The benefit of exercise rehabilitation guided by 6-minute walk test on lipoprotein-associated phospholipase A2 in patients with coronary heart disease undergoing percutaneous coronary intervention: a prospective randomized controlled study.

BACKGROUND: Lipoprotein-associated phospholipase A2 (Lp-PLA2) has been taken as a biomarker of inflammation in patients with acute coronary diseases. Regular exercise rehabilitation could attenuate inflammation and promote the rehabilitation of coronary heart disease (CHD). The level of Lp-PLA2 is negatively correlated with 6-min walk test (6-MWT). The exercise prescription of appropriate intensity is the basis of exercise rehabilitation. 6-MWT is associated with maximal oxygen consumption, and can be used to determine the intensity of exercise prescription guiding patients how to do exercise rehabilitation. The aim of this study was to observe the benefit of 6-MWT guided exercise rehabilitation on the level of Lp-PLA2 in patients with CHD undergoing percutaneous coronary intervention (PCI). METHODS: We prospectively, consecutively enrolled 100 patients between Dec 2018 and Dec 2020 in the fourth ward of the Department of Cardiology, Yuebei People's Hospital Affiliated to Shantou University. Eligible patients were 1:1 divided into Group A, with no exercise rehabilitation, and Group B, with regular exercise rehabilitation, using random number table method of simple randomization allocation. Clinical data such as general information, the profile of lipids and the level of Lp-PLA2 were collected at baseline and at 12-week follow-up. RESULTS: There were no statistically significant differences of the percentages of gender, hypertension, type-2 diabetes mellitus (T2DM), the profile of lipids and level of Lp-PLA2 between the groups at baseline (P > 0.05). The level of Lp-PLA2 decreased at 12-week follow-up, moreover, the decline of the Lp-PLA2 level in Group B was more significant than that in Group A (t = 2.875, P = 0.005). Multivariate linear regression analysis indicated that exercise rehabilitation was independently correlated with the level of Lp-PLA2 (ß' = - 0.258, t = - 2.542, P = 0.013). CONCLUSION: Exercise rehabilitation for 12 weeks guided by 6-MWT can further reduce the level of LP-PLA2 in patients with CHD undergoing PCI. Trial registration This trial was registered on the Chinese Clinical Trial Registry: ChiCTR2100048124, registered 3 July 2021- Retrospectively registered. The study protocol adheres to the CONSORT guidelines.

Combined use of xenogeneic bone substitute material covered with a native bilayer collagen membrane for alveolar ridge preservation: A randomized controlled clinical trial.

AIM: The aim of this split-mouth randomized controlled study was to evaluate radiographic dimensional changes after tooth extraction in posterior sites treated with a ridge preservation technique or left for spontaneous healing. MATERIALS AND METHODS: In a total of 18 patients, tooth extraction in posterior sites of the upper and lower jaw was performed in a split-mouth design. The post-extraction sockets were randomly assigned to the following two treatment modalities: deproteinized bovine bone mineral (DBBM) with 10% collagen (DBBM-C) covered with a native bilayer collagen membrane (NBCM) (test group) and spontaneous healing (control group). Cone beam computed tomography (CBCT) scans were performed after extractions, 3 and 6 months later. The following parameters were measured: the height of the buccal bone plate (BH), height of the palatal bone plate (PH), horizontal width of the extraction socket at 1 mm, 3 mm, and 5 mm (HW-1, HW-3, HW-5), and the horizontal width (thickness) of the buccal bone plate at 1 mm, 3 mm, and 5 mm (BHP-1, BHP-3, BHP-5). Statistical analysis was performed applying a nonparametric Wilcoxon signed-rank test. RESULTS: The CBCT analysis showed a bone loss compared to baseline in test and control group. The measurements which have reached statistically significant differences at 6 months were BH (test: -2.31% vs control: -13.11%), PH (test: -2.07% vs control: -15.32%), HW-1 (test: -17.14% vs control: -32.47%), and HW-3 (test: -11.65% vs control: -28.47%). CONCLUSIONS: The posterior ridge preservation technique using DBBM-C covered with a NBCM is a valid approach reducing the amount of the radiographic loss in alveolar ridge dimensions.

Coating of Sandblasted and Acid-Etched Dental Implants With Tantalum Using Vacuum Plasma Spraying.

PURPOSE: The objective was to prepare tantalum (Ta)-coated sandblasted and acid-etched (SLA) dental implants using vacuum plasma spraying (VPS) and to analyze their morphologies. MATERIALS AND METHODS: Twelve SLA implants were coated with Ta using VPS. The topographies of the coatings and Ta/SLA surface interfaces were examined using scanning electron microscopy. The thickness at 4 locations for 6 Ta-coated and 6 uncoated SLA implants and pore sizes of the neck, central, and root areas of Ta-coated implants were measured. SPSS v20.0 was used for statistical analysis. RESULTS: The Ta coatings were rough and consisted of pitted structures with various pore sizes; no cracks were observed. The Ta/SLA surface interface was tightly bonded. The 95% confidence interval of the Ta coating thickness was (114.0759, 129.3574). The maximal pore diameter was concentrated at 200 to 400 nm. CONCLUSION: SLA dental implants were successfully coated with Ta using VPS. The nanoporous structure of these implants may facilitate osseointegration compared with uncoated SLA implants.

[A minimally invasive extraction technique using Benex Extraction System in flapless immediate implant placement in anterior teeth].

PURPOSE: To evaluate the feasibility and clinical outcomes of an atraumatic extraction technique using Benex Extraction System in flapless immediate implant placement in anterior teeth. METHODS: Twenty-five patients with single hopeless anterior maxillary teeth were enrolled in the study. The involved teeth were extracted using Benex Extraction System and implants were immediately placed in a flapless way. Healing abutments were connected immediately. After 4-6 months of healing, screw-retained implant temporary crowns were used to reshape the peri-implant gingiva. Permanent restorations were delivered 3 months later. Extraction time was recorded and the technique feasibility was evaluated using visual analogue scale (VAS). Peri-implant marginal bone resorption was measured in X- ray films after loading for 1 year later. Pink esthetic score (PES) was checked to evaluate the gingival esthetics. Questionnaire was delivered and collected to assess patients' satisfaction on surgical experience and esthetic outcomes. SPSS 13.0 software package was used for statistical analysis. RESULTS: Twenty-five implants osseointegrated successfully. The marginal bone resorption was (0.21±0.23) mm and PES was 8.8±1.19 after loading for 1 year. The mean extraction time was 6.87 minutes and the VAS was 3.32. All patients were satisfied with the final esthetic outcomes and felt comfort during surgery. CONCLUSIONS: According to the limited data in the study, Benex extraction System is a convenient, atraumatic and predictable technique during flapless immediate implant placement in anterior teeth.

[A novel technique to preserve the alveolar ridge width following tooth extraction in the maxillary frontal area].

OBJECTIVE: To introduce a novel ridge preservation technique with micro-titanium plate avoiding the use of bone grafting materials, and evaluate the potential horizontal bone preservation effect of this new technique, applied on single maxillary central incisors after tooth extraction for future implant restoration. METHODS: Nine patients (six women and three men), mean age (26.0 ± 5.7) years(from 18 to 34 years) referred to the Department of Oral Implantology, Peking University School and Hospital of Stomotology, were selected and diagnosed with unsalvageable single middle incisor with fine general conditions, no signs of acute local inflammation, no ongoing or previous periodontitis, healthy neighboring teeth and intact buccal bone walls. Tooth extraction, delayed implant placement and implant-supported single crown restoration were selected as treatment plan. The teeth were extracted atraumatically with local anesthesia, followed by a reflection of a minor flap to exposed 2-3 mm of the buccal bone plate. After that, a micro-titanium plate was trimmed and bended to fit the convexity of the labial bone and fixed by two mini pins with intent to support the labial soft tissue. The flap was then repositioned over the micro titanium plate and secured with two single sutures. No bone grafting materials or releasing incisions were needed. The sockets were left to heal without any intention of primary wound closure. Cone-beam computed tomographic (CBCT) scans were obtained before and four months after tooth extraction. Horizontal ridge widths were measured with CBCT software, and the preservation effects were calculated and recorded by the percentage of horizontal ridge alteration. RESULTS: The nine extraction sockets were healed uneventfully. The average socket width before extraction was (7.51 ± 0.48) mm (6.92-7.82 mm). The average alveolar ridge labial-palatal width at the control point of the edentulous area was (6.81±0.44) mm (6.04-7.38 mm) 4 months after tooth extraction, the mean percentage of ridge width preserved was 90.87% ± 2.91% (87.28%-95.60%). CONCLUSION: This novel ridge preservation method by the usage of a micro-titanium plate did not interfere with the natural socket healing process, and at the same time, largely preserved the width of alveolar ridge without any bone grafting procedures. Long term results remain to be seen.

Changes in proximal contact tightness between fixed implant prostheses and adjacent teeth: A 1-year prospective study.

STATEMENT OF PROBLEM: No study has evaluated consecutive changes in proximal contact tightness (PCT) between fixed implant prostheses and adjacent teeth after delivery. PURPOSE: The purpose of this clinical study was to investigate consecutive biological changes in PCT between fixed implant prostheses and adjacent teeth after placement. MATERIAL AND METHODS: Eighteen participants who had been treated with a single first molar implant in the mandible were included. Mesial and distal PCT were measured using the custom-made contact pressure system at immediate crown delivery (T0), 3-month follow-up (T1), and 1-year follow-up (T2). The PCT of natural teeth in the mesial direction of the same quadrant was also measured at T2 as a control. Repeated-measures analysis of variance (ANOVA) and 1-way ANOVA were used for statistical analysis. RESULTS: At T0, the PCT between fixed implant prostheses and adjacent teeth was designed deliberately to be higher than the PCT between natural teeth. Using multivariate analyses, the PCT between fixed implant prostheses and adjacent teeth decreased between T0 and T1 (P<.001), while there was no significant difference between T1 and T2 (P=.506). At T2, the distal PCT was tighter than the mesial PCT (P<.001); however, no statistical difference was found in the PCT between the implant-supported restoration and the natural teeth. CONCLUSIONS: PCT decreased significantly at both mesial and distal sites over time. The major changes occurred over the 3-month period after crown delivery.

[Maxillary sinus augmentation and implant placement following removal of a maxillary antral cyst: a preliminary clinical study].

OBJECTIVE: To evaluate the clinical outcome of maxillary sinus augmentation and implant placement following removal of a maxillary antral cyst. METHODS: In this study 32 patients with 33 maxillary antral cysts were enrolled. The partial wall of cyst was removed through a small lateral sinus approach and cyst spontaneous shrink was expected when wall of cyst was destroyed for open drainage. Three to six months later the secondary sinus approach 1.5 mm circling the first approach for augmentation was undertaken. Dental implants were placed simultaneously or later. All patients finished prosthetic rehabilitation in the study and were followed up for (30.9 ± 11.5) months. The intraoperative and postoperative complications were recorded. The survival rate of the implants was calculated. RESULTS: In this study, 33 maxillary antral cysts of 32 patients were removed. Maxillary sinus augmentation was performed after a mean of (4.5 ± 1.5) months (range, 2-8 months). Sixty-two implants were inserted and all patients finished prosthetic rehabilitation after a mean of (10.8 ± 2.7) months (range, 5-17 months). The survival rate of implants was 95% (59/62). Three implants failed before their prosthesis delivered due to failure of osseointegration and were reinserted later. No recurrence of cyst was observed until the last recall. In this study, 24 specimens were mucosal cysts. Five specimens were mucoceles and 4 specimens were not certain in pathology. CONCLUSIONS: Maxillary sinus cysts have a negative effect on maxillary sinus augumentation if not removed. The present preliminary data of the study suggests that the clinical result of maxillary sinus augmentation and implant placement following removal of a maxillary antral cyst is predictable.

[Application of xenograft for alveolar ridge preservation in posterior sites: a randomized controlled clinical trial].

OBJECTIVE: To investigate the effect of ridge preservation with Bio-Oss Collagen and Bio-Gide in posterior sites. METHODS: From May 2010 to July 2013, 16 patients with bilateral posterior teeth planned to be extracted and replaced by implants were enrolled. One of the sockets was randomly selected and presserved with Bio-Oss Collagen and Bio-Gide (intervention group). The contralateral socket was left to heal spontaneously (control group). Cone-beam (CBCT) scans were performed immediately after the extraction and 6 month later. The bone cores were collected during the implant placement surgery and analyzed by micro-computed tomography. RESULTS: After 6 month healing, the vertical and horizontal dimensional alteration of the treatment group were (0.55 ± 1.05) mm and (-0.99 ± 0.94) mm respectively, while the vertical and horizontal change of control group were (-0.71 ± 1.41) mm and (-2.26 ± 1.29) mm respectively. The micro-computed tomography results showed that there was no significant difference in new bone volume between control and intervention groups. CONCLUSIONS: Applying Bio-Oss Collagen and Bio-Gide for ridge preservation in posterior sites resulted in less vertical and horizontal bone resorption of sockets following extraction.

[A 10-year retrospective analysis of clinical results of implant-retained/ supported prostheses in full edentulous patients].

OBJECTIVE: To evaluate the 10-year clinical results of implant prostheses in edentulous patients. METHODS: Between August 1994 and November 2009, 762 implants were placed in 127 patients (162 jaws) with the mean age of (56.0 ± 10.9) years in Peking University, School and Hospital of Stomatology. Sinus lift, guide bone regeneration (GBR) and onlay graft were used according to the indications of bone defect types. Overdentures and fixed bridges were delivered.Overdentures were retained/supported by ball, magnet, telescopic crown or milled bar. Clinical evaluation included peri-implant soft tissue health status, prostheses functional status and complications.Radiographic evaluations were conducted at operation day, 3 months post-operatively, right after prostheses delivery, and annually afterwards. Clinical data were collected and analyzed. RESULTS: Of the 127 patients, 116 were edentulous mandible and 46 edentulous maxilla, with a mean follow-up period 109.2 months(45-228 months). Thirteen implants were lost and the 10-year implant cumulative survival rate was 97.8% and the prostheses success rate was 100.0%. The prevalence of peri-implantitis was 3.8% (29/762). Sixty-seven point nine percent of the patients underwent implant placement without bone graft.Sinus lift technique and guided bone regeneration technique were the most often used with 84.8% (39/46) in the upper jaws and 6.2% (10/162) in the total jaws respectively. Seventy-one percent of the cases(115/162) was overdentures. Telescopic, milled-bar, and magnetic retained/supported overdentures were the most commonly used with 34.8% (40/115) , 27.0% (31/115) , and 20.0% (23/115) respectively. The implant-supported fixed prostheses included adhesive retained fixed bridges and screw retained fixed bridges with the ratio of 19.1% and 80.9% respectively. The prevalence of 10-year post-prosthodontic complications was 53.5% (68 cases). The most common complications were prosthetic and uperstructure complications. CONCLUSIONS: The 10-year implant-retained/supported prostheses was a successful modality in edentulous cases.Sinus lift technique and guided bone regeneration technique are the most commonly used techniques with predictable clinical results. Telescopic crowns milled bar and magnet with 4-6 implants retained/supported overdenture were the most often used retention systems and telescopic crown overdenture had more advantages in terms of long-term maintenance and satisfaction.

Analysis of soft tissue display during enjoyment smile. Part II: elder Caucasians.

Esthetic parameters in elder patients are essential in esthetic oral rehabilitation. To date, no study has quantified the amount and frequency of soft tissue display in the papilla area in patients over 50 years of age. Photographic examination of 42 fully dentate patients with a mean age of 59 years was performed during enjoyment smile. Digital processing and measurement of the tooth, gingiva, and papilla display revealed that over 90% of subjects displayed soft tissue in the papilla area of the anterior teeth and first premolar during enjoyment smile regardless of their sex. The frequency of the display in descending order follows: maxillary lateral incisor (96%), central incisor (94%), canine (94%), first premolar (91%), second premolar (85%), and first molar (39%). The mean amount of papilla display was 3.4 mm (0 to 10 mm). There was no significant difference in the amount of papilla display between sexes for anterior teeth, premolars, or first molar (P = .97, P = .79, and P = .48, respectively). Elder caucasians showed significantly less gingiva in the area of the premolars and molars but not in the anterior region. The amount of papilla display is significantly less in elder caucasians in the anterior and premolar region. The mean amount of soft tissue display decreased with age but the frequency of papilla display was more than 90% in the anterior region and greater than 70% in the premolar region, suggesting that pink esthetics is an issue in patients over 50 years of age.

[Computer-assisted implant restoration of free-end partially edentulous mandible with severe vertical bone deficiency].

OBJECTIVE: To evaluate the applicability, accuracy and clinical outcome of the computer assisted design and computer assisted manufacture (CAD & CAM) tooth-supported implant surgical guide in the mandibular free-end partially edentulous patients with insufficient vertical bone height. METHODS: According to the inclusion criteria, 3 patients (2 women, and 1 man) with the mean age of 45 years (from 44 to 46 years) with 10 implant sites were involved in this study. With the help of Computer-assisted-design software to plan and simulate the surgical strategies, the implant surgical guides were fabricated via the rapid prototyping technique, then the guided implant placement was implemented, finally the post-surgical evaluations were accomplished by the clinical and radiographic examinations. RESULTS: Ten implants were placed in 3 mandibles via the surgical guides, and the implant supported non-split restorations were in place. All the implant restorations revealed good clinical function until the last review. No inferior alveolar nerve injury was detected by the clinical neurosensory test. The immediate post surgical CBCT was performed to confirm a safe distance of 1.5 to 3.0 mm between the implant apical and the nerve canal. The deviations between the planed and the actually placed implant were: coronal deviation (0.84±0.30) mm (0.31-1.24 mm); apical deviation (1.42±0.52) mm (0.52-2.36 mm); angular deviation 7.65°±1.84° (4.43°-9.81°). CONCLUSION: In case of distal free-end partially edentulous with insufficient vertical bone height in the posterior mandibular region, computer assisted surgical design and guided surgery can offer a treatment option with minimal invasiveness and a shorter treatment period, and avoid the complicated bone augmentation procedure and the high risk of nerve transposition. This technique is clinically and technically feasible, but the cases using this technique should be strictly selected according to the indication.

[Normal occlusion study: using T-Scan III occlusal analysis system].

OBJECTIVE: To investigate the normal occlusal force distribution and the characteristics of the occlusion time at different occlusion position using T-Scan III occlusal analysis system. METHODS: Fifty-three volunteers with normal occlusion, including 29 males and 24 females, were included in this study. The average age was (25.9 ± 2.1) years old. T-Scan III occlusal analysis system was used to measure the occlusal force distribution and the time character of normal occlusion at intercuspal position, protrusive position, and lateral excursive position. RESULTS: At intercuspal position the left and right side molar teeth took the most part of force percentage, followed by (13.3 ± 4.3)%, (13.6 ± 5.4)%, (15.7 ± 7.1)%, (18.7 ± 7.5)% (6, 6, 7, 7); and 7654, 4567 took (61.3 ± 12.4)% force percentage; and the left and right sides took the respective percentages of (46.4 ± 7.0)%, (53.6 ± 7.0)%, the left side was significantly less than the right side(P < 0.05). At the protrusion position the region ( 21, 12) commitment to take the percentage of (85.1 ± 25.5)%. At left and right lateral position, 28% (13/46) and 30%(14/46) were cuspid-protected occlusion, and 33%(15/46) and 44%(20/46) were group functional occlusion, and 39%(18/46) and 26%(12/46) were multiple-protected occlusion. The average occlusion time was (0.34 ± 0.11) s, and disclusion time was (1.00 ± 0.39) s. CONCLUSIONS: At intercuspal position the region from first premolar to second molar teeth were the occlusal force centers, and the second molar is the most;.the force concentrated in the area ( 21, 12) at the protrusion position. The lateral occlusal pattern is multiformity.

Essentials of standard chinese phonetics for prosthetic dentistry.

Speech adaptation after oral rehabilitation is based on a complex interaction of articulatory and myofunctional factors. The knowledge of basic phonetic principles may help clinicians identify phonetic problems associated with prosthodontic treatment. The purpose of this article is to illustrate basic phonetic terminology, standard Chinese (Putonghua) phonetics, and the anatomic structures relevant for dentistry. In cooperation with a Chinese linguistic specialist, Chinese articulators were selected and are described and compared with English phonetics. Established test words and sentences aid the identification of mispronounced articulators and their related dental structures. The pronunciation of most consonants and vowels in standard Chinese is similar to English, but some of them, such as the retropalatals (/zh/ [tʂ], /ch/ [thʂ], /sh/ [ʂ]), have notable differences. Palatal consonants (/j/ [tɕ], /q/ [tɕh], /x/ [ɕ]) are unique to the Chinese phonetic system and are not found in English phonetics. The comprehension of the basic anatomic regions involved in Chinese phonetics may help prosthodontists treat patients whose native language is standard Chinese.

Analysis of soft tissue display during enjoyment smiling: part 1--Caucasians.

Esthetic considerations have become increasingly important in dental therapy. Evaluation of the soft tissue display during enjoyment smiling can provide useful information for esthetic oral rehabilitation. To date, no study has quantified the amount and frequency of soft tissue display in the area of the papilla. Photographic examination of 66 fully dentate patients with a mean age of 28.5 years was performed during enjoyment smiling. Digital processing and measurement of the tooth, gingival, and papillary display revealed that over 90% of subjects displayed papillae in the anterior teeth and first premolars during enjoyment smiling regardless of sex. The frequency of display in descending order consisted of maxillary lateral incisors (96%), central incisors (94%), canines (94%), first premolars (91%), second premolars (85%), and first molars (39%). The mean papillary display was 3.4 mm (range, 0.0 to 10.0 mm). There was no significant difference in the amount of papillary display between the sexes for anterior teeth, premolars, or first molars (P = .97, P = .79, and P = .48, respectively).

[Influence of the placing depth of implants with platform switching on the marginal bone level in the posterior mandible: a clinical study].

OBJECTIVE: The purpose of this study was to evaluate the influence of the placing depth of the implants with platform switching (Ankylos) on the marginal bone remodeling, by means of radiological observation. METHODS: 111 Ankylos implants in the posterior mandible from 46 patients (20 male and 27 female) were enrolled in this study. Followed up by 58.1 months on average (from 36 to 85), 222 mesial and distal sites of these implants were evaluated by means of measuring the level of the marginal bone (LMB) on the panoramic radiograph. RESULTS: Among these 111 successfully functional loaded implants, there were no significant differences with the marginal bone absorption values, no matter the implants were placed below, at, or above the bone level (P>0.05). Concerning the stabilization of the marginal bone, when placed below the bone level, 67.7% of the implant sites had their LMBs stabilized at or above the implant platform, and 23.3% absorbed vertically, respectively 19.7% and 80.3% when placed at the bone level, with significant difference (P<0.001). CONCLUSION: Based on a long-term (over 3 years) observation, the implants placed below, as compared to at or above, the alveolar crest level, might have more chance to keep the marginal bone stabilized at or above the implant platform.

Analysis of soft tissue display in Chinese subjects during an enjoyment smile.

OBJECTIVE: Due to global migration, clinicians often see patients with different ethnic backgrounds. Planning esthetic prosthodontic treatment for patients with different ethnicities can be a challenge. The aim of this study is to analyze the smile features of Chinese individuals. METHOD AND MATERIALS: Sixty-two Han-Chinese subjects with a mean age of 28.5 years were enrolled and photographed. Standardized digital photographs were made to measure the height of displayed maxillary gingivae, papillae, and teeth during an enjoyment smile. The data were then compared with the data acquired from Caucasians in a previous study. Statistical analysis was performed using the Mann-Whitney test and two-factorial nonparametric analysis. RESULTS: The mean display of the central incisors was 10 mm, with no significant difference between sexes (P = .74). The mean amount of display of the molars and premolars was significantly lower in Chinese (P < .001) than in Caucasians. The mean displayed gingiva in all subjects (n = 62) was 1.3 mm (0 to 8 mm). There was no significant difference between sexes (P > .05), but there was a significantly lower display of gingiva at the molars in Chinese (P < .001). Of all the subjects, 16.1% (n = 10) displayed gingivae from the central incisor to the first molar with a mean gingival height of 2.8 mm. The subjects showed a mean papilla height of 3.4 mm (0 to 11.6 mm) with no significant difference between sexes (P > .05). Again, a significantly lower display of papilla at the molar (P < .001) was found in Chinese. Of all subjects, 43.5% (n = 27) of all subjects showed papilla from the central incisor to the first molar. The mean papilla height of these subjects was 3.9 mm. All subjects displayed at least one papilla. CONCLUSION: The results indicate that pink esthetics is a prime factor for both Chinese men and women in the esthetic restoration from the central incisors to the premolars.

[Measurement and analysis of smile line of 62 Han-Chinese].

OBJECTIVE: To analyze smile features in maximum lip-dynamic in Chinese. METHODS: Sixty-two Han-Chinese, travelling in Germany, with a mean age of 28.5 years were enrolled and photographed. Standardized digital photos were made to measure the height of displayed maxillary gingiva, papilla and tooth during an enjoyment smile. Statistical analysis was performed using Mann-Whitney-U Test and non-parametric analysis. RESULTS: The mean height of tooth display for the central incisors was 10 mm, with no significant difference between the gender (P > 0.05). The mean height of gingival display was 1.3 mm and the mean papilla height was 3.4 mm. There was no significant difference between the genders (P > 0.05). 31% (19/62) of the subjects belonged to high smile line type, 50% (31/62) to medium smile line type and 19% (12/62) to low smile line type. CONCLUSIONS: The red esthetics is a paramount factor for Chinese men and women in the esthetic restoration. 81% of the Chinese studied showed various degree of gingival exposure from central incisor to the premolars, which defined the esthetic area for Chinese people. Papilla is a critical parameter for esthetic evaluation and treatment design. The ratio of high smile line in Chinese may be higher than that in Caucasian.

Maxillary sinus augmentation following removal of a maxillary sinus pseudocyst after a shortened healing period.

PURPOSE: Dome-shaped radiopacities on the floor of the maxillary sinus are commonly interpreted as a sinus cyst on radiographs during dental implant planning. They might present an obstacle in sinus grafting, leading to bone graft failure or implant loss later. The therapeutic approaches to the removal of such cystic lesions and the following sinus augmentation are still controversial. The purpose of this article is to present a modified technique that can be used for predictable removal of a maxillary sinus cyst and sinus augmentation after a shortened healing period in patients with maxillary sinus pseudocysts. MATERIALS AND METHODS: A total of 11 patients with a mean age of 43.7 years with a radiographic dome-shaped opacity in the posterior maxilla sinus were included in this study. A lateral sinus window (with a diameter of about 5 mm) was prepared, and removal of the cyst was performed with grasping forceps. Three months after removal of the cyst, a conventional sinus augmentation with xenogeneic material was undertaken. Dental implants were placed 6 months later. Panoramic radiography and coronal/axial computed tomography were performed to diagnose the sinus lesion preoperatively and for follow-up. RESULTS: A total of 11 pseudocysts were removed from the sinuses of 11 patients under local anesthesia. Histologic evaluation showed antral pseudocysts in all specimens. A soft tissue scar was evident after 3 months of healing at the time of sinus augmentation. No sinus membrane perforation was seen or occurred during the sinus augmentation. A total of 17 implants were placed and restored prosthetically. No clinical complications were observed. The patients were followed up for a mean of 29.2 months (range, 17-43 months) after prosthetic loading, during which no implants were lost and no recurrence of the antral pseudocyst was observed. CONCLUSION: The described modified surgical technique allows the minimally invasive removal of the antral pseudocyst and histologic verification of the diagnosis without compromising the nasoantral entrance as well as the anatomy of the sinus for future sinus augmentations. It can be performed under local anesthesia without endoscopic equipment while shortening the treatment period.