oral and maxillary sinus perforation and maxillary sinus fistula based on the double-layer closure technique can improve the one-time cure rate in these patients under the premise that the inflammation in the maxillary sinus can be controlled.


Assuntos
Fístula , Seio Maxilar , Fístula/cirurgia , Humanos , Inflamação , Maxila , Seio Maxilar/cirurgia , Fístula Bucoantral/cirurgia
17.
Clin Oral Implants Res ; 33(11): 1098-1113, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36062937

RESUMO

OBJECTIVES: To retrospectively compare multilevel volumetric changes in both hard and soft tissues between antral pseudocyst (AP) removal and retainment before maxillary sinus floor augmentation (MSFA) and immediate implant placement. MATERIAL AND METHODS: Twenty-six patients with 38 implants placed from 2016 to 2021 were included and divided according to a cohort design as follows: 13 removing the cyst (RC group) and 13 "leaving alone" the cyst (LC group). 3D radiographic parameters (primary outcome), 2D parameters and clinical records (secondary outcome) involving both hard and soft tissues were evaluated for four periods (T1: immediate postoperative, T2: 6-month, T3: 12-month, and T4: 2- to 5- year follow-up). Possible confounding factors, including sinus anatomical features and implant distribution, were also analyzed to eliminate their disturbance. RESULTS: The 3D volumetric change rate of bone grafts in the RC group (-9.32% ± 10.01%) from T2 to T3 was significantly lower than that in the LC group (-19.8% ± 10.59%) (p < .05). The change rate of apical bone height (ABH), endo-sinus bone gain (ESBG) and other 2D parameters were not significantly different between the two groups. 5.3% implants in RC group and 9.1% implants in LC group failed during follow-ups. 0% postoperative complications were observed in RC group. The Schneiderian membrane of RC group was significantly thinner than that of LC group at two measuring points in sinus. CONCLUSION: The present study demonstrated that compared to AP retainment, AP removal before MSFA and immediate implant placement can obtain higher bone graft volumetric stability and favorable prognosis.


Assuntos
Cistos , Implantes Dentários , Levantamento do Assoalho do Seio Maxilar , Humanos , Estudos Retrospectivos , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/cirurgia , Transplante Ósseo , Cistos/diagnóstico por imagem , Cistos/cirurgia , Implantação Dentária Endóssea
18.
Quintessence Int ; 53(9): 798-807, 2022 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-35976752

RESUMO

OBJECTIVE: Dental anxiety (DA) is a frequent and widespread phenomenon worldwide. There are few studies that have discussed the preoperative intervention of dental anxiety. The aim of this study was to explore the clinical efficacy of an online intervention to improve understanding and reduce dental anxiety in patients with transcrestal sinus floor elevation (TSFE) and to explore the correlation between patients' understanding and dental anxiety, pain perception, and satisfaction. METHOD AND MATERIALS: This prospective randomized controlled trial enrolled patients who underwent TSFE and simultaneous implant placement. Patients were randomly allocated to the preoperative online intervention group (test group) and the non-online intervention group (control group). Two patient interview topic guide questionnaires were utilized to assess the extent and source of patients' understanding of the treatment process after a consultation at the hospital (T1) and prior to the surgery (T2). The preoperative dental anxiety was also assessed using the modified Corah dental anxiety scale (MDAS) at T1 and T2. All patients used the visual analog scale to describe their pain perception and satisfaction with the treatment process immediately after surgery (T3). A correlation analysis was performed to analyze the interrelationship between patient understanding, dental anxiety, pain perception, and satisfaction. RESULTS: At T1, both groups were homogenous in their knowledge of the TSFE procedure and preoperative dental anxiety. At T2, the test group showed a better understanding of the TSFE procedure and lower preoperative dental anxiety than that of T1 and the control group at T2. Pain perception was significantly lower in the test group than in the control group at T3. Patients in the test group expressed significantly greater satisfaction with the treatment process than the control test group. There was a negative correlation between patients' understanding and preoperative dental anxiety. A positive correlation between preoperative dental anxiety and pain perception was found with a significant difference. Patients' satisfaction was positively correlated with understanding and negatively correlated with pain perception. CONCLUSIONS: Preoperative online intervention effectively increased patients' understanding of the treatment process. This resulted in decreased preoperative dental anxiety, decreased pain perception, and greater postoperative satisfaction from patients who underwent TSFE. CLINICAL RELEVANCE: Online medical care can be considered as an auxiliary tool to improve the effect of implant surgery.


Assuntos
Implantes Dentários , Levantamento do Assoalho do Seio Maxilar , Ansiedade ao Tratamento Odontológico/prevenção & controle , Implantação Dentária Endóssea/métodos , Humanos , Seio Maxilar/cirurgia , Estudos Prospectivos , Levantamento do Assoalho do Seio Maxilar/métodos
19.
PLoS One ; 17(8): e0273399, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36007001

RESUMO

OBJECTIVES: This study aimed to evaluate the clinical and radiographic outcomes of early implant placement and functional loading in maxillary sinus floor augmentation (MSFA) using recombinant human bone morphogenetic protein 2/hydroxyapatite (rhBMP-2/HA) and to compare these outcomes with those of the conventional protocol in MSFA using deproteinized bovine bone (DBB). MATERIALS AND METHODS: The rhBMP-2/HA and DBB groups consisted of 14 and 13 patients who underwent MSFA with BMP and DBB, respectively. After placement of 22 implants and 21 implants in the rhBMP-2/HA and DBB groups, respectively, abutment connections were performed 3 months after implant placement for the rhBMP-2/HA group and 6 months after implant placement for the DBB group. Changes in grafted sinus height (GSH), marginal bone loss (MBL), and implant stability were evaluated up to one year after functional loading. RESULTS: Survival rates for the rhBMP-2/HA and DBB groups after one year of functional loading were 90.9% and 90.5%, respectively. Both groups exhibited no significant time-course changes in GSH until one year of functional loading (rhBMP-2/HA, p = 0.124; DBB, p = 0.075). Although significant MBL occurred after one year of functional loading for both groups (rhBMP-2/HA, p < 0.001; DBB, p < 0.001), there were no significant differences in time-course changes in MBL between the two groups (p = 0.450). The mean implant stability quotient values in the rhBMP-2/HA and DBB groups were 75.3 and 75.4 after one year of functional loading, respectively, and there were no significant differences between the two groups (p = 0.557). CONCLUSIONS: MSFA using rhBMP-2/HA allowed implant rehabilitation with early implant placement and functional loading and led to a comparable survival rate and implant stability after 1 year of functional loading with acceptable MBL and stable maintenance of GSH compared to the MSFA using DBB with 6 months of healing after implant placement.


Assuntos
Implantes Dentários , Levantamento do Assoalho do Seio Maxilar , Animais , Proteína Morfogenética Óssea 2 , Bovinos , Implantação Dentária Endóssea , Durapatita , Humanos , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/cirurgia , Levantamento do Assoalho do Seio Maxilar/métodos
20.
Artigo em Inglês | MEDLINE | ID: mdl-35954926

RESUMO

Rehabilitation of an edentulous posterior maxilla with dental implants is challenging, and sinus floor augmentation could be considered as an important surgical procedure for bone augmentation in this region before implant placement. Platelet-rich fibrin (PRF) is a new-generation platelet concentrate with simplified processing: its application in sinus floor augmentation has been widely investigated in literature. However, the biological properties and actual efficacy of this product remain controversial. This study assessed the effect of sinus floor augmentation with PRF versus freeze-dried bone allograft (FDBA) on stability of one-stage dental implants. This split-mouth randomized clinical trial evaluated 10 patients who required bilateral sinus floor augmentation. PRF and L-PRF membrane were used in one quadrant while FDBA and collagen membrane were used in the other quadrant. Implant stability was assessed by resonance frequency analysis (RFA) immediately, and 2, 4, and 6 months after implant placement. The implant stability quotient (ISQ) was compared over time and between the two groups using repeated measures ANOVA and independent sample t-test. The mean ISQ significantly increased over time in both groups (p < 0.001). The increase was greater in the PRF group (p < 0.05). Within the limitations of this study, PRF yielded superior results compared with FDBA regarding the stability of one-stage dental implants.


Assuntos
Implantes Dentários , Transplante de Células-Tronco Hematopoéticas , Fibrina Rica em Plaquetas , Levantamento do Assoalho do Seio Maxilar , Humanos , Seio Maxilar/cirurgia , Boca , Levantamento do Assoalho do Seio Maxilar/métodos
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