ABSTRACT
The objective was to test the hypothesis of no difference in long-term (≥5 years) implant treatment outcomes after maxillary sinus floor augmentation (MSFA) with autogenous bone graft compared to a mixture of autogenous bone graft and bone substitutes or bone substitutes alone. A MEDLINE (PubMed), Embase, and Cochrane Library search in combination with a hand-search of relevant journals was conducted. Human studies published in English between January 1, 1990 and October 1, 2016 were included. Nine studies fulfilled the inclusion criteria. The survival of suprastructures has never been compared within the same study. The 5-year implant survival after MSFA with autogenous bone graft was 97%, compared to 95% for Bio-Oss; the reduction in vertical height of the augmented sinus was equivalent with the two treatment modalities. Non-comparative studies demonstrated high survival rates for suprastructures and implants regardless of the grafting material used. Meta-analysis revealed an overall estimated patient-based implant survival of 95% (confidence interval 0.92-0.96). High implant stability quotient values, high patient satisfaction, and limited peri-implant marginal bone loss were revealed in non-comparative studies. No long-term randomized controlled trial comparing the different treatment modalities was identified. Hence, the conclusions drawn from the results of this systematic review should be interpreted with caution.
Subject(s)
Bone Substitutes/therapeutic use , Bone Transplantation/methods , Dental Implantation, Endosseous , Dental Implants , Sinus Floor Augmentation/methods , Dental Restoration Failure , HumansABSTRACT
The objective of this systematic review was to test the hypothesis of no difference in implant treatment outcomes when using Bio-Oss alone or Bio-Oss mixed with particulate autogenous bone grafts for lateral ridge augmentation. A search of the MEDLINE, Cochrane Library, and Embase databases in combination with a hand-search of relevant journals was conducted. Human studies published in English from 1 January 1990 to 1 May 2016 were included. The search provided 337 titles and six studies fulfilled the inclusion criteria. Considerable variation prevented a meta-analysis from being performed. The two treatment modalities have never been compared within the same study. Non-comparative studies demonstrated a 3-year implant survival of 96% with 50% Bio-Oss mixed with 50% autogenous bone graft. Moreover, Bio-Oss alone or Bio-Oss mixed with autogenous bone graft seems to increase the amount of newly formed bone as well as the width of the alveolar process. Within the limitations of this systematic review, lateral ridge augmentation with Bio-Oss alone or in combination with autogenous bone graft seems to induce newly formed bone and increase the width of the alveolar process, with high short-term implant survival. However, long-term studies comparing the two treatment modalities are needed before final conclusions can be drawn.
Subject(s)
Alveolar Ridge Augmentation/methods , Bone Substitutes/therapeutic use , Bone Transplantation/methods , Minerals/therapeutic use , Bone Regeneration/physiology , Dental Implants , Graft Survival , Humans , Sinus Floor Augmentation/methodsABSTRACT
PURPOSE: The purpose of this study was to evaluate the periodontal and pulpal condition of the central incisors after Le Fort I and midline osteotomies for transverse expansion of the maxilla. PATIENTS AND METHODS: The series included 12 women and eight men, with an average age at operation of 28.4 years (range, 17 to 48 years). Each patient, examined retrospectively, underwent transverse expansion of the maxilla by combined Le Fort I and midline osteotomies. The minimum follow-up was 12 months (range, 12 to 85 months, with an average of 38 months). The central incisors were tested for percussion sound, mobility, and pulpal response to electric stimulation, and then compared with the lateral incisors. The pocket depths and the height of the alveolar bone were measured, and the root surface was evaluated for resorption on radiographs. RESULTS: Percussion and mobility tests indicated normal values for all teeth. Four (11%) of the central incisors did not respond to electrical stimulation. There was no difference in pocket depth between the mesial and distal sulci of the central incisors. In one tooth, resorption was detectable on the medial surface of the root. Minor root surface injury was seen in two roots, although these injuries were not progressive. The alveolar bone level of the central incisors was located slightly more superiorly on the mesial than on the distal side. CONCLUSIONS: Although there may be some minor complications to the periodontal and pulpal tissues after combined Le Fort I and midline osteotomies, the harmful effects seem to be of negligible clinical significance.
Subject(s)
Dental Pulp Diseases/etiology , Incisor , Maxilla/surgery , Osteotomy, Le Fort , Osteotomy , Periodontal Diseases/etiology , Adolescent , Adult , Alveolar Process/diagnostic imaging , Dental Pulp/physiopathology , Electric Stimulation , Female , Follow-Up Studies , Humans , Incisor/diagnostic imaging , Male , Middle Aged , Osteotomy/adverse effects , Osteotomy, Le Fort/adverse effects , Percussion , Periodontal Pocket/etiology , Radiography , Retrospective Studies , Root Resorption/diagnostic imaging , Root Resorption/etiology , Tooth Mobility/etiology , Tooth Root/injuriesABSTRACT
This report describes a life-threatening hemorrhage in the floor of a patient's mouth during routine implant placement in the anterior mandible. Airway obstruction caused by hematoma development resulted in acute nasotracheal intubation and subsequent surgical intervention. Surgical, radiographic, and anatomic considerations to prevent severe bleeding are discussed. An extraoral submental approach in cases with large sublingual hematomas is recommended. An outpatient should be treated in or close to a hospital where these complications can be dealt with promptly and effectively.