ABSTRACT
BACKGROUND: Previous studies have shown that simultaneous elevation of the sinus mucosal lining and placement of dental implants without graft materials can be a predictable procedure. Nevertheless, few prospective, controlled, and randomized studies have evaluated this technique. The aim of this prospective, controlled, and randomized clinical study is to evaluate whether sinus membrane elevation and simultaneous placement of dental implants without autogenous bone graft can create sufficient bone support to allow implant success 6 months post-surgically. METHODS: Sinus membrane elevation and simultaneous placement of dental implants were performed bilaterally in 15 patients in a split-mouth design. The sinuses were assigned to two groups: the test group, with simultaneous sinus mucosal lining elevation and placement of dental implants without graft materials; and the control group, with simultaneous sinus mucosal lining elevation and placement of dental implants with intraoral autogenous bone graft. After 6 months of healing, abutments were connected. For each implant, length of implant protrusion into the sinus, resonance frequency analysis, and bone gain were recorded at baseline and 6 months follow-up. RESULTS: Clinical complications were not observed, except for two postoperative fistulas and suppuration in both groups. Only one implant of the test group was lost, reaching a success rate of 96.4% and 100% for the test and control groups, respectively. After healing, radiographic new peri-implant bone was observed in both groups ranging between 8.3 ± 2.6 and 7.9 ± 3.6 mm for the control and test groups, respectively (P >0.05). Resonance frequency analysis values were lower for the control group compared to baseline (P <0.05). However, these values were similar at 6 months (P >0.05). A significant positive correlation was found between the protruded implant length/bone gain and implant survival/sinusitis (P <0.0001). CONCLUSION: Implants placed simultaneously to sinus membrane elevation without graft material resulted in bone formation over a period of 6 months.
Subject(s)
Bone Regeneration , Bone Transplantation/statistics & numerical data , Dental Implantation, Endosseous/methods , Maxillary Sinus/surgery , Oral Surgical Procedures, Preprosthetic/methods , Chi-Square Distribution , Dental Prosthesis Design , Dental Prosthesis Retention , Dental Restoration Failure , Humans , Imaging, Three-Dimensional , Postoperative Care , Prospective Studies , Statistics, Nonparametric , Time Factors , Treatment Outcome , VibrationABSTRACT
Smoking has adverse effects on peri-implant bone healing and can cause bone loss around successfully integrated implants placed on type IV bone. This study evaluated the influence of implant surface topography of microimplants retrieved from posterior maxilla of smokers after 2 months of unloaded healing. Seven partially edentulous patients received 2 microimplants (machined and sandblasted acid-etched surface) each during conventional implant surgery. Histometric evaluation showed that the mean bone to implant contact was 10.40 +/- 14.16% and 22.19 +/- 14.68% to machined and sandblasted acid-etched surfaces, respectively (P < .001). These data suggest that the sandblasted acid-etched surface presented better results than the machined surface after a short healing time in smokers.
Subject(s)
Dental Implants , Dental Prosthesis Design , Osseointegration , Smoking/adverse effects , Adult , Aged , Bone Density , Dental Etching/methods , Dental Implantation, Endosseous , Dental Polishing , Female , Humans , Jaw, Edentulous, Partially/rehabilitation , Male , Maxilla , Middle Aged , Miniaturization , Molar , Statistics, Nonparametric , Surface PropertiesABSTRACT
PURPOSE: The following case series evaluated the maxillary sinus augmentation responses to tissue-engineered bone graft obtained by a culture of autogenous osteoblasts seeded on polyglycolic-polylactic scaffolds and calcium phosphate. MATERIALS AND METHODS: Sinus floor augmentation was performed bilaterally in five patients (mean age 58.4 years) with tissue-engineered bone (test site - Oral Bone, BioTissue, Freiburg, Germany) or calcium phosphate (control site - Biocoral, Novaxa Spa, Milan, Italy). Biopsies were harvested 6 months after sinus augmentation for histometric evaluation. Volumetric measurements were taken at baseline and 6 months after the surgical procedure. RESULTS: The mean of vertical bone gain was 6.47 +/- 1.39 mm and 9.14 +/- 1.19 mm to test and control sites, respectively. The histological sections depicted mature bone with compact and cancellous areas. All biopsies contained varying percentages of newly formed bone and marrow spaces. The mean of bone tissue in the grafted area was 37.32 +/- 19.59% and 54.65 +/- 21.17% for tissue-engineered bone and calcium phosphate, respectively. CONCLUSION: Within the limits of the present report, the histological data in humans confirmed that tissue-engineered bone and calcium phosphate allowed newly formed bone after maxillary sinus augmentation.
