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Figure 9. Q14. Do you have any requests for dentis...

Figure 9. Q14. Do you have any requests for dentists who practice implant treatment? Figure 9. Q14. Do you have any requests for dentists who practice implant treatment?

Figure 8. Q13. What are the frequently received re...

Figure 8. Q13. What are the frequently received repair requests for IODs? Figure 8. Q13. What are the frequently received repair requests for IODs?

Figure 7. Q12. What kind of creative steps do you ...

Figure 7. Q12. What kind of creative steps do you take in order to prevent veneer fracture and chipping in the molar region? Figure 7. Q12. What kind of creative steps do you take in order to prevent veneer fracture and chipping in the molar region?

Figure 6. Q11. What are the frequently received re...

Figure 6. Q11. What are the frequently received repair requests involving implant fixed prostheses? Figure 6. Q11. What are the frequently received repair requests involving implant fixed prostheses?

Figure 5. Q10. What are the main fabrication chall...

Figure 5. Q10. What are the main fabrication challenges faced? Figure 5. Q10. What are the main fabrication challenges faced?

Figure 4. Q8. What are the proportions of attachme...

Figure 4. Q8. What are the proportions of attachment types used with IODs? Figure 4. Q8. What are the proportions of attachment types used with IODs?

Figure 3. Q6. What types of implant fixed prosthes...

Figure 3. Q6. What types of implant fixed prostheses are used in the posterior region? Figure 3. Q6. What types of implant fixed prostheses are used in the posterior region?

Figure 2. Q5. What types of materials (i.e. veneer...

Figure 2. Q5. What types of materials (i.e. veneer, coping) are used to make implant prostheses in the anterior region? Figure 2. Q5. What types of materials (i.e. veneer, coping) are used to make implant prostheses in the anterior region?

Figure 1. Q4. What are the proportions of abutment...

Figure 1. Q4. What are the proportions of abutments used with cement-retained prostheses? Figure 1. Q4. What are the proportions of abutments used with cement-retained prostheses?

Table 4 Prosthetic complic...

Question   Values Q9. What are the main issues generally encountered? Compatibility precision issues 29.6% Aesthetic issues 33.2% ...

Table 3 Implant overdentur...

Question   Values Q7. The design of the implant overdenture: Decision made according to instructions of dentist 43.2% Work is left to technicians 19.3% ...

Table 2 Implant fixed pros...

Question   Values Q3. The percentages of implant fixed prostheses: Cement-retained 61.4% Screw-retained 38.6% ...

Table 1 Conditions charact...

Question   Values Q1. The years of experience working as a dental technician, and the number of dentists from whom job orders are received.   Mean (SD) 17.0 (6.8) years 36.5(12.4)/Lab. ...

About this article : Current status of implant pro...

Hagiwara, Y., Narita, T., Shioda, Y. et al. Current status of implant prosthetics in Japan: a survey among certified dental lab technicians. Int J Implant Dent 1, 4 (2015). https://doi.org/10.1186/s40729-015-0005-3 Download citation Received: 13 October 2014 Accepted: 22 January 2015 Published: 17 February 2015 DOI: https://doi.org/10.1186/s40729-015-0005-3

Rights and permissions : Current status of implant...

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0), which permits use, duplication, adaptation, distribution, and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and in...

Additional information : Current status of implant...

The authors have declare that they have no competing interests. TN, YS, KI, TI and SN were compiled and aggregate of the questionnaire. YH and TS conceived of the study and participated in its design and coordination and helped to draft the manuscript. All authors read and approved the final manuscript.

Author information : Current status of implant pro...

Implant Dentistry, Nihon University School of Dentistry, Dental Hospital, 1-8-13 Kandasurugadai, Chiyoda-ku, Tokyo, 101-8310, Japan Yoshiyuki Hagiwara, Tatsuya Narita, Yohei Shioda, Keisuke Iwasaki, Takayuki Ikeda & Shunsuke Namaki Department of Dental Specialties, Mayo Clinic, Mayo Clinic, 200 First Street SW, Rochester, MINN, 55905, USA Thomas J Salinas You can also search for this aut...

Acknowledgements : Current status of implant prost...

This paper was partially supported by a Grant-in-Aid for Scientific Research (C) (No. 24592935) from the Japan Society for the Promotion of Science.

References : Current status of implant prosthetics...

Larsson C. Vult von Steyern P. Five-year follow-up of implant-supported Y-TZP and ZTA fixed dental prostheses. A randomized, prospective clinical trial comparing two different material systems. Int J Prosthodont. 2010;23:555–61. Gonda T, Maeda Y. Why are magnetic attachments popular in japan and other asian countries? Jpn Dental Sci Rev. 2011;47:124–30. Carlsson GE, Kronström M, de Baat C, ...

References : Current status of implant prosthetics...

Andreiotelli M, Att W, Strub JR. Prosthodontic complications with implant overdentures: a systematic literature review. Int J Prosthodont. 2010;3:195–203. Cehreli MC, Karasoy D, Kokat AM, Akca K, Eckert SE. Systematic review of prosthetic maintenance requirements for implant-supported overdentures. Int J Oral Maxillofac Implants. 2010;25:163–80. Hatzikyriakos A, Petridis HP, Tsiggos N, Sakel...

References : Current status of implant prosthetics...

Gatten DL, Riedy CA, Hong SK, Johnson JD, Cohenca N. Quality of life of endodontically treated versus implant treated patients: a University-based qualitative research study. J Endocrinol. 2011;37:903–9. Johannsen A, Wikesjö U, Tellefsen G, Johannsen G. Patient attitudes and expectations of dental implant treatment—a questionnaire study. Swed Dent J. 2012;36:7–14. Pavel K, Seydlova M, Dos...

References : Current status of implant prosthetics...

Att W, Stappert C. Implant therapy to improve quality of life. Quintessence Int. 2003;34:573–81. Papaspyridakos P, Chen CJ, Singh M, Weber HP, Gallucci GO. Success criteria in implant dentistry: a systematic review. J Dent Res. 2012;91:242–8. Shumaker ND, Metcalf BT, Toscano NT, Holtzclaw DJ. Periodontal and periimplant maintenance: a critical factor in long-term treatment success. Compend C...

Conclusions : Current status of implant prosthetic...

This survey served to clarify the current status of implant prosthodontics, issues, and considerations in their fabrication, and the status of prosthetic complications and preventive initiatives, all from a laboratory perspective. Concerning implant treatment, it was concluded that dentists either play the leading role or work in collaboration with technicians, including in the formulation of tre...

Results and discussion : Current status of implant...

Finally, technicians gave voice to the several requests for dentists, who are their customers, as a result of their daily experiences accomplishing implant laboratory procedures (Q14) (Figure 9). These included asking dentists to use suitable implant location and orientation (31.8%), to allow technicians to participate and consult with technicians from the treatment planning stage (28.3%), to imp...

Results and discussion : Current status of implant...

The questionnaire revealed several creative steps, based on laboratory considerations, being taken to prevent veneer chipping and fractures, a frequent and problematic prosthetic complication (Q12) (Figure 7). Technicians were taking into account metal (including zirconia) coping designs (36.3%), covering only the distal-most part of the molar region with metal (24%), using veneering composite re...

Results and discussion : Current status of implant...

Looking at repair requests (i.e., complications) involving the superstructures of fixed implant prostheses (Q11) (Figure 6), facing damage and chipping accounted for more than half of all requests (54.5%). Generally speaking, there are many reports that indicate a high incidence of complications related to fixed prostheses involving abutment screw loosening, detachment of cement-retained crowns, ...

Results and discussion : Current status of implant...

Bar and clip attachments were most commonly used for IODs, followed by magnet, ball, and socket, and Locator attachments (Q8) (Figure 4). It is noteworthy among the questionnaire results that magnetic attachment use is highest in Asian countries, including Japan [43]. Additionally, it is thought that the low use of Locators (5.2%) is strongly influenced by Japan’s strict pharmaceutical regulati...

Results and discussion : Current status of implant...

Concerning the types of prostheses used in the posterior region (Q6) (Figure 3), PFM design accounts for about 40% of the total, although the questionnaire also revealed a trend (in 9.1% of all cases) toward metal occlusal designs to avoid fracture and chipping of the veneer material. The same trend is evident in indirect composite facing crowns, where metal occlusal designs are used in about 35%...

Results and discussion : Current status of implant...

Next, concerning the types of abutments used with cement-retained prostheses (Q4) (Figure 1), CAD/CAM abutments accounted for about one third of the total (titanium, 19.7%; zirconia, 12.1%), and custom UCLA-type abutments made from cast gold alloy accounted for about the same proportion. It is likely that this breakdown is because, in many cases, implant systems using fabricated crowns are not su...

Results and discussion : Current status of implant...

Dentists play a leading role in 39.3% of the time in implant treatment planning and prosthetic design, and dental technicians are consulted concerning cases and part usage 34.7% of the time, suggesting the approach to implants is driven by prosthetic considerations (by dentists) to some degree. However, because dental technicians indicated that they take the initiative 15% of the time, it is impos...

Results and discussion : Current status of implant...

Out of 120 surveys sent, 74 technicians responded, resulting in a response rate of 61.6%. A summary of the responses is provided in Tables 1, 2, 3, and 4 and Figures 1, 2, 3, 4, 5, 6, 7, 8, and 9. Because implant treatment (implant prostheses) requires a significant amount of specialized, high-precision laboratory procedures, this area of dental care exhibits slightly different trends than pros...

Methods : Current status of implant prosthetics in...

This cross-sectional questionnaire survey was performed among the certified dental technicians of JSOI from September to December in 2011. Selected were 120 out of 285 certified dental technicians of JSOI using a random number table and mailing each questionnaire directly to the participant. To facilitate coverage of a broad range of topics, the survey classified content into the following four ca...

Background : Current status of implant prosthetics...

This survey consists of a questionnaire targeting the certified dental technicians of the Japanese Society of Oral Implantology (JSOI) [32] who are primarily involved in fabricating dental implant restorations. It was formulated to clarify the current status of implant prostheses from a prosthetic and technician-oriented standpoint through questions addressing current trends among dental implant t...

Background : Current status of implant prosthetics...

Currently, dental implant treatment is evaluated on the basis not only of restoring masticatory function, but also a variety of other factors, including the implant and superstructure survival rate and psychological impacts [1-3]. Numerous factors must be taken into account, to offer highly predictable implant treatment, and there is no doubt that prosthetic-related factors such as the type and co...

Abstract : Current status of implant prosthetics i...

There are many implant cases in which dental technicians take initiative with regard to the design of implant prostheses, and to a certain extent, this area of care is one in which dentists do not necessarily play the leading role. Moreover, inadequate communication between dental technicians and dentists and insufficient instructions for technicians has been highlighted as issues in the past. The...

Figure 2. Results for all implants instrumented wi...

Figure 2. ture. Temperature rise at 30 s: bone level 3.3 mm > bone level 4.1 mm > Straumann regular neck 3.3 mm = Astra 3.5 mm = Straumann regular neck 4.8 mm. (b) Temperature rise when instrumenting with the Satelec ultrasonic device with cooling. The horizontal dotted line denotes the assumed critical rise in temperature. Temperature rise at 30 s: bone level 3.3 mm =...

Figure 1. Implant embedded in epoxy resin with the...

Figure 1. Implant embedded in epoxy resin with thermocouple at the outer surface. Figure 1. Implant embedded in epoxy resin with thermocouple at the outer surface.

About this article : Temperature rise during remov...

Meisberger, E.W., Bakker, S.J.G. & Cune, M.S. Temperature rise during removal of fractured components out of the implant body: an in vitro study comparing two ultrasonic devices and five implant types. Int J Implant Dent 1, 7 (2015). https://doi.org/10.1186/s40729-015-0008-0 Download citation Received: 19 December 2014 Accepted: 02 March 2015 Published: 20 March 2015 DOI: https://doi.org/10.1...

Rights and permissions : Temperature rise during r...

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0), which permits use, duplication, adaptation, distribution, and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and in...

Additional information : Temperature rise during r...

This research was made possible by the support of the authors’ institutions. Eric W Meisberger, Sjoerd JG Bakker and Marco S Cune declare that they have no competing interests. EM and SB carried out the experiment. MC participated in the design of the study and performed the statistical analysis and helped to draft the manuscript. All authors read and approved the final manuscript.

Author information : Temperature rise during remov...

University Medical Center Groningen, Center for Dentistry and Oral Hygiene, Department of Fixed and Removable Prosthodontics and Biomaterials, The University of Groningen, Gebouw 3216, kamer 206, A. Deusinglaan 1, 9713 AV, Groningen, The Netherlands Eric W Meisberger, Sjoerd J G Bakker & Marco S Cune Department of Oral-Maxillofacial Surgery, Prosthodontics and Special Dental Care, St. Antoniu...

Acknowledgements : Temperature rise during removal...

The input of Prashant K. Sharma PhD, material scientist of the Department of Biomedical Engineering (Kolff Institute) of the UMC Groningen is greatly appreciated for his help interpreting the data. Michael Kars, DDS assisted during the collection of the data.

References : Temperature rise during removal of fr...

Satterthwaite JD, Stokes AN, Frankel NT. Potential for temperature change during application of ultrasonic vibration to intra-radicular posts. Eur J Prosthodont Restor Dent. 2003;11:51–6. Horan BB, Tordik PA, Imamura G, Goodell GG. Effect of dentin thickness on root surface temperature of teeth undergoing ultrasonic removal of posts. J Endod. 2008;34:453–5. Dominici JT, Clark S, Scheetz J, E...

References : Temperature rise during removal of fr...

Eriksson AR, Albrektsson T. Temperature threshold levels for heat-induced bone tissue injury: a vital-microscopic study in the rabbit. J Prosthet Dent. 1983;50:101–7. Benington IC, Biagioni PA, Briggs J, Sheridan S, Lamey PJ. Thermal changes observed at implant sites during internal and external irrigation. Clin Oral Implants Res. 2002;13:293–7. Li S, Chien S, Branemark PI. Heat shock-induce...

References : Temperature rise during removal of fr...

Assenza B, Tripodi D, Scarano A, Perrotti V, Piattelli A, Iezzi G, et al. Bacterial leakage in implants with different implant-abutment connections: an in vitro study. J Periodontol. 2011;83:491–7. Ha CY, Lim YJ, Kim MJ, Choi JH. The influence of abutment angulation on screw loosening of implants in the anterior maxilla. Int J Oral Maxillofac Implants. 2011;26:45–55. Spazzin AO, Henrique GE,...

References : Temperature rise during removal of fr...

Sailer I, Philipp A, Zembic A, Pjetursson BE, Hammerle CH, Zwahlen M. A systematic review of the performance of ceramic and metal implant abutments supporting fixed implant reconstructions. Clin Oral Implants Res. 2009;20 Suppl 4:4–31. Romeo E, Storelli S. Systematic review of the survival rate and the biological, technical, and aesthetic complications of fixed dental prostheses with cantilever...

Conclusions : Temperature rise during removal of f...

It is concluded from this in vitro study that heat accumulation and transfer is dependent on the type of ultrasonic device, the use of coolant, and the implant type. The highest rise in temperature is seen when using the Satelec device without coolant on the smaller diameter implants. The EMS device causes limited rise in temperature when used without coolant for less than 10 s, but presumably de...

Discussion : Temperature rise during removal of fr...

Cooling proves effective for both systems, increasing the outer implant temperature by an acceptable 1°C to 3°C during continued instrumentation; however, as already stated, the spray will blur the vision of the operator. One would expect the temperature to drop immediately after cessation of instrumentation and cooling, but the peak temperature is reached some seconds later for all experimenta...

Discussion : Temperature rise during removal of fr...

The degree to which a material is able to transfer heat is called thermal conductivity. It can be defined as the time rate of transfer by conduction, through unit thickness, across unit area for unit temperature gradient. Differences in design and wall thickness of the implants used in the present study account for the variation in outcome (i.e., Straumann tissue level 4.8 implant less effected), ...

Discussion : Temperature rise during removal of fr...

Several techniques have been described to deal with biomechanical complications. Acquiring adequate visibility and access is essential to success which will require the use of a dental microscope. Several mechanical approaches to remove screw remnants can be employed. Generally, after identifying the position and condition of the screw remnant, it can be carefully removed using manual instrumenta...

Results : Temperature rise during removal of fract...

The mean maximum rise in temperature (deltaTmax, all implants averaged per experimental condition) was reached at 30 to 40 s for all conditions. There was a significant difference for the Satelec device without cooling (mean 9.6, SD 1.6°C) and the EMS device without cooling (mean 4.3, SD 2.0°C) (t-test, t(28) = 4.7, p 

Results : Temperature rise during removal of fract...

The results for all implants instrumented with the two tested ultrasonic devices, either with or without cooling, are presented in Figure 2a,b,c,d. For the Satelec device, applied without coolant, only the temperature of the Straumann wide body regular neck implant never exceeded the 50 threshold. The data proved normally distributed (Kolmogorov-Smirnov test, p > 0.05). Analysis of variance ...

Methods : Temperature rise during removal of fract...

Two different types of commercially available ultrasonic devices, set at their lowest intensity for endodontic purpose, were used to instrument the internal portion of five different implant types, either with or without cooling. Intermittent anti-clockwise strokes were made, assuring that the tip was constantly in contact with the inner implant wall, as much as possible mimicking the motion that ...

Background : Temperature rise during removal of fr...

The use of ultrasonic equipment under adequate magnification may facilitate removal. It generates heat. Instrumentation without a coolant likely increases the temperature of the implant body and could cause tissue damage, in particular be harmful to osseointegration. The use of a coolant could be effective, but compromises visibility considerably, hence increases the risk of damaging the internal ...

Background : Temperature rise during removal of fr...

Complications in implant dentistry are generally divided into biological and mechanical complications. Mechanical complications include fracture of the implant body or prosthetic components such as chipping of ceramic material as well as loosening or fracture of implant abutments or fixation screws. This has a documented prevalence of 6 to 13% and 0.4 to 2% respectively after 5 years [1-7]. With...

Abstract : Temperature rise during removal of frac...

Ultrasonic instrumentation under magnification may facilitate mobilization of screw remnants but may induce heat trauma to surrounding bone. An increase of 5°C is considered detrimental to osseointegration. The objective of this investigation was to examine the rise in temperature of the outer implant body after 30 s of ultrasonic instrumentation to the inner part, in relation to implant type, t...

Fig. 12. Radiographic bone levels three years afte...

Fig. 12. Radiographic bone levels three years after placement. Bone levels remain unchanged during long-term follow-up Fig. 12. Radiographic bone levels three years after placement. Bone levels remain unchanged during long-term follow-up

Fig. 11. Implant restoration. Implants were restor...

Fig. 11. Implant restoration. Implants were restored by dental students supervised by prosthodontists at the Dental Center Fig. 11. Implant restoration. Implants were restored by dental students supervised by prosthodontists at the Dental Center

Fig. 10. Palatal approach lateral window sinus aug...

Fig. 10. Palatal approach lateral window sinus augmentation. This photographic series shows the surgical procedure that augmented bone and allowed implant placement at the no. 14 site. a Preoperative view prior to infiltration anesthesia. b Full-thickness midcrestal incision with palatal release and flap elevation. This was aided by a small bony ridge that separated the alveolar crest from the s...

Fig. 9. Schematic diagram of palatal approach sinu...

Fig. 9. Schematic diagram of palatal approach sinus augmentation. The diagram shows the location of the lateral window, avoiding the thick grafted bone on the buccal, and the greater palatal neurovascular bundle Fig. 9. Schematic diagram of palatal approach sinus augmentation. The diagram shows the location of the lateral window, avoiding the thick grafted bone on the buccal, and the greater ...

Fig. 8. Blood supply of the sinus. There are three...

Fig. 8. Blood supply of the sinus. There are three areas in the sinus where blood vessels may be encountered during sinus augmentation procedures for implants. On the inflection point between hard palate and alveolar ridge in the posterior maxilla, the greater palatine neurovascular bundle is located embedded in soft tissue. This inflection point is matched in the internal sinus anatomy and pres...

Fig. 7. Schematic diagram of sinus balloon dilatin...

Fig. 7. Schematic diagram of sinus balloon dilating procedure. This diagram shows how the balloon is inserted into a small transcrestal osteotomy and then expanded with balloon Fig. 7. Schematic diagram of sinus balloon dilating procedure. This diagram shows how the balloon is inserted into a small transcrestal osteotomy and then expanded with balloon

Fig. 6. Right sinus balloon dilation procedure. Th...

Fig. 6. Right sinus balloon dilation procedure. This photographic series shows the surgical procedure that augmented bone and allowed implant placement at the no. 3 site. a Preoperative view after infiltration anesthesia. b Full-thickness midcrestal incision. c Osteotomy preparation with implant drills and osteotomes. d, e The dilating balloon, which is inflated using saline pressure from a syri...

Fig. 5. Left sinus about 12 months after first gr...

Fig. 5. Left sinus about 12 months after first grafting procedure. Cone beam CT imaging shows unusual sinus anatomy after grafting, with finger-like sinus extension at implant site, and thick-grafted bone buccal and apical to it. The infractured wall is still clearly visible, as well as the bovine bone particles used as radiographic marker Fig. 5. Left sinus about 12 months after first graf...

Fig. 4. Right sinus about 12 months after first g...

Fig. 4. Right sinus about 12 months after first grafting procedure. Cone beam CT imaging shows little suitable bone at implant site, but grafted bone displaced distal to site. Bone hydroxyapatite particles were added as radiographic marker to the graft material for the first sinus augmentation procedure and are still visible as radiopaque specks Fig. 4. Right sinus about 12 months after fir...

Fig. 3. Left sinus prior to first sinus grafting p...

Fig. 3. Left sinus prior to first sinus grafting procedure. Cone beam CT imaging also shows very little bone volume on left side for the no. 14 area Fig. 3. Left sinus prior to first sinus grafting procedure. Cone beam CT imaging also shows very little bone volume on left side for the no. 14 area

Fig. 2. Right sinus prior to first sinus grafting ...

Fig. 2. Right sinus prior to first sinus grafting procedure. Cone beam CT imaging shows very little residual bone volume at implant site for the no. 3 area Fig. 2. Right sinus prior to first sinus grafting procedure. Cone beam CT imaging shows very little residual bone volume at implant site for the no. 3 area

Fig. 1. Initial presentation. Panoramic radiograph...

Fig. 1. Initial presentation. Panoramic radiograph taken at initial visit shows severe bone loss, supraerupted molars and furcation involvement Fig. 1. Initial presentation. Panoramic radiograph taken at initial visit shows severe bone loss, supraerupted molars and furcation involvement

About this article : Case report on managing incom...

Boehm, T.K. Case report on managing incomplete bone formation after bilateral sinus augmentation using a palatal approach and a dilating balloon technique. Int J Implant Dent 3, 3 (2017). https://doi.org/10.1186/s40729-017-0065-7 Download citation Received: 08 November 2016 Accepted: 13 January 2017 Published: 19 January 2017 DOI: https://doi.org/10.1186/s40729-017-0065-7

Rights and permissions : Case report on managing i...

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...

Author information : Case report on managing incom...

Western University of Health Sciences College of Dental Medicine, 309 E Second Street, Pomona, CA, 91766, USA Tobias K. Boehm You can also search for this author in PubMed Google Scholar Correspondence to Tobias K. Boehm.

Acknowledgements : Case report on managing incompl...

I would like to thank the former dental students Dr. Lily Hoang and Dr. Shirley Hsieh and their prosthodontic supervisors Dr. James Ywom, Dr. Steven Sanders, and Dr. Alessandro Urdaneta for providing this patient’s continued restorative and preventive care after the surgeries and the dental assistants of the Western University of Health Sciences Dental Center, Mrs. Cindy Morton and Mrs. Melody P...

References : Case report on managing incomplete bo...

Penarrocha-Diago M, Galan-Gil S, Carrillo-Garcia C, Penarrocha-Diago D, Penarrocha-Diago M. Transcrestal sinus lift and implant placement using the sinus balloon technique. Med Oral Patol Oral Cir Bucal. 2012;17(1):e122–8. Kfir E, Goldstein M, Abramovitz I, Kfir V, Mazor Z, Kaluski E. The effects of sinus membrane pathology on bone augmentation and procedural outcome using minimal invasive antr...

References : Case report on managing incomplete bo...

Hernandez-Alfaro F, Torradeflot MM, Marti C. Prevalence and management of Schneiderian membrane perforations during sinus-lift procedures. Clin Oral Implants Res. 2008;19(1):91–8. Wallace SS, Mazor Z, Froum SJ, Cho SC, Tarnow DP. Schneiderian membrane perforation rate during sinus elevation using piezosurgery: clinical results of 100 consecutive cases. Int J Periodontics Restorative Dent. 2007;...

Conclusions : Case report on managing incomplete b...

We conclude that incomplete bone formation after sinus augmentation can be managed successfully through a variety of re-entry procedures and that successful long-term implant placement and restoration is possible in a compliant patient of good overall health.

Case presentation : Case report on managing incomp...

Healing was uneventful with little discomfort reported by the patient during the first week, and implant uncovery revealed an implant firmly embedded in bone after 12 months. A third implant was placed at the no. 30 site and supraerupted no. 18 extracted as planned. Restoration of the implants was uneventfully performed by senior dental students supervised by various prosthodontists (Fig. 11). P...

Case presentation : Case report on managing incomp...

For the left side, we decided to access the sinus using a lateral window as the area of deficient bone was much larger in size and more complex in shape. We also decided to approach this area from the palate, as the defect was closer to the palate and required much less bone removal as a buccal approach. Most importantly, we were already familiar with the anatomical structures on the lower medial ...

Case presentation : Case report on managing incomp...

A year later, we requested cone beam computed tomography for both posterior maxilla sites, and we found incomplete bone growth in the sinus. On the right side, bone growth had occurred only distal to the desired implant site, and there was an ovoid extension of sinus into the area planned for implant placement (Fig. 4). On the left side, a finger-like extension of sinus had developed between graf...

Case presentation : Case report on managing incomp...

Lateral window sinus augmentation was performed on each side during appointments spaced 3 months apart, following the technique developed by Tatum in 1974. For each site, a midcrestal mucoperiosteal incision with buccal releases was created, and the lateral Schneiderian membrane of the maxillary sinus exposed through an ovoid window osteotomy of about 15 mm diameter. Osteotomy was performed usin...

Case presentation : Case report on managing incomp...

A 65-year-old retired Caucasian male presented to the Western University of Health Sciences Dental Center expressing an interest in implants after consulting with a private practice periodontist and a dentist from a large implant dentistry practice. He had no medical conditions or known allergies, but reported a 40-pack-year history of using tobacco and quit just before attending the Dental Center...

Background : Case report on managing incomplete bo...

Membrane tears are a significant concern as they may result in postoperative complications such as an oroantral communication as reported recently. In this case, the communication was managed by inserting a fibrin sponge, but it resulted in a cyst-like concavity within grafted bone, which was subsequently managed by re-entry and grafting of the affected site prior to implant placement [14]. As see...

Background : Case report on managing incomplete bo...

Patients with severe periodontal disease often display severely resorbed ridges in the posterior maxilla. Implant therapy can be a challenge for those patients as available bone height is limited by the maxillary sinus. Although sinus augmentation using subantral or lateral window approaches are routinely used, complications occur that may limit bone augmentation in the sinus after any given proce...

Abstract : Case report on managing incomplete bone...

Patients with resorbed edentulous alveolar ridges in the posterior maxilla often require lateral window sinus augmentation procedures prior to implant placement. Lateral window sinus augmentation procedures can produce incomplete bone augmentation as consequence of surgical and healing complications producing unusual and complex sinus anatomy. Although incomplete bone formation after sinus augment...

Fig. 5. Survival rate of dental implants after aut...

Fig. 5. Survival rate of dental implants after autologous bone augmentation Fig. 5. Survival rate of dental implants after autologous bone augmentation

Fig. 4. Postoperative nerve alterations. Single as...

Fig. 4. Postoperative nerve alterations. Single asterisk, N refers to the total number of the surgical approaches in the mandible (N = 155). Double asterisk, N refers to the total number of the surgical approaches in the maxilla (N = 225) Fig. 4. Postoperative nerve alterations. Single asterisk, N refers to the total number of the surgical approaches in the mandible (N = 155). Dou...

Fig. 3. Surgical outcome after autologous augmenta...

Fig. 3. Surgical outcome after autologous augmentation procedures from different donor sites Fig. 3. Surgical outcome after autologous augmentation procedures from different donor sites

Fig. 2. Survival rate of autologous bone grafts : ...

Fig. 2. Survival rate of autologous bone grafts Fig. 2. Survival rate of autologous bone grafts

Fig. 1. Postoperative complications at the donor a...

Fig. 1. Postoperative complications at the donor and recipient site, N refers to the total number of the donor sites (N = 300), N refers to the total number of the recipient sites (N = 378) Fig. 1. Postoperative complications at the donor and recipient site, N refers to the total number of the donor sites (N = 300), N refers to the total number of the recipient sites (N = 378)

Table 3 Intra- and postoperative complications aft...

Postoperative complications %/procedures (N) At donor sitea    Wound infection 2.6% (8/300) At recipient site...

Table 2 Donor sites and numbers of bone grafts as ...

Donor site Bone grafts (N)/patients (N) Lateral zygomatic buttress 113/112 Mandibular ramus (retromolar) ...

Table 1 Patient characteristics at the time of aug...

Patient characteristics N (%) Gendera    Male 250 (89.6%)  Female 29 (10.4%) ...

About this article : Autogenous bone grafts in ora...

Sakkas, A., Wilde, F., Heufelder, M. et al. Autogenous bone grafts in oral implantology—is it still a “gold standard”? A consecutive review of 279 patients with 456 clinical procedures. Int J Implant Dent 3, 23 (2017). https://doi.org/10.1186/s40729-017-0084-4 Download citation Received: 27 February 2017 Accepted: 22 May 2017 Published: 01 June 2017 DOI: https://doi...

Rights and permissions : Autogenous bone grafts in...

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...

Author information : Autogenous bone grafts in ora...

Department of Oral and Plastic Maxillofacial Surgery, Military Hospital Ulm, Academic Hospital of the University of Ulm, Oberer Eselsberg 40, 89081, Ulm, Germany Andreas Sakkas, Frank Wilde, Marcus Heufelder & Alexander Schramm Institute of Anatomy, Medical Faculty of Leipzig University, Leipzig, Germany Karsten Winter Department of Oral and Plastic Maxillofacial Surgery, University Hospit...

Acknowledgements : Autogenous bone grafts in oral ...

The authors thank the patients for their kindness to participate as study cases and the whole medical team at the Bundeswehrkrankenhaus Ulm. AS participated in its design and coordination, carried out the data selection, and drafted the manuscript, and is the corresponding author. FW participated in its design and coordination and helped in drafting the manuscript. MH participated in its design a...

References : Autogenous bone grafts in oral implan...

Semper W, Kraft S, Mehrhof J, Nelson K. Impact of abutment rotation and angulation on marginal fit: theoretical considerations. Int J Oral Maxillofac Implants. 2010;25:752–8. Wiltfang J, Jätschmann N, Hedderich J, Neukam FW, Schlegel KA, Gierloff M. Effect of deproteinized bovine bone matrix coverage on the resorption of iliac cortico-spongeous bone grafts—a prospective study of two cohorts....

References : Autogenous bone grafts in oral implan...

Chiapasco M, Zaniboni M. Clinical outcomes of GBR procedures to correct peri-implant dehiscences and fenestrations: a systematic review. Clin Oral Implants Res. 2009;20:113–23. Felice P, Pellegrino G, Checchi L, Pistilli R, Esposito M. Vertical augmentation with interpositional blocks of anorganic bovine bone vs. 7-mm-long implants in posterior mandibles: 1-year results of a randomized clinical...

References : Autogenous bone grafts in oral implan...

Verdugo F, Castillo A, Moragues MD, Pontón J. Bone microbial contamination influences autogenous grafting in sinus augmentation. J Periodontol. 2009;80:1355–64. Wiltfang J, Schultze-Mosgau S, Merten HA, Kessler P, Ludwig A, Engelke W. Endoscopic and ultrasonographic evaluation of the maxillary sinus after combined sinus floor augmentation and implant insertion. Oral Surg Oral Med Oral Pathol O...

References : Autogenous bone grafts in oral implan...

von Arx T, Buser D. Horizontal ridge augmentation using autogenous block grafts and the guided bone regeneration technique with collagen membranes: a clinical study with 42 patients. Clin Oral Implants Res. 2006;17:359–66. Levin L, Nitzan D, Schwartz-Arad D. Success of dental implants placed in intraoral block bone grafts. J Periodontol. 2007;78:18–21. Andersson L. Patient self-evaluation of...

References : Autogenous bone grafts in oral implan...

Aghaloo TL, Moy PK. Which hard tissue augmentation techniques are the most successful in furnishing bony support for implant placement? Int J Oral Maxillofac Implants. 2007;22:49–70. Margonar R, dos Santos PL, Queiroz TP, Marcantonio E. Rehabilitation of atrophic maxilla using the combination of autogenous and allogeneic bone grafts followed by protocol-type prosthesis. J Craniofac Surg. 2010;2...

References : Autogenous bone grafts in oral implan...

Schwartz-Arad D, Dori S. Intraoral autogenous onlay block bone grafting for implant dentistry. Refuat Hapeh Vehashinayim. 2002;19:35–9. 77. Misch CM. Ridge augmentation using mandibular ramus bone grafts for the placement of dental implants: presentation of a technique. Pract Periodontics Aesthet Dent. 1996;8:127–35. Altiparmak N, Soydan SS, Uckan S. The effect of conventional surgery and pi...

References : Autogenous bone grafts in oral implan...

Jensen AT, Jensen SS, Worsaae N. Complications related to bone augmentation procedures of localized defects in the alveolar ridge. A retrospective clinical study. Oral Maxillofac Surg. 2016;20(2):115–22 [Epub ahead of print]. Buser D, Dula K, Hirt HP, Schenk RK. Lateral ridge augmentation using autografts and barrier membranes: clinical study with 40 partially edentulous patients. J Oral Maxill...

Conclusions : Autogenous bone grafts in oral impla...

The results of the clinical study proves the reliability and low comorbidity of autologous bone grafts in preprosthetic alveolar ridge reconstructions prior to implant insertion. The high graft success rate (95.6%) and the low early implant failure rate (0.38%) in a surveillance of all patients treated in three following years with this technique showing no exclusion and no dropout of any case for...

Discussion : Autogenous bone grafts in oral implan...

Data on risk factors based on the original examination and documentation are difficult to assess the adverse effects of variable factors on the surgical prognosis because of the multifactorial genesis of surgical complications [73]. Factors such as gender, age, or smoking habit could be associated with postoperative complications after two-stage dentoalveolar reconstruction with autologous bone gr...

Discussion : Autogenous bone grafts in oral implan...

The results of the present study have to take into account the absence of a control group with patients undergoing bone augmentation procedures with bone substitutes (allogen, alloplastic, exogen). Without a comparative group of grafting surgeries using alternative bone material, only limited statements can be made. However, the excellent surgical outcome of autologous surgical methods providing ...

Discussion : Autogenous bone grafts in oral implan...

The use of autologous bone in this study has shown excellent graft survival and success rate (95.6%). This is equal to the results from the studies on implants inserted in reconstructed sites [6, 8, 24]. The early implant survival rate of 99.7% found in the present material is very high comparable to that in the previous systematic reviews after staged horizontal ridge augmentation [9, 10, 22, 62,...

Discussion : Autogenous bone grafts in oral implan...

Of the sinus floor elevations performed in this study, 84.8% were defined absolutely successful. Only two of our 72 patients having sinus lift operations could not finally be treated with dental implants. These results are comparable to other studies considering the sinus graft to be a safe treatment modality with few complications [6, 8, 51,52,53]. Raghoebar et al. reported incidences of sinus co...

Discussion : Autogenous bone grafts in oral implan...

Postoperative morbidity after mandibular bone harvesting procedures was reported to be mainly related to temporary or permanent neural disturbances involving the inferior alveolar nerve and its branches [19]. In this study, only the incidence of the temporary hypoesthesia of the mandibular and lingual nerve after harvesting from the retromolar area could be detected. It was 10.4 and 2.8%, respecti...

Discussion : Autogenous bone grafts in oral implan...

Systematic reviews have failed to find evidence that one particular grafting technique is superior to others [10]. Intraoral bone grafts from the mandibular symphysis, mandibular ramus, and maxillary tuberosity provide a good treatment modality for ridge augmentation, and the amount of bone available for harvesting is sufficient for defects up to the width of three teeth [42]. Harvesting of retrom...

Discussion : Autogenous bone grafts in oral implan...

Several grafting procedures have been described to create sufficient volume of bone for implant placement [8, 9]. Autologous bone grafts can be harvested by an intraoral approach (mandibular ramus, mandibular symphysis, zygomatic buttress) or from distant sites (iliac crest, calvaria, and etc.) [17, 36, 37]. However, bone harvesting potentially causes donor site morbidity which is a major issue fo...

Results : Autogenous bone grafts in oral implantol...

The average healing period until implant placement after bone harvesting was 4.53 months. Initially, 546 implants in 279 patients were planned. After the healing period, it was possible to place 525 implants in 436 successfully augmented areas in 259 patients. Three hundred implants were inserted in the maxilla and 225 in the mandible. The remaining 21 implants planned for 20 patients could not b...

Results : Autogenous bone grafts in oral implantol...

Regarding intraoperative complications, all sinus membrane perforations were covered with a resorbable collagen membrane (Bio-Gide®, Geistlich Biomaterials, Baden-Baden, Germany) which applied as sealant to overlap the site of perforation prior to insertion of the graft material. These patients were advised to avoid physical stress, blowing their noses, or sneezing for a period of 3 weeks, and n...

Results : Autogenous bone grafts in oral implantol...

No permanent damage to any trigeminal nerves was evident in any of our entire cohort. All cases of postoperative hypoesthesia of the mental, lingual, or infraorbital nerve were just a temporary nature. At the time of implant surgery, none of these patients reported any persisting neural disturbances (Fig. 4). In eleven patients, hypoesthesia of the mental area was mentioned, and three of them al...

Results : Autogenous bone grafts in oral implantol...

Thirty-eight patients underwent a total of 116 augmentation procedures harvesting from the iliac crest. In 20 patients, a bone graft augmentation of the maxilla and the mandible in combination with bilateral sinus floor augmentations was performed. Eighteen patients had augmentations only in the maxilla, involving bone grafting and sinus lift elevations. Totally, 76 sinus lifts with bone material ...

Results : Autogenous bone grafts in oral implantol...

In six patients, a partial graft resorption was detected at the time of implantation and an additional simultaneous augmentation with bone chips harvested with the Safescraper device (C.G.M. S.p.A., Divisione Medicale META, Italy) was then necessary in order to ensure the osseointegration of the implants. Two out of these six cases had grafts from the crista zygomatico-alveolaris, two from the ram...

Results : Autogenous bone grafts in oral implantol...

A total of 112 sinus floor elevations were performed. In all of the cases, implants were inserted in a two-stage procedure. The donor site for harvesting the bone for the sinus elevations was in 76 procedures in the iliac crest area, and in 36 procedures, the bone was harvested with a bone scraper device from the lateral sinus wall at the site of sinus lifting. The distribution and number of tran...

Results : Autogenous bone grafts in oral implantol...

Two hundred seventy-nine patients—250 men and 29 women—underwent 456 augmentation procedures involving autologous bone grafts prior to implant placement. The patients ranged in age from 18.5 to 71.5 years (average 43.1 years) at the moment of augmentation surgery. Of those patients, 162 (58.1%) were younger than 40 years of age and 117 (41.9%) were older than 40 years of age. Caries or pe...

Methods : Autogenous bone grafts in oral implantol...

Early and late implant loss was documented in this study, defining the clinical success of osseointegration. Early implant failures were assessed before the acquisition of osseointegration, i.e., before the placement of prosthodontic restorations. Early implant failure could occur from the time of placement, during the healing phase and before abutment connection. The implant inserted after re-aug...

Methods : Autogenous bone grafts in oral implantol...

Medical history of patient Age of patient at the time of bone harvesting and augmentation History of periodontal disease Smoking habits Donor site Jaw area and dental situation of the recipient site Intraoperative complications Postoperative complications after augmentation Management of complications Bone graft stability and clinical resorption prior to implant placement Complications a...

Methods : Autogenous bone grafts in oral implantol...

In addition to the bone already gained with the bone scraper device from the sinus wall during the antrostomy, bone was harvested with the same device from the maxillary buccal buttress, if more volume was needed. By taking this approach, the collection of enough bone for the augmentation of at least two implantation sites was feasible with a mean surgical time of 5 to 10 min for harvesting. In c...

Methods : Autogenous bone grafts in oral implantol...

Grafting from the iliac crest was always performed under general anesthesia in a two-team approach. The iliac crest was exposed and autogenous grafts from the anterosuperior inner edge of the iliac wing were harvested with an oscillating saw and/or a chisel, keeping a safe distance of around 2 cm from the anterosuperior iliac spine. After harvesting the bone grafts, the corticocancellous bone blo...

Methods : Autogenous bone grafts in oral implantol...

A standardized two-stage surgical protocol was used, and all sites were treated in a similar fashion. In the first intervention, a bone block harvested from the donor site was fixed with osteosynthesis titanium screws to the recipient site as an onlay graft to achieve a horizontal and/or vertical enlargement of the alveolar ridge. Placement of the bone graft was always guided by an augmentation te...

Methods : Autogenous bone grafts in oral implantol...

For this retrospective cohort study, we reviewed the records of all patients without exclusion criteria who were referred to the department of oral and plastic maxillofacial surgery at the military hospital of Ulm, Germany, between January 2009 and December 2011 for alveolar ridge augmentations prior to implant insertions using autologous bone grafts harvested from different donor sites and unilat...

Background : Autogenous bone grafts in oral implan...

In our military outpatient center exclusively, autologous bone transplantations harvested from different donor sites were used intraorally (crista zygomatico-alveolaris, ramus mandible, symphysis mandible, anterior sinus wall) and extraorally (iliac crest) to reconstruct severe horizontal and/or vertical alveolar ridge atrophy prior to implant placement. The aim of this study was to assess the cli...

Background : Autogenous bone grafts in oral implan...

Although the iliac crest is most often used in jaw reconstruction, a significant bone resorption has been mentioned [12]. This disadvantage, and the fact that dental implants do not always require a large amount of bone, has increased the use of autologous block bone grafts from intraoral sources [13]. Bone grafts from intraoral donor sites offer several benefits like surgical accessibility, proxi...

Background : Autogenous bone grafts in oral implan...

Oral implantation has a significant role in the rehabilitation of patients. Bone reconstruction techniques have been advanced in order to optimize the esthetic and functional outcome. However, the restoration of the oral function of atrophic alveolar crests still remains a challenge in oral implantology. Bone augmentation procedures are often indicated to allow implant placement in an optimal thre...

Abstract : Autogenous bone grafts in oral implanto...

This review demonstrates the predictability of autologous bone material in alveolar ridge reconstructions prior to implant insertion, independent from donor and recipient site including even autologous bone chips for sinus elevation. Due to the low harvesting morbidity of autologous bone grafts, the clinical results of our study indicate that autologous bone grafts still remain the “gold standar...

Abstract : Autogenous bone grafts in oral implanto...

This study assessed the clinical outcomes of graft success rate and early implant survival rate after preprosthetic alveolar ridge reconstruction with autologous bone grafts. A consecutive retrospective study was conducted on all patients who were treated at the military outpatient clinic of the Department of Oral and Plastic Maxillofacial Surgery at the military hospital in Ulm (Germany) in the ...

About this article : Case report on managing incom...

Boehm, T.K. Case report on managing incomplete bone formation after bilateral sinus augmentation using a palatal approach and a dilating balloon technique. Int J Implant Dent 3, 3 (2017). https://doi.org/10.1186/s40729-017-0065-7 Download citation Received: 08 November 2016 Accepted: 13 January 2017 Published: 19 January 2017 DOI: https://doi.org/10.1186/s40729-017-0065-7...

Rights and permissions : Case report on managing i...

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...

Author information : Case report on managing incom...

Western University of Health Sciences College of Dental Medicine, 309 E Second Street, Pomona, CA, 91766, USA Tobias K. Boehm You can also search for this author in PubMed Google Scholar Correspondence to Tobias K. Boehm.

Acknowledgements : Case report on managing incompl...

I would like to thank the former dental students Dr. Lily Hoang and Dr. Shirley Hsieh and their prosthodontic supervisors Dr. James Ywom, Dr. Steven Sanders, and Dr. Alessandro Urdaneta for providing this patient’s continued restorative and preventive care after the surgeries and the dental assistants of the Western University of Health Sciences Dental Center, Mrs. Cindy Morton and Mrs. Melody P...

References : Case report on managing incomplete bo...

Penarrocha-Diago M, Galan-Gil S, Carrillo-Garcia C, Penarrocha-Diago D, Penarrocha-Diago M. Transcrestal sinus lift and implant placement using the sinus balloon technique. Med Oral Patol Oral Cir Bucal. 2012;17(1):e122–8. Kfir E, Goldstein M, Abramovitz I, Kfir V, Mazor Z, Kaluski E. The effects of sinus membrane pathology on bone augmentation and procedural outcome using minimal invasive antr...

References : Case report on managing incomplete bo...

Hernandez-Alfaro F, Torradeflot MM, Marti C. Prevalence and management of Schneiderian membrane perforations during sinus-lift procedures. Clin Oral Implants Res. 2008;19(1):91–8. Wallace SS, Mazor Z, Froum SJ, Cho SC, Tarnow DP. Schneiderian membrane perforation rate during sinus elevation using piezosurgery: clinical results of 100 consecutive cases. Int J Periodontics Restorative Dent. 2007;...

Conclusions : Case report on managing incomplete b...

We conclude that incomplete bone formation after sinus augmentation can be managed successfully through a variety of re-entry procedures and that successful long-term implant placement and restoration is possible in a compliant patient of good overall health.

Case presentation : Case report on managing incomp...

Healing was uneventful with little discomfort reported by the patient during the first week, and implant uncovery revealed an implant firmly embedded in bone after 12 months. A third implant was placed at the no. 30 site and supraerupted no. 18 extracted as planned. Restoration of the implants was uneventfully performed by senior dental students supervised by various prosthodontists (Fig. 11). P...

Case presentation : Case report on managing incomp...

For the left side, we decided to access the sinus using a lateral window as the area of deficient bone was much larger in size and more complex in shape. We also decided to approach this area from the palate, as the defect was closer to the palate and required much less bone removal as a buccal approach. Most importantly, we were already familiar with the anatomical structures on the lower medial ...

Case presentation : Case report on managing incomp...

A year later, we requested cone beam computed tomography for both posterior maxilla sites, and we found incomplete bone growth in the sinus. On the right side, bone growth had occurred only distal to the desired implant site, and there was an ovoid extension of sinus into the area planned for implant placement (Fig. 4). On the left side, a finger-like extension of sinus had developed between graf...

Case presentation : Case report on managing incomp...

Lateral window sinus augmentation was performed on each side during appointments spaced 3 months apart, following the technique developed by Tatum in 1974. For each site, a midcrestal mucoperiosteal incision with buccal releases was created, and the lateral Schneiderian membrane of the maxillary sinus exposed through an ovoid window osteotomy of about 15 mm diameter. Osteotomy was performed usin...

Case presentation : Case report on managing incomp...

A 65-year-old retired Caucasian male presented to the Western University of Health Sciences Dental Center expressing an interest in implants after consulting with a private practice periodontist and a dentist from a large implant dentistry practice. He had no medical conditions or known allergies, but reported a 40-pack-year history of using tobacco and quit just before attending the Dental Center...

Background : Case report on managing incomplete bo...

Membrane tears are a significant concern as they may result in postoperative complications such as an oroantral communication as reported recently. In this case, the communication was managed by inserting a fibrin sponge, but it resulted in a cyst-like concavity within grafted bone, which was subsequently managed by re-entry and grafting of the affected site prior to implant placement [14]. As see...

Background : Case report on managing incomplete bo...

Patients with severe periodontal disease often display severely resorbed ridges in the posterior maxilla. Implant therapy can be a challenge for those patients as available bone height is limited by the maxillary sinus. Although sinus augmentation using subantral or lateral window approaches are routinely used, complications occur that may limit bone augmentation in the sinus after any given proce...

Abstract : Case report on managing incomplete bone...

Patients with resorbed edentulous alveolar ridges in the posterior maxilla often require lateral window sinus augmentation procedures prior to implant placement. Lateral window sinus augmentation procedures can produce incomplete bone augmentation as consequence of surgical and healing complications producing unusual and complex sinus anatomy. Although incomplete bone formation after sinus augment...

Fig. 5. Survival rate of dental implants after aut...

Fig. 5. Survival rate of dental implants after autologous bone augmentation Fig. 5. Survival rate of dental implants after autologous bone augmentation

Fig. 4. Postoperative nerve alterations. Single as...

Fig. 4. Postoperative nerve alterations. Single asterisk, N refers to the total number of the surgical approaches in the mandible (N = 155). Double asterisk, N refers to the total number of the surgical approaches in the maxilla (N = 225) Fig. 4. Postoperative nerve alterations. Single asterisk, N refers to the total number of the surgical approaches in the mandible (N = 155). Dou...

Fig. 3. Surgical outcome after autologous augmenta...

Fig. 3. Surgical outcome after autologous augmentation procedures from different donor sites Fig. 3. Surgical outcome after autologous augmentation procedures from different donor sites

Fig. 2. Survival rate of autologous bone grafts : ...

Fig. 2. Survival rate of autologous bone grafts Fig. 2. Survival rate of autologous bone grafts

Fig. 1. Postoperative complications at the donor a...

Fig. 1. Postoperative complications at the donor and recipient site, N refers to the total number of the donor sites (N = 300), N refers to the total number of the recipient sites (N = 378) Fig. 1. Postoperative complications at the donor and recipient site, N refers to the total number of the donor sites (N = 300), N refers to the total number of the recipient sites (N = 378)

Table 3 Intra- and postoperative complications aft...

Postoperative complications %/procedures (N) At donor sitea    Wound infection 2.6% (8/300) At recipient site...

Table 2 Donor sites and numbers of bone grafts as ...

Donor site Bone grafts (N)/patients (N) Lateral zygomatic buttress 113/112 Mandibular ramus (retromolar) ...

Table 1 Patient characteristics at the time of aug...

Patient characteristics N (%) Gendera    Male 250 (89.6%)  Female 29 (10.4%) ...

About this article : Autogenous bone grafts in ora...

Sakkas, A., Wilde, F., Heufelder, M. et al. Autogenous bone grafts in oral implantology—is it still a “gold standard”? A consecutive review of 279 patients with 456 clinical procedures. Int J Implant Dent 3, 23 (2017). https://doi.org/10.1186/s40729-017-0084-4 Download citation Received: 27 February 2017 Accepted: 22 May 2017 Published: 01 June 2017 DOI: https://doi...

Rights and permissions : Autogenous bone grafts in...

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...

Author information : Autogenous bone grafts in ora...

Department of Oral and Plastic Maxillofacial Surgery, Military Hospital Ulm, Academic Hospital of the University of Ulm, Oberer Eselsberg 40, 89081, Ulm, Germany Andreas Sakkas, Frank Wilde, Marcus Heufelder & Alexander Schramm Institute of Anatomy, Medical Faculty of Leipzig University, Leipzig, Germany Karsten Winter Department of Oral and Plastic Maxillofacial Surgery, University Hospit...

Acknowledgements : Autogenous bone grafts in oral ...

The authors thank the patients for their kindness to participate as study cases and the whole medical team at the Bundeswehrkrankenhaus Ulm. AS participated in its design and coordination, carried out the data selection, and drafted the manuscript, and is the corresponding author. FW participated in its design and coordination and helped in drafting the manuscript. MH participated in its design a...

References : Autogenous bone grafts in oral implan...

Semper W, Kraft S, Mehrhof J, Nelson K. Impact of abutment rotation and angulation on marginal fit: theoretical considerations. Int J Oral Maxillofac Implants. 2010;25:752–8. Wiltfang J, Jätschmann N, Hedderich J, Neukam FW, Schlegel KA, Gierloff M. Effect of deproteinized bovine bone matrix coverage on the resorption of iliac cortico-spongeous bone grafts—a prospective study of two cohorts....

References : Autogenous bone grafts in oral implan...

Chiapasco M, Zaniboni M. Clinical outcomes of GBR procedures to correct peri-implant dehiscences and fenestrations: a systematic review. Clin Oral Implants Res. 2009;20:113–23. Felice P, Pellegrino G, Checchi L, Pistilli R, Esposito M. Vertical augmentation with interpositional blocks of anorganic bovine bone vs. 7-mm-long implants in posterior mandibles: 1-year results of a randomized clinical...

References : Autogenous bone grafts in oral implan...

Verdugo F, Castillo A, Moragues MD, Pontón J. Bone microbial contamination influences autogenous grafting in sinus augmentation. J Periodontol. 2009;80:1355–64. Wiltfang J, Schultze-Mosgau S, Merten HA, Kessler P, Ludwig A, Engelke W. Endoscopic and ultrasonographic evaluation of the maxillary sinus after combined sinus floor augmentation and implant insertion. Oral Surg Oral Med Oral Pathol O...

References : Autogenous bone grafts in oral implan...

von Arx T, Buser D. Horizontal ridge augmentation using autogenous block grafts and the guided bone regeneration technique with collagen membranes: a clinical study with 42 patients. Clin Oral Implants Res. 2006;17:359–66. Levin L, Nitzan D, Schwartz-Arad D. Success of dental implants placed in intraoral block bone grafts. J Periodontol. 2007;78:18–21. Andersson L. Patient self-evaluation of...

References : Autogenous bone grafts in oral implan...

Aghaloo TL, Moy PK. Which hard tissue augmentation techniques are the most successful in furnishing bony support for implant placement? Int J Oral Maxillofac Implants. 2007;22:49–70. Margonar R, dos Santos PL, Queiroz TP, Marcantonio E. Rehabilitation of atrophic maxilla using the combination of autogenous and allogeneic bone grafts followed by protocol-type prosthesis. J Craniofac Surg. 2010;2...

References : Autogenous bone grafts in oral implan...

Schwartz-Arad D, Dori S. Intraoral autogenous onlay block bone grafting for implant dentistry. Refuat Hapeh Vehashinayim. 2002;19:35–9. 77. Misch CM. Ridge augmentation using mandibular ramus bone grafts for the placement of dental implants: presentation of a technique. Pract Periodontics Aesthet Dent. 1996;8:127–35. Altiparmak N, Soydan SS, Uckan S. The effect of conventional surgery and pi...

References : Autogenous bone grafts in oral implan...

Jensen AT, Jensen SS, Worsaae N. Complications related to bone augmentation procedures of localized defects in the alveolar ridge. A retrospective clinical study. Oral Maxillofac Surg. 2016;20(2):115–22 [Epub ahead of print]. Buser D, Dula K, Hirt HP, Schenk RK. Lateral ridge augmentation using autografts and barrier membranes: clinical study with 40 partially edentulous patients. J Oral Maxill...

Conclusions : Autogenous bone grafts in oral impla...

The results of the clinical study proves the reliability and low comorbidity of autologous bone grafts in preprosthetic alveolar ridge reconstructions prior to implant insertion. The high graft success rate (95.6%) and the low early implant failure rate (0.38%) in a surveillance of all patients treated in three following years with this technique showing no exclusion and no dropout of any case for...

Discussion : Autogenous bone grafts in oral implan...

Data on risk factors based on the original examination and documentation are difficult to assess the adverse effects of variable factors on the surgical prognosis because of the multifactorial genesis of surgical complications [73]. Factors such as gender, age, or smoking habit could be associated with postoperative complications after two-stage dentoalveolar reconstruction with autologous bone gr...

Discussion : Autogenous bone grafts in oral implan...

The results of the present study have to take into account the absence of a control group with patients undergoing bone augmentation procedures with bone substitutes (allogen, alloplastic, exogen). Without a comparative group of grafting surgeries using alternative bone material, only limited statements can be made. However, the excellent surgical outcome of autologous surgical methods providing ...

Discussion : Autogenous bone grafts in oral implan...

The use of autologous bone in this study has shown excellent graft survival and success rate (95.6%). This is equal to the results from the studies on implants inserted in reconstructed sites [6, 8, 24]. The early implant survival rate of 99.7% found in the present material is very high comparable to that in the previous systematic reviews after staged horizontal ridge augmentation [9, 10, 22, 62,...

Discussion : Autogenous bone grafts in oral implan...

Of the sinus floor elevations performed in this study, 84.8% were defined absolutely successful. Only two of our 72 patients having sinus lift operations could not finally be treated with dental implants. These results are comparable to other studies considering the sinus graft to be a safe treatment modality with few complications [6, 8, 51,52,53]. Raghoebar et al. reported incidences of sinus co...

Discussion : Autogenous bone grafts in oral implan...

Postoperative morbidity after mandibular bone harvesting procedures was reported to be mainly related to temporary or permanent neural disturbances involving the inferior alveolar nerve and its branches [19]. In this study, only the incidence of the temporary hypoesthesia of the mandibular and lingual nerve after harvesting from the retromolar area could be detected. It was 10.4 and 2.8%, respecti...

Discussion : Autogenous bone grafts in oral implan...

Systematic reviews have failed to find evidence that one particular grafting technique is superior to others [10]. Intraoral bone grafts from the mandibular symphysis, mandibular ramus, and maxillary tuberosity provide a good treatment modality for ridge augmentation, and the amount of bone available for harvesting is sufficient for defects up to the width of three teeth [42]. Harvesting of retrom...

Discussion : Autogenous bone grafts in oral implan...

Several grafting procedures have been described to create sufficient volume of bone for implant placement [8, 9]. Autologous bone grafts can be harvested by an intraoral approach (mandibular ramus, mandibular symphysis, zygomatic buttress) or from distant sites (iliac crest, calvaria, and etc.) [17, 36, 37]. However, bone harvesting potentially causes donor site morbidity which is a major issue fo...

Results : Autogenous bone grafts in oral implantol...

The surgical outcome after augmentation and implantation procedures is presented in Fig. 5.

Results : Autogenous bone grafts in oral implantol...

The average healing period until implant placement after bone harvesting was 4.53 months. Initially, 546 implants in 279 patients were planned. After the healing period, it was possible to place 525 implants in 436 successfully augmented areas in 259 patients. Three hundred implants were inserted in the maxilla and 225 in the mandible. The remaining 21 implants planned for 20 patients could not b...

Results : Autogenous bone grafts in oral implantol...

Regarding intraoperative complications, all sinus membrane perforations were covered with a resorbable collagen membrane (Bio-Gide®, Geistlich Biomaterials, Baden-Baden, Germany) which applied as sealant to overlap the site of perforation prior to insertion of the graft material. These patients were advised to avoid physical stress, blowing their noses, or sneezing for a period of 3 weeks, and n...

Results : Autogenous bone grafts in oral implantol...

No permanent damage to any trigeminal nerves was evident in any of our entire cohort. All cases of postoperative hypoesthesia of the mental, lingual, or infraorbital nerve were just a temporary nature. At the time of implant surgery, none of these patients reported any persisting neural disturbances (Fig. 4). In eleven patients, hypoesthesia of the mental area was mentioned, and three of them al...

Results : Autogenous bone grafts in oral implantol...

Thirty-eight patients underwent a total of 116 augmentation procedures harvesting from the iliac crest. In 20 patients, a bone graft augmentation of the maxilla and the mandible in combination with bilateral sinus floor augmentations was performed. Eighteen patients had augmentations only in the maxilla, involving bone grafting and sinus lift elevations. Totally, 76 sinus lifts with bone material ...

Results : Autogenous bone grafts in oral implantol...

A total of 104 retromolar bone graft procedures in 86 patients were conducted. Twenty-two harvesting procedures were performed for augmentation of the maxilla and 82 for the mandible. Seven retromolar bone grafts (93.2%) in seven single-tooth gap dental regions by seven patients had been lost. Therefore, seven implants could not be inserted in augmented alveolar sites after graft failure. Three of...

Results : Autogenous bone grafts in oral implantol...

In six patients, a partial graft resorption was detected at the time of implantation and an additional simultaneous augmentation with bone chips harvested with the Safescraper device (C.G.M. S.p.A., Divisione Medicale META, Italy) was then necessary in order to ensure the osseointegration of the implants. Two out of these six cases had grafts from the crista zygomatico-alveolaris, two from the ram...

Results : Autogenous bone grafts in oral implantol...

A total of 112 sinus floor elevations were performed. In all of the cases, implants were inserted in a two-stage procedure. The donor site for harvesting the bone for the sinus elevations was in 76 procedures in the iliac crest area, and in 36 procedures, the bone was harvested with a bone scraper device from the lateral sinus wall at the site of sinus lifting. The distribution and number of tran...

Results : Autogenous bone grafts in oral implantol...

Two hundred seventy-nine patients—250 men and 29 women—underwent 456 augmentation procedures involving autologous bone grafts prior to implant placement. The patients ranged in age from 18.5 to 71.5 years (average 43.1 years) at the moment of augmentation surgery. Of those patients, 162 (58.1%) were younger than 40 years of age and 117 (41.9%) were older than 40 years of age. Caries or pe...

Methods : Autogenous bone grafts in oral implantol...

Early and late implant loss was documented in this study, defining the clinical success of osseointegration. Early implant failures were assessed before the acquisition of osseointegration, i.e., before the placement of prosthodontic restorations. Early implant failure could occur from the time of placement, during the healing phase and before abutment connection. The implant inserted after re-aug...

Methods : Autogenous bone grafts in oral implantol...

Medical history of patient Age of patient at the time of bone harvesting and augmentation History of periodontal disease Smoking habits Donor site Jaw area and dental situation of the recipient site Intraoperative complications Postoperative complications after augmentation Management of complications Bone graft stability and clinical resorption prior to implant placement Complications a...

Methods : Autogenous bone grafts in oral implantol...

In addition to the bone already gained with the bone scraper device from the sinus wall during the antrostomy, bone was harvested with the same device from the maxillary buccal buttress, if more volume was needed. By taking this approach, the collection of enough bone for the augmentation of at least two implantation sites was feasible with a mean surgical time of 5 to 10 min for harvesting. In c...

Methods : Autogenous bone grafts in oral implantol...

Grafting from the iliac crest was always performed under general anesthesia in a two-team approach. The iliac crest was exposed and autogenous grafts from the anterosuperior inner edge of the iliac wing were harvested with an oscillating saw and/or a chisel, keeping a safe distance of around 2 cm from the anterosuperior iliac spine. After harvesting the bone grafts, the corticocancellous bone blo...

Methods : Autogenous bone grafts in oral implantol...

A standardized two-stage surgical protocol was used, and all sites were treated in a similar fashion. In the first intervention, a bone block harvested from the donor site was fixed with osteosynthesis titanium screws to the recipient site as an onlay graft to achieve a horizontal and/or vertical enlargement of the alveolar ridge. Placement of the bone graft was always guided by an augmentation te...

Methods : Autogenous bone grafts in oral implantol...

For this retrospective cohort study, we reviewed the records of all patients without exclusion criteria who were referred to the department of oral and plastic maxillofacial surgery at the military hospital of Ulm, Germany, between January 2009 and December 2011 for alveolar ridge augmentations prior to implant insertions using autologous bone grafts harvested from different donor sites and unilat...

Background : Autogenous bone grafts in oral implan...

In our military outpatient center exclusively, autologous bone transplantations harvested from different donor sites were used intraorally (crista zygomatico-alveolaris, ramus mandible, symphysis mandible, anterior sinus wall) and extraorally (iliac crest) to reconstruct severe horizontal and/or vertical alveolar ridge atrophy prior to implant placement. The aim of this study was to assess the cli...

Background : Autogenous bone grafts in oral implan...

Although the iliac crest is most often used in jaw reconstruction, a significant bone resorption has been mentioned [12]. This disadvantage, and the fact that dental implants do not always require a large amount of bone, has increased the use of autologous block bone grafts from intraoral sources [13]. Bone grafts from intraoral donor sites offer several benefits like surgical accessibility, proxi...

Background : Autogenous bone grafts in oral implan...

Oral implantation has a significant role in the rehabilitation of patients. Bone reconstruction techniques have been advanced in order to optimize the esthetic and functional outcome. However, the restoration of the oral function of atrophic alveolar crests still remains a challenge in oral implantology. Bone augmentation procedures are often indicated to allow implant placement in an optimal thre...

Abstract : Autogenous bone grafts in oral implanto...

This review demonstrates the predictability of autologous bone material in alveolar ridge reconstructions prior to implant insertion, independent from donor and recipient site including even autologous bone chips for sinus elevation. Due to the low harvesting morbidity of autologous bone grafts, the clinical results of our study indicate that autologous bone grafts still remain the “gold standar...

Abstract : Autogenous bone grafts in oral implanto...

This study assessed the clinical outcomes of graft success rate and early implant survival rate after preprosthetic alveolar ridge reconstruction with autologous bone grafts. A consecutive retrospective study was conducted on all patients who were treated at the military outpatient clinic of the Department of Oral and Plastic Maxillofacial Surgery at the military hospital in Ulm (Germany) in the ...

Fig. 5. Bone resorption in the follow-up of the co...

Fig. 5. Bone resorption in the follow-up of the control group and the perforation group Fig. 5. Bone resorption in the follow-up of the control group and the perforation group

Fig. 4. The initial bone level of the control grou...

Fig. 4. The initial bone level of the control group and the perforation group Fig. 4. The initial bone level of the control group and the perforation group

Fig. 3. Reasons for perforations : Impact of surgi...

Fig. 3. Reasons for perforations Fig. 3. Reasons for perforations

Fig. 2. Overview of the perforation treatment in t...

Fig. 2. Overview of the perforation treatment in the study group Fig. 2. Overview of the perforation treatment in the study group

Fig. 1. Bone levels after sinus floor elevation : ...

Fig. 1. Bone levels after sinus floor elevation Fig. 1. Bone levels after sinus floor elevation

Table 6 Fisher’s exact test: incidence of peri-i...

  Peri-implantitis No peri-implantitis Perforation group 12 80 Control group ...

Table 5 Fisher’s exact test: surgical strategy d...

  One-stage procedure Two-stage procedure Perforation group 11 81 Control group ...

Table 4 Multiple comparisons of subgroups: postope...

Adjusted p values multiple comparison Control group bone level  4 mm 0.0453 Control group bone level > ...

Table 3 Data summary of bone level development : I...

  Bone level preoperatively Bone level postoperatively Bone level follow-up Bone resorption Perforation group ...

Table 2 Origin of bone graft : Impact of surgical ...

Origin of bone graft No bone graft Linea obliqua Iliac crest Scapula flap Perforation...

Table 1 Distribution of implant positions : Impact...

Implant position 3 4 5 6 7 8...

About this article : Impact of surgical management...

Beck-Broichsitter, B.E., Westhoff, D., Behrens, E. et al. Impact of surgical management in cases of intraoperative membrane perforation during a sinus lift procedure: a follow-up on bone graft stability and implant success. Int J Implant Dent 4, 6 (2018). https://doi.org/10.1186/s40729-018-0116-8 Download citation Received: 03 October 2017 Accepted: 03 January 2018 Publish...

Rights and permissions : Impact of surgical manage...

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...

Ethics declarations : Impact of surgical managemen...

The authors Benedicta Beck-Broichsitter, Dorothea Westhoff, Eleonore Behrens, Jörg Wiltfang, and Stephan T. Becker declare that there are no existing competing interests concerning this collaborative work. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Author information : Impact of surgical management...

Correspondence to Benedicta E. Beck-Broichsitter.

Author information : Impact of surgical management...

Department of Oral and Maxillofacial Surgery, Charité–University Medical Center Berlin, Augustenburger Platz 1, 13353, Berlin, Germany Benedicta E. Beck-Broichsitter Department of Oral and Maxillofacial Surgery, Schleswig-Holstein University Hospital, Arnold-Heller-Straße 3, Haus 26, 24105, Kiel, Germany Dorothea Westhoff, Eleonore Behrens, Jörg Wiltfang & Stephan T. Becker You can al...

Funding : Impact of surgical management in cases o...

This study was not funded.

References : Impact of surgical management in case...

Shlomi B, Horowitz I, Kahn A, Dobriyan A, Chaushu G. The effect of sinus membrane perforation and repair with Lambone on the outcome of maxillary sinus floor augmentation: a radiographic assessment. Int J Oral Maxillofac Implants. 2004;19(4):559–62. Moreno Vazquez JC, Gonzalez de Rivera AS, Gil HS, Mifsut RS. Complication rate in 200 consecutive sinus lift procedures: guidelines for prevention ...

References : Impact of surgical management in case...

Sakkas A, Konstantinidis I, Winter K, Schramm A, Wilde F. Effect of Schneiderian membrane perforation on sinus lift graft outcome using two different donor sites: a retrospective study of 105 maxillary sinus elevation procedures. GMS Interdiscip Plast Reconstr Surg DGPW. 2016;5:Doc11. Springer IN, Terheyden H, Geiss S, Harle F, Hedderich J, Acil Y. Particulated bone grafts—effectiveness of bone...

References : Impact of surgical management in case...

Wiltfang J, Schultze-Mosgau S, Nkenke E, Thorwarth M, Neukam FW, Schlegel KA. Onlay augmentation versus sinuslift procedure in the treatment of the severely resorbed maxilla: a 5-year comparative longitudinal study. Int J Oral Maxillofac Surg. 2005;34(8):885–9. Pikos MA. Maxillary sinus membrane repair: report of a technique for large perforations. Implant Dent. 1999;8(1):29–34. Cha HS, Kim ...

Conclusions : Impact of surgical management in cas...

In conclusion, and within the limits of its retrospective nature, our study implies that in cases of intraoperative perforation of the Schneiderian membrane, a consequent surgical assessment and treatment might avoid complications regarding graft stability and implant survival. Two-stage procedures might be appropriate if primary stability does not seem to be achievable. Augmentation of the sinus ...

Discussion : Impact of surgical management in case...

The surgical management in cases of a membrane perforation might also influence the overall postoperative outcome and complications. Although the sinus lifting procedure has been established for many years now, there are no evidence-based guidelines for perforation closure or indications to interrupt the procedure. To date, most existing studies recommend sealing smaller sizes of perforations with...

Discussion : Impact of surgical management in case...

One implant was lost in the perforation group due to early-onset peri-implantitis, whereas all implants in the control group were still in place. As we had previously prospectively reported on the first 6 months after dental implantation in this cohort [11], there was no further impact of membrane perforation on implant loss for at least 12 to 24 months in this retrospective evaluation. The appe...

Discussion : Impact of surgical management in case...

The aim of this retrospective cohort study was to evaluate the impact of intraoperative perforations of the Schneiderian membrane during sinus floor elevation on the stability of the augmented area and its influence on osseointegration after implant insertion. Therefore, we could re-assess a patient cohort of originally 34 patients with 41 perforations and compare their outcome with a control grou...

Results : Impact of surgical management in cases o...

The initial bone level differed significantly (p = 0.05) between both groups with a median value of 5.69 mm in the study group and 3.87 mm in the control group (Fig. 4). A Mann-Whitney-U-Wilcoxon test revealed no significant difference between bone level postoperatively (p = 0.7851; median value control group 17.40 mm; median value perforation group 16.91 mm), in follow-up (p = 0....

Results : Impact of surgical management in cases o...

The mean control interval was 2.69 (± 2.03) years. At the time of the follow-up examination, the average age was 59.95 (± 11.82) years. In the remaining collective of 31 patients (96.97%; 12 males (37.54%) and 19 females (59.43%)), a total of 92 implants were inserted. The overview of perforation treatment in the study group is given in Fig. 2, and Fig. 3 depicts the reasons for perforati...

Methods : Impact of surgical management in cases o...

One independent oral and maxillofacial surgeon performed the clinical follow-up examinations according to a standardized protocol. A peri-implant probing including probing pocket depths and recessions on four sites of each implant was assessed as was bleeding on probing (BOP) to determine the status of oral hygiene objectively. Signs of gingivitis and pus suppuration were also recorded. The criter...

Methods : Impact of surgical management in cases o...

Three different oral and maxillofacial surgeons performed the sinus lift procedure with an external approach according to comparable surgical standards and inserted all implants examined in this study in a submerged protocol with uncovering after 3–4 months due to the manufacturer’s surgical recommendations. Specifically, a total of 35 external sinus floor elevations were performed through a ...

Methods : Impact of surgical management in cases o...

In accordance with the WMA Declaration of Helsinki—Ethical Principles for Medical Research Involving Human Subjects, approval was given by the local ethics committee of the Christian-Albrechts-University in Kiel (AZ 132/10). All patients gave informed written consent to participate. A total of 201 sinus floor elevation procedures, which were performed from 2005 to 2006 in the Department of Oral...

Background : Impact of surgical management in case...

Sinus floor elevation procedures have become a predictable and successful treatment, performed when the maxillary alveolar ridge is atrophied and the bone height is not sufficient for primary implantation. If the postoperative course remains uneventful, the outcome is highly predictable [1,2,3]. However, complications may have a negative impact on the overall treatment success. As a common complic...

Abstract : Impact of surgical management in cases ...

Until now, sinus floor elevation represents the gold standard procedure in the atrophic maxilla in order to facilitate dental implant insertion. Although the procedure remains highly predictive, the perforation of the Schneiderian membrane might compromise the stability of the augmented bone and implant success due to chronic sinus infection. The aim of this retrospective cohort study was to show ...

Fig. 1. Treatment strategies for OAF closure : Sur...

Fig. 1. Treatment strategies for OAF closure Fig. 1. Treatment strategies for OAF closure

Table 1 Studies on surgical techniques for closure...

Author year No. of participants Method Autogenous soft tissue flaps  Lin et al. 1991 16 ...

About this article : Surgical options in oroantral...

Parvini, P., Obreja, K., Sader, R. et al. Surgical options in oroantral fistula management: a narrative review. Int J Implant Dent 4, 40 (2018). https://doi.org/10.1186/s40729-018-0152-4 Download citation Received: 14 August 2018 Accepted: 02 November 2018 Published: 27 December 2018 DOI: https://doi.org/10.1186/s40729-018-0152-4

Rights and permissions : Surgical options in oroan...

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...

Ethics declarations : Surgical options in oroantra...

Not applicable. Not applicable. Puria Parvini, Karina Obreja, Robert Sader, Jürgen Becker, Frank Schwarz, and Loutfi Salti declare that they have no competing interests. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Author information : Surgical options in oroantral...

Correspondence to Karina Obreja.

Author information : Surgical options in oroantral...

Department of Oral Surgery and Implantology, Carolinum, Johann Wolfgang Goethe-University, Frankfurt, Germany Puria Parvini, Karina Obreja, Frank Schwarz & Loutfi Salti Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of the Goethe University Frankfurt, Frankfurt am Main, Germany Robert Sader Department of Oral Surgery, Universitätsklinikum Düsseldorf,...

Acknowledgements : Surgical options in oroantral f...

Not applicable No funding to declare. All data generated or analyzed during this study are included in this published article.

References : Surgical options in oroantral fistula...

Waldrop TC, Semba SE. Closure of oroantral communication using guided tissue regeneration and an absorbable gelatin membrane. J Periodontol. 1993;64:1061–6. Götzfried HF, Kaduk B. Okklusion der Mund-Antrum-Verbindung durch eine: alkoholische Prolaminelösung; Tierexperimentelle Studie und erste klinische Erfahrungen. Dtsch Z Mund Kiefer Gesichts Chir. 1985;9:390. Grzesiak-Janas G, Janas A. Co...

References : Surgical options in oroantral fistula...

Shaker MA, Hindy AM, Mounir RM, Geaisa KM. Competent closure of chronic oroantral fistula with Zenoderm. Egypt Dent J. 1995;41:1237–42. Ogunsalu C. A new surgical management for oro-antral communication: the resorbable guided tissue regeneration membrane—bone substitute sandwich technique. West Indian Med J. 2005;54:261–3. Goldman EH, Stratigos GT, Arthur AL. Treatment of oroantral fistula...

References : Surgical options in oroantral fistula...

Joshi A, Kostakis GC. An investigation of post-operative morbidity following iliac crest graft harvesting. Br Dent J. 2004;196:167–71. Misch CM. Harvesting of ramus bone in conjunction with third molar removal for onlay grafting before placement of dental implants. J Oral Maxillofac Surg. 1999;57:1376–9. Nkenke E, Radespiel-Tröger M, Wiltfang J, Schultze-Mosgau S, Winkler G, Neukam FW. Morb...

References : Surgical options in oroantral fistula...

El-Hakim IE, El-Fakharany AM. The use of the pedicled buccal fat pad (BFP) and palatal rotating flaps in closure of oroantral communication and palatal defects. J Laryngol Otol. 1999;113:834–8. Singh J, Prasad K, Lalitha RM, Ranganath K. Buccal pad of fat and its applications in oral and maxillofacial surgery: a review of published literature (February) 2004 to (July) 2009. Oral Surg Oral Med O...

References : Surgical options in oroantral fistula...

Awang MN. Closure of oroantral fistula. Int J Oral Maxillofac Surg. 1988;17:110–5. Hynes W. Fistula in the hard palate following cleft surgery. Br J Plast Surg. 1957:377–84. Genden EM, Lee BB, Urken ML. The palatal island flap for reconstruction of palatal and retromolar trigone defects revisited. Arch Otolaryngol Head Neck Surg. 2001;127(7):837–41. Salins PC, Kishore SK. Anteriorly based...

References : Surgical options in oroantral fistula...

Yilmaz T, Suslu AE, Gursel B. Treatment of oroantral fistula: experience with 27 cases. Am J Otolaryngol. 2003;24:221–3. Borgonovo AE, Berardinelli FV, Favale M, Maiorana C. Surgical options in oroantral fistula treatment. Open Dent J. 2012;6:94–8. Güven O. A clinical study on oroantral fistulae. J Craniomaxillofac Surg. 1998;26:267–71. Amaratunga NADES. Oro-antral fistulae- a study of c...

Abbreviations : Surgical options in oroantral fist...

Buccal fat pad Bone graft transplantation Connective tissue grafts Free mucosal graft Guided tissue regeneration Oroantral fistula Platelet-rich fibrin

Summary and conclusion : Surgical options in oroan...

By reviewing the literature, we can conclude that in selecting the surgical approach to close an oroantral fistula, different parameters have to be taken into account, including location and size of fistula as well as its relationship to the adjacent teeth, height of the alveolar ridge, persistence, sinus inflammation and the general health of the patient. A small oroantral fistula of less than 5...

Materials and methods : Surgical options in oroant...

Logan and Coates described a procedure that provided closure of OAF in immunocompromised patients [74]. The oroantral fistula was de-epithelialized under local anesthesia, and the patient wore an acrylic surgical splint continuously for an 8-week period. The acrylic surgical splint covered the fistula and the edentulous area including the hard palate. The investigators reported complete healing o...

Materials and methods : Surgical options in oroant...

Use of guided tissue regeneration has been documented by Waldrop and Semba [71]. This method uses an absorbable gelatin membrane, allogenic bone graft material, and a nonresorbable expanded polytetrafluoroethylene (ePTFE) membrane. After flap reflection, an absorbable gelatin membrane is placed over the OAF with its edges on the bony margins of the perforation, which serve as a barrier for the bon...

Materials and methods : Surgical options in oroant...

The use of a bioabsorbable root analog made of β-tricalcium phosphate for closure of oroantral fistulas was proposed by Thoma et al. [68]. The root replicas were fabricated chair side, using a mold of the extracted tooth [10]. The investigators reported that the healing was uneventful. However, fragmentary roots or overly large defects prevent replica fabrication or accurate fitting of the analog...

Materials and methods : Surgical options in oroant...

Polymethylmethacrylate has been introduced as an alternative technique for closing OAFs [64]. After 24 h of immersion in a sterilizing solution, the polymethylmethacrylate plate is placed over the defect. Mucoperiosteal flaps are then replaced without attempting to cover the acrylic plate. The polymethylmethacrylate plate is removed as soon as the edges become exposed. One of the common disadvant...

Materials and methods : Surgical options in oroant...

Various synthetic materials have been used for OAF closures. Use of gold foil and gold plate for the closure of OAFs was reported for the first time by Goldman and Salman, respectively [59, 60]. It is a simplified technique for the closure of oroantral fistulas. The technique consists of elevating the mucoperiosteum to expose the bony margins of the fistula. Then, the opening is covered with an ov...

Materials and methods : Surgical options in oroant...

Multiple techniques have been described for the closure of OAFs using lyophilized fibrin glue of human origin [53]. In this technique, the fibrin glue is prepared and injected into the socket, together with the collagen sheet. Stajčić et al. stressed the importance of inserting the syringe above the floor of the antrum to protect the clot from airflow [53]. The technique is simple with few posto...

Materials and methods : Surgical options in oroant...

An autogenous bone graft and platelet-rich fibrin (PRF) membrane as a treatment strategy for closure of OAF has also been proposed [50]. PRF is a product of centrifuged blood. The biochemical components of PRF are well-known as factors acting synergistically in the healing process. This includes platelet-derived growth factor (PDGF), whose components are the reason why PRF has anti-inflammatory pr...

Materials and methods : Surgical options in oroant...

Recently, auricular cartilage graft has been used for the closure of OAFs. A full-thickness flap is raised at the defect site [47]. A semicircular incision is then made posteriorly over the conchal cartilage. The conchal cartilage with overlying perichondrium is exposed with a blunt dissection. The harvested auricular graft is then adapted on the defect site and sutured with the surrounding tissue...

Materials and methods : Surgical options in oroant...

A retromolar bone graft is a viable procedure for OAF closure. However, harvesting of a retromolar bone can occasionally be combined with removal of the third molar, which may affect acceptance of the procedure by patients [44]. When compared to chin bone grafts, the significant disadvantage of the retromolar donor area is the confined amount of bone available [45]. The incision is made medial to ...

Materials and methods : Surgical options in oroant...

The tongue is an excellent donor site for soft tissue defects of the oral cavity, due to its pliability, position, and abundant vascularity. Tongue flaps can be created from the ventral, dorsal, or lateral part of the tongue [36]. The surgical design of the flap is dictated by the location of the defect. A lateral tongue flap has been described as a suitable method for the closure of large OAF [37...

Materials and methods : Surgical options in oroant...

Free mucosal grafts (FMG) or connective tissue grafts (CTG) are suitable for the closure of small to moderate size defects in the premolar area as well as small to medium size-persistent defects. In contrast to the techniques described so far, the harvested grafts are not directly vascularized. The flap initially receives its nutrients within the first three postoperative days by diffusion alone, ...

Materials and methods : Surgical options in oroant...

The palatal straight advancement flap is of limited use due to the inelastic nature of the palatal tissue, which reduces its lateral mobility. For the same reason, it is suitable for the closure of minor palatal or alveolar defects [17]. The palatal hinged flap has been used successfully to close small fistula of the hard palate, i.e., those less than 2 cm in diameter in a one-stage operation [1...

Materials and methods : Surgical options in oroant...

Môczáir [14] described closing alveolar fistulas by the buccal sliding flap, shifting the flap one tooth distally. This technique produces only a negligible change in the depth of the buccal vestibule. A drawback of this approach is that it requires a large amount of dentogingival detachment in order to facilitate the shift, which may result in gingival recession and periodontal disease. The fi...

Materials and methods : Surgical options in oroant...

A narrative literature review of articles and case reports for oroantral fistula has been conducted in the PubMed databases of published English literature. Articles published until April 2018 were reviewed. In addition to 262 articles on the closure of oroantral, 4 articles on the closure of antrooral fistula in humans, and 5 articles in animals, citations were referenced to identify further rele...

Background : Surgical options in oroantral fistula...

Radiologically, in the computed tomography (CT) or cone beam computed tomography (CBCT), the oroantral fistula might show as sinus floor discontinuity, opacification of the sinus, or communication between the oral cavity and the sinus. In addition, focal alveolar atrophy and associated periodontal disease may be observed [6]. In chronic OAF, there is generalized mucosal thickening. Recent studies ...

Background : Surgical options in oroantral fistula...

An oroantral fistula (OAF) can be defined as an epithelialized pathological unnatural communication between the oral cavity and the maxillary sinus [1]. The term oroantral fistula is used to indicate a canal lined by epithelium that may be filled with granulation tissue or polyposis of the sinus membrane [2]. They can arise as late sequelae from perforation and last at least 48–72 h. An oroantr...

Figure 9. Do you have any requests for dentists wh...

Figure 9. Do you have any requests for dentists who practice implant treatment?

Figure 8. What are the frequently received repair ...

Figure 8. What are the frequently received repair requests for IODs?

Figure 7. Creative steps to prevent veneer fractur...

  Figure 7. Creative steps to prevent veneer fracture and chipping in the molar region

Figure 6. the frequently received repair requests ...

Figure 6. the frequently received repair requests involving implant fixed prostheses

Figure 5. The main fabrication challenges faced

Figure 5. The main fabrication challenges faced

Figure 4. The proportions of attachment types used...

Figure 4. The proportions of attachment types used with IODs

Figure 3. Types of implant fixed prostheses are us...

Figure 3. Types of implant fixed prostheses are used in the posterior region

Figure 2. Types of materials used to make implant ...

Figure 2. Types of materials used to make implant prostheses in the anterior region

Figure 1. The proportions of abutments used with c...

Figure 1. The proportions of abutments used with cement-retained prostheses    

Conclusions: Current status of implant prosthetics...

  This survey served to clarify the current status of implant prosthodontics, issues, and considerations in their fabrication, and the status of prosthetic complications and preventive initiatives, all from a laboratory perspective. Concerning implant treatment, it was concluded that dentists either play the leading role or work in collaboration with technicians, inc...

Result & discussion: Current status of implant pro...

While the literature includes reports of frequent IOD-related prosthetic complications such as attachment-related compromised retention, detachment or fracturing of denture teeth, relining, and attachment damage, this survey showed a somewhat different trend. It can be inferred that these results differ from actual complication trends because they constitute responses to cases sent to ...

Result & discussion: Current status of implant pro...

The questionnaire revealed several creative steps, based on laboratory considerations, being taken to prevent veneer chipping and fractures, a frequent and problematic prosthetic complication (Q12) (Figure 7). Technicians were taking into account metal (including zirconia) coping designs (36.3%), covering only the distal-most part of the molar region with metal (24%), using veneering composi...

Result & discussion: Current status of implant pro...

Looking at repair requests (i.e., complications) involving the superstructures of fixed implant prostheses (Q11) (Figure 6), facing damage and chipping accounted for more than half of all requests (54.5%). Generally speaking, there are many reports that indicate a high incidence of complications related to fixed prostheses involving abutment screw loosening, detachment of cement-retained cro...

Result & discussion: Current status of implant pro...

This number was lower than in any of the other nine countries, and future changes in IOD use in Japan are a topic that remains interesting. 4. Prosthetic complications (Table 4) According to Papaspyridakos et al., indicators such as implant level (the relationship between the implant and bone) and the state of soft tissue around the implant are the most frequently used indices of implant s...

Result & discussion: Current status of implant pro...

There is also a greater possibility of direct (in-mouth) repair of failed veneering materials and greater shock-absorbing potential relative to occlusal force in comparison with porcelain. The trend to adhere resin materials instead of porcelain, from Brånemark and colleagues’ recommendations for acrylic resin as an occlusal surface material in the early 1980s, also cannot be ignored. All...

Result & discussion: Current status of implant pro...

There is a low risk of facing damage and chipping for prostheses in the anterior region. Nonetheless, the questionnaire revealed the unexpected result that indirect composite facing crowns accounted for 21.3% of the total. This may be because there are many indirect composite resins (Estenia, Ceramage, etc.) available in Japan, and crowns and bridges in the anterior region (natural abutment ...

Result & discussion: Current status of implant pro...

Our questionnaire indicated a distribution of 61.4% cement-retained versus 38.6% screw-retained prostheses (Q3), suggesting that cement retention is used more frequently in Japan. Unfortunately, the fabrication-oriented focus of this survey prevented clarification of the types of cement used for cement retention and the breakdown between provisional and definitive cement. Next, ...

Result & discussion: Current status of implant pro...

Dentists play a leading role in 39.3% of the time in implant treatment planning and prosthetic design, and dental technicians are consulted concerning cases and part usage 34.7% of the time, suggesting the approach to implants is driven by prosthetic considerations (by dentists) to some degree. However, because dental technicians indicated that they take the initiative 15% of the time, it is...

Result & discussion: Current status of implant pro...

Results and discussion Out of 120 surveys sent, 74 technicians responded, resulting in a response rate of 61.6%. A summary of the responses is provided in Tables 1, 2, 3, dan 4 dan Gambar 1, 2, 3, 4, 5, 6, 7, 8, dan 9. Because implant treatment (implant prostheses) requires a significant amount of specialized, high-precision laboratory procedures, this area of dental care exhibits slight...

Table 4 Prosthetic complications

Question   Values Q9. What are the main issues generally encountered? Compatibility precision issues 29.6% Aesthetic issues 33.2% Occlusal issues 37.2% Q10. What are the main fabrication challenges faced? Poor implant location and orientation 42.4% Inadequate consideration of occlusion 17.0% Defects and inaccuracies in impression and bite registrat...

Table 3 Implant overdentures (IODs)

Question   Values Q7. The design of the implant overdenture: Decision made according to instructions of dentist 43.2% Work is left to technicians 19.3% Decided upon through consultation with each other 37.5% Q8. What are the proportions of attachment types used with IODs? Bar and clip 35.6% Magnet 30.2% Ball and socket 19.0% Locator 5.2% ...

Table 2 Implant fixed prostheses

Question   Values Q3. The percentages of implant fixed prostheses: Cement-retained 61.4% Screw-retained 38.6% Q4. What are the proportions of abutments used with cement-retained prostheses? CAD/CAM (titanium) 19.7% CAD/CAM (zirconia) 12.1% Custom abutments (UCLA-type abutment + gold alloy) 33.2% Two-piece-type titanium (prepable type) 28.3% ...

Table 1 Conditions characterizing implant laborato...

Question   Values Q1. The years of experience working as a dental technician, and the number of dentists from whom job orders are received.   Mean (SD) 17.0 (6.8) years 36.5(12.4)/Lab. Q2. Who takes the leading role in treatment planning and prosthetic design (initiative with regard to prostheses)? Dentists mainly exercise initiative 39.3% Technicians mai...

Methods : Current status of implant prosthetics in...

Methods This cross-sectional questionnaire survey was performed among the certified dental technicians of JSOI from September to December in 2011. Selected were 120 out of 285 certified dental technicians of JSOI using a random number table and mailing each questionnaire directly to the participant. To facilitate coverage of a broad range of topics, the survey classified content into the follow...

Background : Current status of implant prosthetics...

However, because understanding the status of these complications is based on the results of surveys targeting dentists, information is needed on the situation as seen from the standpoint of implant technicians, to clarify the causes of these complications and the techniques for dealing with them. Issues including inadequate communication between dental technicians and dentists and insufficient ins...

Background : Current status of implant prosthetics...

Background Currently, dental implant treatment is evaluated on the basis not only of restoring masticatory function, but also a variety of other factors, including the implant and superstructure survival rate and psychological impacts. Numerous factors must be taken into account, to offer highly predictable implant treatment, and there is no doubt that prosthetic-related factors such as the typ...

Current status of implant prosthetics in Japan

Abstract Background There are many implant cases in which dental technicians take initiative with regard to the design of implant prostheses, and to a certain extent, this area of care is one in which dentists do not necessarily play the leading role. Moreover, inadequate communication between dental technicians and dentists and insufficient instructions for technicians has been highlighte...