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1.
J. appl. oral sci ; 29: e20200568, 2021. tab, graf
Article in English | LILACS, BBO | ID: biblio-1143153

ABSTRACT

Abstract Objective The aim of this study is to evaluate the new bone and connective tissue formation and the biomaterial remaining after maxillary sinus bone augmentation using 5 different bone substitutes. The osteocalcin immunolabeling was performed to demonstrate their calcification and the possibility of receiving dental implants. Methodology 40 patients underwent maxillary sinus bone augmentation and were divided in 5 groups: Group 1 with 8 maxillary sinuses were grafted with autogenous bone graft (AB); Group 2 with 8 maxillary sinuses grafted with bioactive glass (BG); Group 3 with 8 maxillary sinuses grafted with bioactive glass added to autogenous bone graft (BG + AB) 1:1; Group 4 with 8 maxillary sinuses grafted with Bio-Oss (BO) and Group 5 with 8 maxillary sinuses grafted with Bio-Oss added to autogenous bone graft (BO + AB) 1:1. Results In group AB, 37.8% of bone was formed in the pristine bone region, 38.1% in the intermediate and 44.5% in the apical region. In group BG, 43.6% was formed in the pristine bone, 37% in the intermediate and 49.3% in the apical region. In group BG + AB 1:1, 39.0% was formed in the pristine bone region, 34.8% in the intermediate and 36.8% in apical region. In group BO, 33.4% was formed in the pristine bone, 32.5% in the intermediate and 34.3% in the apical region. In group BO + AB 1:1, 32.8% was formed in the pristine bone, 36.1% in intermediate and 27.8% in the apical regions. The immunolabeling for osteocalcin showed an intensive staining for all groups, which could demonstrate the calcification of the bone formed. Conclusion This study showed that the groups evaluated formed a suitable lamellar bone in the maxillary sinus reconstruction after six months of bone healing, thus being indicated to receive dental implants.


Subject(s)
Humans , Osteogenesis , Dental Implants , Bone Transplantation , Bone Substitutes , Sinus Floor Augmentation , Dental Implantation, Endosseous , Maxillary Sinus/surgery , Maxillary Sinus/diagnostic imaging
2.
Rev. Odontol. Araçatuba (Impr.) ; 41(3): 33-39, set./dez. 2020. ilus
Article in Portuguese | LILACS, BBO | ID: biblio-1121742

ABSTRACT

Este relato de caso clínico tem como objetivo descrever a utilização de osso alógeno na reconstrução de maxila atrófica para posterior reabilitação com prótese fixa metalocerâmica sobre implantes, fazer uma análise histológica do tecido ósseo enxertado e descrever o acompanhamento clínico e radiográfico por 8 anos. Uma paciente de 54 anos, com edentulismo parcial e atrofia moderada-a-severa na maxila, apresentou-se para tratamento demonstrando muito interesse em receber prótese sobre implantes. Após exame clínico e radiográfico, foi realizada montagem dos modelos de estudo em ASA para enceramento diagnóstico e obtenção de um guia multifuncional (tomográfico/ cirúrgico). A tomografia indicou a necessidade de reconstrução óssea maxilar. Procedeuse então à aposição de blocos de osso alógeno para aumento horizontal nas regiões anterior e posterior da maxila. Um dos blocos foi triturado e utilizado para levantamento do assoalho do seio maxilar no lado esquerdo. Dez meses depois, uma nova tomografia foi solicitada, utilizando o mesmo guia inicial, e os implantes instalados, utilizando o guia multifuncional como guia cirúrgico. Neste momento, material ósseo foi coletado na interface osso enxertado/osso nativo com uma broca trefina. Os resultados histológicos demonstraram viabilidade das células ósseas no enxerto, além da presença de vasos sanguíneos. Após o tempo necessário para osseointegração, procedeu-se com tratamento protético. Nenhuma complicação foi relatada até oito anos de controle. A sequência de tratamento proposta forneceu bons resultados estéticos e funcionais. Concluiu-se, então, que o emprego de osso alógeno é uma alternativa viável para a reconstrução de rebordos alveolares severamente reabsorvidos(AU)


This clinical case report aims to describe the use of allogeneic bone in the atrophic maxilla reconstruction for subsequent rehabilitation with a fixed metal-ceramic prosthesis on implants; to perform a histological analysis of the grafted bone tissue; and to describe the clinical and radiographic monitoring for 8 years. A 54-year-old patient, with partial edentulism and moderate-to-severe atrophy in the maxilla showed great interest in receiving implant prostheses. After c linical and radiographic examination, the ASA study models were assembled for diagnostic waxing and a multifunctional guide (tomographic / surgical) was obtained. Tomography indicated the need for maxillary bone reconstruction. Allogeneic bone blocks were then placed for horizontal enlargement in the anterior and posterior regions of the maxilla. One of the blocks was crushed and used to lift the floor of the maxillary sinus on the left side. Ten months later, a new tomography was requested, using the same initial guide, and the implants installed, using the multifunctional guide as a surgical guide. At this time, bone material was collected at the grafted bone / native bone interface with a trephine drill. Histological results demonstrated viability of bone cells in the graft, besides the presence of blood vessels. After the necessary time for osseointegration, a prosthetic treatment was performed. No complications were reported up to eight years of control. The propose treatment sequence provided good aesthetic and functional results. It was concluded, then, that the use of allogeneic bone is a viable alternative for the reconstruction of severely reabsorbed alveolar edges(AU)


Subject(s)
Bone Transplantation , Dental Prosthesis, Implant-Supported , Dental Prosthesis Design , Sinus Floor Augmentation
3.
Int. j interdiscip. dent. (Print) ; 13(1): 35-39, abr. 2020. graf
Article in Spanish | LILACS | ID: biblio-1114891

ABSTRACT

La cirugía de elevación de seno maxilar se considera como la técnica de aumento óseo más predecible. Sin embargo, no está exenta de complicaciones las cuales deben ser manejadas adecuadamente. Se presenta un caso clínico rehabilitado, con un seguimiento de 3 años, en el cual se realizó un manejo multidisciplinario y resolutivo de complicaciones asociadas a la técnica quirúrgica de elevación de membrana sinusal vía ventana lateral. Frente a una infección postoperatoria, como la presentada en el caso, hay que considerar iniciar un tratamiento antibiótico en el momento adecuado para impedir el agravamiento del cuadro clínico o un cambio de esquema en caso de resistencia antimicrobiana.


Maxillary sinus lift surgery is considered the most predictable bone augmentation technique. However, this procedure is not without complications, which must be handled properly. We present a rehabilitated clinical case, with a 3-year follow-up, in which a multidisciplinary and resolutive management of complications associated with the surgical technique of sinus lift procedure, using lateral window approach, was performed. In case of postoperative infection, such as the one presented in this report, it is necessary to consider starting an antibiotic treatment at the adequate moment to prevent the aggravation of the illness or change the pharmacological treatment in case of antimicrobial resistance.


Subject(s)
Humans , Female , Adult , Sinusitis/therapy , Bacterial Infections/therapy , Rhinitis/therapy , Sinus Floor Augmentation/adverse effects , Postoperative Complications/rehabilitation , Sinusitis/etiology , Sinusitis/microbiology , Bacterial Infections/etiology , Dental Implants , Rhinitis/etiology , Rhinitis/microbiology , Acute Disease , Follow-Up Studies , Treatment Outcome
4.
Odovtos (En línea) ; 22(1): 61-70, ene.-abr. 2020. graf
Article in Spanish | LILACS, BBO | ID: biblio-1091506

ABSTRACT

RESUMEN La elevación de piso de seno maxilar ha sido sumamente documentada en implantología como una técnica segura y predecible en el procedimiento de ganancia vertical ósea, en el maxilar posterior atrófico. Sin embargo, conjuntamente se han reportado complicaciones en este procedimiento, las cuales podrían poner en peligro los resultados de la regeneración, y por consiguiente la colocación del implante. El propósito de esta revisión de literatura es exponer y analizar diferentes complicaciones que pueden presentarse en la elevación de piso de seno maxilar.


ABSTRACT Maxillary sinus floor elevation has been extensively documented as a safe and predictable procedure for gaining vertical bone height in the atrophic posterior maxilla. Even though, complications have been reported, which can potentially jeopardize the outcome of the regeneration and implant therapy. Therefore, the purpose of this literature review is to present, debate and analyze the different complications that can occur during a sinus floor elevation.


Subject(s)
Dental Implants/adverse effects , Sinus Floor Augmentation/adverse effects , Maxillary Sinus/surgery , Maxillary Nerve/injuries , Nasal Mucosa/injuries
5.
Rev. Odontol. Araçatuba (Impr.) ; 41(1): 24-29, jan.-abr. 2020. ilus
Article in Portuguese | LILACS, BBO | ID: biblio-1102366

ABSTRACT

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)


Subject(s)
Dental Implants , Sinus Floor Augmentation , Platelet-Rich Fibrin , Maxillary Sinus
6.
Article in Chinese | WPRIM | ID: wpr-781340

ABSTRACT

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.


Subject(s)
Dental Implantation, Endosseous , Dental Implants , Dental Prosthesis Design , Humans , Maxilla , Maxillary Sinus , Sinus Floor Augmentation
7.
J. appl. oral sci ; 28: e20200568, 2020. tab, graf
Article in English | LILACS, BBO | ID: biblio-1143146

ABSTRACT

Abstract Objective The aim of this study is to evaluate the new bone and connective tissue formation and the biomaterial remaining after maxillary sinus bone augmentation using 5 different bone substitutes. The osteocalcin immunolabeling was performed to demonstrate their calcification and the possibility of receiving dental implants. Methodology 40 patients underwent maxillary sinus bone augmentation and were divided in 5 groups: Group 1 with 8 maxillary sinuses were grafted with autogenous bone graft (AB); Group 2 with 8 maxillary sinuses grafted with bioactive glass (BG); Group 3 with 8 maxillary sinuses grafted with bioactive glass added to autogenous bone graft (BG + AB) 1:1; Group 4 with 8 maxillary sinuses grafted with Bio-Oss (BO) and Group 5 with 8 maxillary sinuses grafted with Bio-Oss added to autogenous bone graft (BO + AB) 1:1. Results In group AB, 37.8% of bone was formed in the pristine bone region, 38.1% in the intermediate and 44.5% in the apical region. In group BG, 43.6% was formed in the pristine bone, 37% in the intermediate and 49.3% in the apical region. In group BG + AB 1:1, 39.0% was formed in the pristine bone region, 34.8% in the intermediate and 36.8% in apical region. In group BO, 33.4% was formed in the pristine bone, 32.5% in the intermediate and 34.3% in the apical region. In group BO + AB 1:1, 32.8% was formed in the pristine bone, 36.1% in intermediate and 27.8% in the apical regions. The immunolabeling for osteocalcin showed an intensive staining for all groups, which could demonstrate the calcification of the bone formed. Conclusion This study showed that the groups evaluated formed a suitable lamellar bone in the maxillary sinus reconstruction after six months of bone healing, thus being indicated to receive dental implants.


Subject(s)
Humans , Osteogenesis , Dental Implants , Bone Transplantation , Bone Substitutes , Sinus Floor Augmentation , Dental Implantation, Endosseous , Maxillary Sinus/surgery , Maxillary Sinus/diagnostic imaging
8.
Article in Chinese | WPRIM | ID: wpr-878392

ABSTRACT

OBJECTIVE@#To explore the changes in bone height of the maxillary sinus floor at different sinus ridge heights after transcrestal sinus floor elevation (tSFE) with the simultaneous implantation of short implants.@*METHODS@#A total of 74 Bicon short implants were implanted into 37 patients during the same period of maxillary sinus elevation. The residual bone height (RBH)<4 mm group has 43 sites, and the RBH≥4 mm group has 31 sites. After 5 years of follow-up observation, the implant survival rate and the change in bone height achieved in the maxillary sinus over time were measured and analyzed via clinical examination and X-ray imaging.@*RESULTS@#In the 74 implantation sites, the elevation height of the sinus floor was (6.64±1.32) mm and the bone height of the sinus floor was (3.35±1.29) mm 5 years after loading. No statistical difference was observed in the bone resorption of the implant neck between the RBH<4 mm and RBH≥4 mm groups. Meanwhile, a statistical difference was noted in the bone height obtained in the maxillary sinus between the two groups.@*CONCLUSIONS@#When RBH in the maxillary posterior tooth area was <4 mm, the simultaneous implantation of Bicon short implants with tSFE can achieve a high implant survival rate and bone gain in the maxillary sinus, but does not increase the absorption of the alveolar ridge bone.


Subject(s)
Dental Implantation, Endosseous , Dental Implants , Humans , Maxilla , Maxillary Sinus/surgery , Retrospective Studies , Sinus Floor Augmentation , Treatment Outcome
9.
Article in Chinese | WPRIM | ID: wpr-878389

ABSTRACT

OBJECTIVE@#To investigate the effect of three anatomical parameters (maxillary sinus width, maxillary sinus angle, and residual bone height) on the outcomes of transcrestal sinus lift with simultaneous implant placement.@*METHODS@#A total of 60 maxillary sinuses in 42 patients were included in this study. All patients were treated with transcrestal sinus lift procedure associated with simultaneous implant placement using a composite graft material of autogenous bone and Bio-Oss. For each patient, beam computed tomography (CBCT) scans were performed preoperatively, immediately after surgery, and 6 months after surgery. The parameters were measured on the preoperative and postoperative CBCT images. The correlation of three anatomical parameters with graft resorption was analyzed using Pearson's correlation test.@*RESULTS@#The average residual bone height was (4.46±1.55) mm. The average width of maxillary sinus was (13.86±2.71) mm. The average sinus angle was 78.09°±10.27°. A significant positive correlation was observed between maxillary sinus width and graft resorption (P<0.01). A positive association was also found between sinus angle and graft resorption (P<0.01).@*CONCLUSIONS@#The findings show that graft bone resorption in elevated sinus has a positive correlation with the sinus width and sinus angle.


Subject(s)
Bone Resorption , Dental Implantation, Endosseous , Dental Implants , Humans , Maxillary Sinus/surgery , Sinus Floor Augmentation , Tomography, X-Ray Computed
10.
Actual. osteol ; 15(3): 225-236, Sept-Dic. 2019. ilus
Article in English | LILACS | ID: biblio-1116171

ABSTRACT

Bone grafting is important to preserve the alveolar bone ridge height and volume for dental implant placement. Even though implant-supported overdentures present highly successful outcomes, it seems that a great number of edentulous individuals have not pursued implant-based rehabilitation. The cost of the treatment is one of the reasons of discrepancy between highly successful therapy and its acceptance. Therefore, the development of biomaterials for bone grafting with comparable characteristics and biological effects than those renowned internationally, is necessary. In addition, domestic manufacture would reduce the high costs in public health arising from the application of these biomaterials in the dental feld. The purpose of this clinical case report is to provide preliminary clinical evidence of the efficacy of a new bovine bone graft in the bone healing process when used for sinus floor elevation. (AU)


El uso de injertos óseos es importante para preservar la altura y el volumen de la cresta alveolar para la colocación de implantes dentales. Si bien las sobredentaduras implanto-soportadas presentan resultados altamente exitosos, la mayoría de las personas desdentadas no han sido rehabilitadas mediante implantes dentales. Uno de los principales motivos por los cuales los pacientes no aceptan este tipo de tratamiento, altamente exitoso, es el elevado costo del mismo. Por ello, es necesario el desarrollo de biomateriales de injerto óseo con características y efectos biológicos comparables a los reconocidos internacionalmente. Asimismo, la fabricación nacional reduciría los altos costos en Salud Pública derivados de la aplicación de estos biomateriales en el campo dental. El objetivo de esta comunicación es presentar un caso clínico a fin de proporcionar evidencia preliminar acerca de la eficacia de un nuevo injerto de hueso bovino en el proceso de cicatrización ósea en el levantamiento del piso del seno maxilar. (AU)


Subject(s)
Humans , Animals , Female , Middle Aged , Cattle , Rats , Bone Transplantation/methods , Jaw, Edentulous, Partially/rehabilitation , Sinus Floor Augmentation/methods , Osteogenesis , Argentina , Biocompatible Materials , Cattle/physiology , Carticaine/administration & dosage , Chlorhexidine/administration & dosage , Naproxen/administration & dosage , Public Health/economics , Osseointegration , Dentures , Bone Transplantation/trends , Jaw, Edentulous, Partially/pathology , Jaw, Edentulous, Partially/therapy , Durapatite/therapeutic use , Amoxicillin-Potassium Clavulanate Combination/administration & dosage , Dental Implantation, Endosseous/methods , Sinus Floor Augmentation/trends , Allografts/immunology , Allografts/transplantation
11.
Article in Chinese | WPRIM | ID: wpr-773541

ABSTRACT

OBJECTIVE@#To evaluate the long-term clinical outcomes of two-stage closed sinus lift for the maxillary sinus with residual bone height (RBH) of 1-3 mm in the posterior maxillary.@*METHODS@#Seventy-eight patients with maxillary posterior tooth loss (1 mm≤RBH≤3 mm and alveolar ridge width ≥5 mm) were treated with two-stage closed sinus lift at the Dental Implantation Center of our hospital between March, 2012 and December, 2014. Coral hydroxyapatite powder and 148 implants were implanted. The superstructure was fixed within 6 months after the operation and the patients were followed up for 1-5 years for assessing the patients' satisfaction, postoperative response, stability and survival rates of the implant, soft tissue condition, bone height of maxillary sinus floor elevation and the marginal bone loss.@*RESULTS@#Perforation of the maxillary sinus floor occurred in 3 (3.85%) of the cases. Twenty-three (30.67%) patients complained of mild pain, and 52 (69.33%) did not experience headache or fever or reported obvious pain or swelling after the operation. The overall response to the operation was favorable. The ISQ value was 58.39±1.39 immediately after the operation, and increased significantly to 81.88±1.22 at 6 months ( < 0.05). During the healing period and the follow-up, none of the implants fell off, and the implant survival rate was 100%. The peri-implant probing depth and modified sulcus bleeding index at 1 year after sinus lifting were similar to those at 5 years after the operation ( > 0.05), but the sinus floor elevation and marginal bone resorption at the two time points differed significantly ( < 0.05).@*CONCLUSIONS@#Compared with lateral wall lifting, two-stage close lifting of the maxillary sinus floor is associated with less trauma and less discomfort, and effectively solves the problem of severe alveolar bone height deficiency in the maxillary posterior region to achieve favorable long-term clinical outcomes.


Subject(s)
Bone Resorption , Dental Implantation, Endosseous , Follow-Up Studies , Humans , Maxilla , Maxillary Sinus , Sinus Floor Augmentation , Treatment Outcome
12.
Article in Chinese | WPRIM | ID: wpr-772627

ABSTRACT

Maxillary sinus cystic lesions can often be found in cone-beam computed tomography (CBCT) images. However, whether this change affects the implementation of maxillary sinus floor augmentation remains unclear. Combining the common cystic change performance of CBCT, image classification diagnosis of maxillary sinus cystic change was introduced, and the indications and surgical methods of maxillary sinus floor augmentation and postoperative radiographic changes of mucous were analyzed. This procedure may help clinicians evaluate the feasibility and methods of maxillary sinus augmentation in maxillary sinus cystic changes.


Subject(s)
Cone-Beam Computed Tomography , Maxilla , Maxillary Sinus , Sinus Floor Augmentation
13.
Article in English | WPRIM | ID: wpr-764791

ABSTRACT

PURPOSE: To determine the benefits of autogenous tooth bone (ATB) graft in combination with platelet-rich plasma (PRP) in the rates of success and survival of dental implants placed simultaneously with maxillary sinus floor augmentation (MSFA). MATERIALS AND METHODS: Patients who visited the Department of Oral and Maxillofacial Surgery at Ulsan University Hospital from 2012 to 2014 and underwent simultaneous placement of implants with MSFA using ATB plus PRP were included in the study. Success and survival rates of the implants were evaluated based on the parameters of age and sex of the patient, site, follow-up period, residual bone height before surgery, diameter, and length of implant, sinus mucosa impairment, and postoperative complications. RESULT: A total of 23 patients and 67 implants were included in this study. The average age of the patients was 53.78±10.00 years. The average follow-up period after installation of the prosthesis was 53±5 months. The success and survival rates of the implants after placement of prosthesis were 95.52% and 97.01%, respectively. CONCLUSION: Combination of ATB and PRP showed high overall success rate, and it can be concluded that this combination is a predictable bone graft procedure for MSFA.


Subject(s)
Bone Substitutes , Dental Implantation , Dental Implants , Follow-Up Studies , Humans , Maxillary Sinus , Mucous Membrane , Platelet-Rich Plasma , Postoperative Complications , Prostheses and Implants , Sinus Floor Augmentation , Surgery, Oral , Survival Rate , Tooth , Transplants
14.
Article in English | WPRIM | ID: wpr-766114

ABSTRACT

PURPOSE: The aim of this study was to evaluate the use of dehydrated human amnion/chorion membrane (dHACM) to repair perforated sinus membranes in rabbits. METHODS: Bilateral surgical windows (7.5-mm diameter) were prepared on the nasal bones of 14 rabbits. Standardized circular perforations (5-mm diameter) were made in the sinus membrane by manipulating implant twist drills. The perforated sinus membranes were repaired using dHACM or a resorbable collagen membrane (CM). The negative control (NC) group did not undergo perforated sinus membrane repair, while the positive control (PC) group underwent sinus augmentation without perforations. The same amount of deproteinized porcine bone mineral was grafted in all 4 groups. After 6 weeks, micro-computed tomography (micro-CT) and histomorphometric evaluations were conducted. RESULTS: The micro-CT analysis revealed that the total augmented volume was not significantly different among the groups. In the dHACM group, newly formed bone filled the augmented area with remaining biomaterials; however, non-ciliated flat epithelium and inflammatory cells were observed on the healed sinus membrane. Histometric analysis showed that the percentage of newly formed bone area in the dHACM group did not differ significantly from that in the CM group. The dHACM group showed a significantly higher percentage of newly formed bone area than the NC group, but there was no significant difference between the dHACM and PC groups. CONCLUSIONS: dHACM could be a feasible solution for repairing sinus membrane perforations that occur during sinus floor augmentation.


Subject(s)
Amnion , Biocompatible Materials , Chorion , Collagen , Epithelium , Humans , Membranes , Miners , Nasal Bone , Rabbits , Sinus Floor Augmentation , Transplants
15.
Article in English | WPRIM | ID: wpr-766109

ABSTRACT

PURPOSE: To analyze the maxillary sinus anatomy over edentulous ridges in the bilateral posterior maxillary area in Taiwanese patients using cone-beam computed tomography (CBCT). METHODS: In total, 101 anatomical sites from 61 patients, including 32 premolar and 69 molar regions, were analyzed using CBCT. Measurements were made of the width and height of edentulous ridges, the thickness of the lateral wall of the maxillary sinus, and the presence of a sinus septum and the posterior superior alveolar artery (PSAA). A statistical analysis of the measurements was performed, and correlations among the measurements were assessed. RESULTS: The average ridge width was 10.26±3.16 mm, with a significantly greater ridge width in the second molar region than in the premolar region. The mean residual ridge height was 8.55±4.09 mm, and ridge height showed an opposite trend from ridge width for the premolar and molar regions. A sinus septum was present at 5.9% of the sites, and the PSAA was observed in 24.5%. The average thickness of the lateral wall of the maxillary sinus was 2.08±0.94 mm, with no significant difference between the tooth position and lateral wall thickness. CONCLUSIONS: This study presents the anatomical features of the maxillary sinus, which should be considered in sinus lift procedures for implant placement, in the Taiwanese population. The use of CBCT is recommended to avoid intraoperative complications.


Subject(s)
Arteries , Asian Continental Ancestry Group , Bicuspid , Cone-Beam Computed Tomography , Humans , Intraoperative Complications , Jaw, Edentulous , Maxillary Sinus , Molar , Sinus Floor Augmentation , Tooth
16.
Article in English | WPRIM | ID: wpr-766087

ABSTRACT

PURPOSE: This study was designed to observe the resorption pattern of biphasic calcium phosphate (BCP) used for maxillary sinus augmentation over a 3- to 6-year healing period, and to investigate factors affecting the resorption of BCP. METHODS: A total of 47 implants placed in 27 sinuses of 22 patients were investigated. All patients had residual bone height less than 5 mm at baseline. The modified Caldwell-Luc approach was used to elevate the maxillary sinus membrane, and the sinus cavity was filled with BCP (70% hydroxyapatite and 30% β-tricalcium phosphate). Implant placement was done simultaneously or in a staged manner. Serial radiographic analysis was performed up to 6 years postoperatively. RESULTS: During the follow-up period, no implant loss was reported. The mean reduced height of the augmented sinus (RHO) was 0.27±1.08 mm at 36 months, and 0.89±1.39 mm at 72 months postoperatively. Large amounts of graft material (P=0.021) and a long healing period (P=0.035) significantly influenced the amount of RHO. In particular, there was a significant relationship between a healing period longer than 40 months and RHO. CONCLUSIONS: BCP can achieve proper dimensional stability with minimal reduction of the graft height in a 3- to 6-year healing period after maxillary sinus augmentation. The healing period and the amount of graft material influenced the resorption of BCP.


Subject(s)
Bone Substitutes , Calcium , Dental Implants , Durapatite , Follow-Up Studies , Humans , Maxillary Sinus , Membranes , Sinus Floor Augmentation , Transplants
17.
Rev. odontol. UNESP (Online) ; 48: e20190034, 2019. tab, ilus
Article in English | LILACS, BBO | ID: biblio-1014402

ABSTRACT

Abstract Introduction Pneumatization of the maxillary sinus may make it impossible to insert implants directly in the posterior region of the maxilla, and in these cases, the solution is to submit the patient to maxillary sinus floor augmentation surgery. The most common complication of this surgery is sinus membrane perforation. Anatomical variations of the internal space of the sinus, such as the bone septa, may further hamper detachment of this membrane. Objective To evaluate the prevalence and characteristics of sinus septa in patients from the Zona da Mata Mineira (Minas Gerais, Brazil), to offer relevant information for a safer planning of surgeries involving this region. Material and method A total of 120 patients (240 sinuses) were analyzed using cone-beam computed tomography (CBCT) images, verifying the presence of sinus septa and classifying them for size and anteroposterior location. Result Of the 120 patients analyzed, 45 (37.50%) had sinus septa, 66 septa in total. Of these, 33 (50%) were present in the middle region of the maxillary sinus and the mean septum size was 7.23 mm. There was no significant difference in the septum size between the genders or between the right and left sides. Conclusion The high rates of incidence of sinus septa justify their study, which should be based mainly on accurate exams, such as CBCT, since they represent one of the most relevant anatomical variations for the cases of sinus surgeries.


Resumo Introdução A pneumatização do seio maxilar pode impossibilitar a instalação direta de implantes na região posterior da maxila, e a solução nesses casos é submeter o paciente a uma cirurgia de levantamento do assoalho do seio maxilar. A complicação mais comum dessa cirurgia é a perfuração da membrana sinusal. Variações anatômicas no interior do seio como, por exemplo, os septos ósseos, podem dificultar ainda mais o descolamento dessa membrana. Objetivo Avaliar a prevalência e as características dos septos sinusais em pacientes da Zona da Mata Mineira (Minas Gerais, Brasil), oferecendo informações relevantes para um planejamento mais seguro das cirurgias envolvendo essa região. Material e método Um total de 240 seios (120 pacientes) foram analisados, por meio de imagens de tomografia computadorizada de feixe cônico (TCFC), verificando-se a presença de septos sinusais e classificando-os quanto ao tamanho e à localização anteroposterior. Resultado Dos 120 pacientes analisados, 45 (37,50%) apresentaram septos sinusais, sendo 66 septos no total. Destes, 33 (50%) estavam presentes na região média do seio maxilar e o tamanho médio dos septos foi de 7,23 mm. Não existiu diferença significativa no tamanho dos septos entre os sexos ou entre os lados direito e esquerdo. Conclusão As elevadas taxas de incidência dos septos sinusais justificam o seu estudo, que deve ser baseado principalmente em exames acurados, como a TCFC, uma vez que representam uma das variações anatômicas mais relevantes para os casos de cirurgias de levantamentos de seio.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Cone-Beam Computed Tomography , Sinus Floor Augmentation , Maxillary Sinus/diagnostic imaging , Dental Prosthesis, Implant-Supported , Maxilla/diagnostic imaging
18.
Article in English | WPRIM | ID: wpr-786155

ABSTRACT

Maxillary sinus floor augmentation (MSFA) is an essential procedure for implant installation in the posterior maxillary area with vertical alveolar bone deficiency. For the past several decades, MSFA has been refined in terms of surgical methods along with technical progress, accumulation of clinical studies, and development of graft materials and surgical instruments. Although some complications in MSFA are inevitable in clinical situations, management of those complications in MSFA has been well established thanks to many clinicians and researchers. Nevertheless, some rare complications may arise and can result in fatal results. Therefore, clinicians should be well aware of such rare situations and complications associated with MSFA. In this review, the authors present several rare complications regarding MSFA, along with corresponding management strategies through a thorough review of the literature.


Subject(s)
Maxillary Sinus , Sinus Floor Augmentation , Surgical Instruments , Transplants
19.
Article in English | WPRIM | ID: wpr-786134

ABSTRACT

PURPOSE: The purpose of this study was to elucidate the efficacy and safety of carbonate apatite (CO₃Ap) granules in 2-stage sinus floor augmentation through the radiographic and histomorphometric assessment of bone biopsy specimens.METHODS: Two-stage sinus floor augmentation was performed on 13 patients with a total of 17 implants. Radiographic assessment using panoramic radiographs was performed immediately after augmentation and was also performed 2 additional times, at 7±2 months and 18±2 months post-augmentation, respectively. Bone biopsy specimens taken from planned implant placement sites underwent micro-computed tomography, after which histological sections were prepared.RESULTS: Postoperative healing of the sinus floor augmentation was uneventful in all cases. The mean preoperative residual bone height was 3.5±1.3 mm, and this was increased to 13.3±1.7 mm by augmentation with the CO₃Ap granules. The mean height of the augmented site had decreased to 10.7±1.9 mm by 7±2 months after augmentation; however, implants with lengths in the range of 6.5 to 11.5 mm could still be placed. The mean height of the augmented site had decreased to 9.6±1.4 mm by 18±2 months post-augmentation. No implant failure or complications were observed. Few inflammatory cells or foreign body giant cells were observed in the bone biopsy specimens. Although there were individual differences in the amount of new bone detected, new bone was observed to be in direct contact with the CO₃Ap granules in all cases, without an intermediate layer of fibrous tissue. The amounts of bone and residual CO₃Ap were 33.8%±15.1% and 15.3%±11.9%, respectively.CONCLUSIONS: In this first demonstration, low-crystalline CO₃Ap granules showed excellent biocompatibility, and bone biopsy showed them to be replaced with bone in humans. CO₃Ap granules are a useful and safe bone substitute for two-stage sinus floor augmentation.


Subject(s)
Apatites , Biopsy , Bone Substitutes , Carbon , Dental Implants , Giant Cells, Foreign-Body , Humans , Individuality , Prospective Studies , Sinus Floor Augmentation
20.
ImplantNewsPerio ; 3(3): 463-472, mai.-jun. 2018. ilus, tab
Article in Portuguese | LILACS, BBO | ID: biblio-905505

ABSTRACT

Objetivos: avaliar o aumento ósseo com um biomaterial aloplástico no seio maxilar. Materiais e métodos: foram selecionados seis pacientes, totalizando nove seios maxilares, que realizaram cirurgia de reconstrução óssea em região posterior de maxila. Todas as cirurgias de elevação do seio maxilar traumáticas utilizaram o biomaterial sintético Straumann Bone Ceramic. Os pacientes realizaram uma tomografia pré-operatória, e uma após seis meses do ato cirúrgico, em que foram obtidas medidas lineares horizontais e verticais na imagem panorâmica da tomografia e medidas lineares horizontais e verticais no corte sagital da tomografia, ambas no centro das imagens. Resultados: identificou-se 100% de sucesso nas cirurgias de elevação de seio maxilar, em que verticalmente obteve-se diferença estatística significante (p < 0,05) e horizontalmente sem significância estatística (p > 0,05). Em média, obteve-se ganho vertical ósseo de 14,73 mm na imagem panorâmica e 16,05 mm no corte sagital, e espessura 20,82 mm na imagem panorâmica e 11,37 mm no corte sagital. Conclusão: o biomaterial sintético Straumann Bone Ceramic demonstrou-se excelente para a reconstrução de seios maxilares.


Objectives: to evaluate bone augmentation using an alloplastic material. Material and methods: six patients (9 maxillary sinuses) underwent surgical bone reconstruction at the posterior maxillary region. All surgeries were performed after atraumatic sinus membrane lifting and packing of Straumann BoneCeramic. Also, CBCTs were made at baseline and 6 months later to generate horizontal and vertical measurements at the panoramic and sagittal view modes both at the center of the images. Results: operative procedures were considered 100% successful. At the vertical dimension, statistical differences were obtained (p<0.05) but no significant differences were seen in the horizontal dimension (p>0.05). Overall, the vertical mean gain was 14.73mm at the panoramic and 16.05mm at the sagittal sections, being the observed thicknesses of 20.82mm and 11.37mm, respectively. Conclusion: the Straumann BoneCeramic biomaterial provided excellent results for maxillary sinus reconstructions.


Subject(s)
Humans , Biocompatible Materials/therapeutic use , Bone Regeneration , Bone Substitutes/therapeutic use , Bone Transplantation/methods , Cone-Beam Computed Tomography , Maxillary Sinus/surgery , Sinus Floor Augmentation
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