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Fig. 8. Photomicrographs of decalcified sections. ...

Fig. 8. Photomicrographs of decalcified sections. a Untreated site. Woven bone formed from the sinus walls after 1 week of healing. b Treated site. After 8 weeks, woven bone was still found forming ridges towards residues of provisional matrix, showing that the healing was not completed yet. Scarlet-acid fuchsine and toluidine blue stain. a × 100 magnification. b × 20 magnification ...

Fig. 7. Box-plot representing the new bone percent...

Fig. 7. Box-plot representing the new bone percentage and standard deviations (whiskers) found in the various regions evaluated after 8 weeks of healing. (*), a statistical significant difference Fig. 7. Box-plot representing the new bone percentage and standard deviations (whiskers) found in the various regions evaluated after 8 weeks of healing. (*), a statistical significant difference

Fig. 6. Photomicrographs of decalcified sections i...

Fig. 6. Photomicrographs of decalcified sections illustrating the healing after 8 weeks. a Treated site. Most of the antrostomies presented remaining defects in the outer contour. b, c Untreated sites. Two antrostomies of the treated sites and four of the untreated sites appeared not closed with corticalized bone and presented connective tissue interposed between the edges of the antrostomy. S...

Fig. 5. Photomicrographs of decalcified sections i...

Fig. 5. Photomicrographs of decalcified sections illustrating the healing after 8 weeks. Both at the treated (a) and untreated (b) sites, the antrostomy was closed in most cases, presenting residual defects of various dimensions in the outer side. New bone was connecting the lateral and medial sinus walls. The middle and sub-mucosa regions were not healed completely yet. Scarlet-acid fuchsine ...

Fig. 4. Photomicrographs of ground sections. a) Tr...

Fig. 4. Photomicrographs of ground sections. a) Treated site. Bone residues (examples in yellow asterisks) included in soft tissue containing fibroblast-like cells and inflammatory cells. b) Untreated site. Xenograft residues (examples in red asterisks) surrounded by soft tissue rich in fibroblast-like cells. Scarlet-acid fuchsine and toluidine blue stain. a) 200 x magnification.; b) 100 x magni...

Fig. 3. Photomicrographs of decalcified sections i...

Fig. 3. Photomicrographs of decalcified sections illustrating the healing after 1 week. a Treated site. Bone strips occupying the antrostomy and the subjacent area (close-to-window region). b Untreated site. Note the new bone-forming from the sinus bone walls. Scarlet-acid fuchsine and toluidine blue stain. Images grabbed at × 20 magnification Fig. 3. Photomicrographs of decalcified sect...

Fig. 2. The various regions evaluated at the histo...

Fig. 2. The various regions evaluated at the histomorphometric analyses. Bone walls (red arrow); middle (white arrow); sub-mucosa (yellow arrow); close-to-window (orange arrow). The antrostomy region was also evaluated at the medial and lateral edges (dark green arrows) and in the middle aspect (light green arrow) Fig. 2. The various regions evaluated at the histomorphometric analyses. Bone w...

Fig. 1. Clinical view of the surgical procedures. ...

Fig. 1. Clinical view of the surgical procedures. a Tibial bone exposed for autogenous bone harvesting using a bone scraper. b Antrostomies prepared. c Autogenous bone particles placed in the antrostomy. d Xenograft and bone particles (red arrow) at the antrostomies. e Collagen membranes placed on the antrostomies. f Wounds closed with sutures Fig. 1. Clinical view of the surgical procedures....

Table 2 Histomorphometric analysis. Tissues evalua...

  AntrostomySinus regions  EdgesCenterTotalClose-to-windowMiddleSub-mucosaBone wallsTotalNew boneTreated sites40.3 ± 21.337.8 (27.0;56.0)24.3 ± 23.222.0 (3.4;42.2)35.5 ± 20.927.7 (23.3;52.0)25.8* ± 16.122.9 (15.2;39.7)19.5 ± 16.711.7 (10.1;22.3)22.5 ± 11.620.4 (12.6;31.3)38.0 ± 15.044.8 (31.8;47.5)27.9 ± 12.930.1 (19.6;34.5)Untreated sites32.2 ± 22....

Table 1 Histomorphometric analysis. Tissues evalua...

  AntrostomySinus regions  EdgesCenterTotalClose-to-windowMiddleSub-mucosaBone wallsTotalNew boneTreated sites9.2 ± 10.6 4.6 (3.2;12.5)5.2 ± 13.90.0 (0.0;0.5)7.7 ± 11.22.7 (1.9;7.9)0.6 ± 1.00.0 (0.0;0.7)0.0 ± 0.00.0 (0.0;0.0)1.4 ± 1.80.8 (0.0;2.2)7.7 ± 6.38.2 (1.3;11.1)2.8 ± 2.62.2 (0.7;4.0)Untreated sites8.9 ± 8.5 6.2 (4.0;10.8)1.0 ± 2.70.0 (0....

About this article : Influence of the use of autog...

Favero, G., Viña-Almunia, J., Carda, C. et al. Influence of the use of autogenous bone particles to close the access window after maxillary sinus floor augmentation: an experimental study in rabbits. Int J Implant Dent 6, 9 (2020). https://doi.org/10.1186/s40729-020-0206-2 Download citation Received: 20 October 2019 Accepted: 21 January 2020 Published: 04 March 2020 DOI:...

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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...

Additional information : Influence of the use of a...

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Ethics declarations : Influence of the use of auto...

The present research was approved by the Ethics Committee of Valencia University, Spain. Reference number: A1434714637496. Not applicable. Daniele Botticelli declares to be the co-owner of Ariminum Odontologica. Giacomo Favero, Jose Viña-Almunia, Carmen Carda, José Javier Martín de Llano, Berta García-Mira, David Soto-Peñaloza, Daniele Botticelli, and Miguel Peñarrocha-Diago declare that t...

Author information : Influence of the use of autog...

You can also search for this author in PubMed Google Scholar GF participated in the concept/design, data analysis/interpretation, drafting of the article and surgical procedures. JV-A performed the surgical procedures, made the follow up of the animals, participated in the manuscript revision and ethical committee redaction and approval. BG-M and DS-P performed the surgi...

Author information : Influence of the use of autog...

Private practice, London, UK Giacomo Favero Oral Surgery Unit. Department of Stomatology, Faculty of Medicine and Dentistry, Clinica Odontológica, University of Valencia, Valencia, Spain Jose Viña-Almunia, Berta García-Mira, David Soto-Peñaloza & Miguel Peñarrocha-Diago Department of Pathology and Health Research Institute of the Hospital Clínico (INCLIVA), Faculty of Medicine and De...

Funding : Influence of the use of autogenous bone ...

Funds from the present have been provided by ARDEC Academy, by Ariminum Odontologica s.r.l., Rimini, Italy and Tecnoss srl, Giaveno, Italy. The biomaterials use were provided free of charge by Tecnoss srl, Giaveno, Italy.

References : Influence of the use of autogenous bo...

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References : Influence of the use of autogenous bo...

Favero V, Lang NP, Canullo L, Urbizo Velez J, Bengazi F, Botticelli D. Sinus floor elevation outcomes following perforation of the Schneiderian membrane. An experimental study in sheep. Clin Oral Implants Res. 2016;27(2):233–40. Scala A, Lang NP, Velez JU, Favero R, Bengazi F, Botticelli D. Effects of a collagen membrane positioned between augmentation material and the sinus mucosa in the eleva...

References : Influence of the use of autogenous bo...

Kawakami S, Lang NP, Ferri M, Apaza Alccayhuaman KA, Botticelli D. Influence of the height of the antrostomy in sinus floor elevation assessed by cone beam computed tomography- a randomized clinical trial. Int J Oral Maxillofac Implants. 2019;34(1):223–32. Kawakami S, Lang NP, Iida T, Ferri M, Apaza Alccayhuaman KA, Botticelli D. Influence of the position of the antrostomy in sinus floor elevat...

References : Influence of the use of autogenous bo...

Tatum, H., Jr. Maxillary sinus grafting for endosseous implants. Lecture presented at the Annual Meeting of the Alabama Implant Study Group (1977); cited in Smiler, D.G., Johnson, P.W., Lozada, J.L., Misch, C., Rosenlicht, J.L., Tatum, O.H. Jr. & Wagner J.R. Sinus lift grafts and endosseous implants. Treatment of the atrophic posterior maxilla. Dental clinics of North America. 1992;36:151–186. ...

Abbreviations : Influence of the use of autogenous...

Animal Research Reporting In Vivo Experiments Cone beam computed tomography Deproteinized bovine bone mineral Tricalcium phosphate

Availability of data and materials : Influence of ...

The datasets used or analyzed during the current study are available from the corresponding author on reasonable request.

Discussion : Influence of the use of autogenous bo...

The lower phylogenetic level of the animals compared to humans was the main limitation of the present study. An increased number of animals might allow reaching a statistical difference in favor of the treated sites also in the antrostomy region. Nevertheless, the outcomes obtained, allow to performing studies in humans that might demonstrate the advantages of applying autologous bone on the antro...

Discussion : Influence of the use of autogenous bo...

In both studies presented above on sinus floor elevation in sheep, all the lateral windows were prepared using a piezoelectric device. In an experiment in rabbits [21], the antrostomies were done with either a sonic instrument or drills to evaluate differences in bone formation in the antrostomy. Elevated space is filled with a collagenated porcine bone similar that used in the present experiment,...

Discussion : Influence of the use of autogenous bo...

The present experiment aimed to study the influence on the healing after the placement of autogenous bone on the antrostomy and in the subjacent region after maxillary sinus elevation. After 8 weeks of healing, in the antrostomy region, a trend of higher bone formation in the treated compared to the untreated sites was observed. No statistically significant difference was found. In the subjacent ...

Results : Influence of the use of autogenous bone ...

After 1 week of healing (Table 1), in the close-to-window region, the proportions of xenograft were 21.3 ± 14.7% and 55.9 ± 19.0 (p = 0.012) in the treated and untreated sites, respectively. After 8 weeks of healing (Table 2), these values decreased to a similar percentage (15.5 ± 14.4% and to 15.5 ± 14.2%; p = 0.917, respectively). After 1 week of healing (Table...

Results : Influence of the use of autogenous bone ...

Biopsies could be harvested from all animals. However, histological sections could not be obtained from one rabbit of the 8 weeks group; therefore, eight and seven were achieved for the 1-week and 8-week periods, respectively. After 1 week of healing, at the treated sites, the antrostomy and close-to-windows regions were occupied by a high proportion of residues of autogenous bone (Fig. 3a),...

Materials and methods : Influence of the use of au...

Overlapping calibrated digital images of the tissues were recorded with Leica Applications Suite version 4.4.0 software from a bright field Leica DM4000 B microscope (Leica Microsystems GmbH, Wëtzlar, Germany) equipped with a 5× lens and DFC420 digital camera. Single images were pasted and merged to compose each elevated sinus using the program Photoshop (Adobe Photoshop CC 2015.0.0). The histo...

Materials and methods : Influence of the use of au...

Afterward, a trichotomy was performed in the nasal dorsum and, after disinfection of the experimental region using Betadine (MEDA Pharma®, Madrid, Spain), a sagittal incision was carried out. The skin and the periosteum were dissected and shifted laterally to expose the nasal bone. Antrostomies, 4 × 4 mm in dimensions, located about 3–4 mm laterally to the midline and about 10 mm in f...

Materials and methods : Influence of the use of au...

Prior to the experiment, the protocol was approved by the Ethics Committee of Valencia University, Spain (A1434714637496). The guidelines indicated by the Council Directive of the European Union (53/2013; February 1, 2013) for animal experimentation and the ethical rules proposed by Royal Decree 223, March 14 and October 13, 1988, were fulfilled. The study was reported following the ARRIVE guideli...

Introduction : Influence of the use of autogenous ...

Hence, the present experiment aimed to study the influence on healing, of the autogenous bone particle placement in the antrostomy and in the subjacent region after maxillary sinus elevation.

Introduction : Influence of the use of autogenous ...

Maxillary sinus floor elevation through lateral access was first proposed in 1977 [1], while the technique was published in 1984 [2]. Several modifications in the surgical approach and the biomaterials used have been introduced over time [3,4,5]. In a systematic review with meta-analysis, it was concluded that the best survival rate was observed when implants with rough surface and membrane to cov...

Abstract : Influence of the use of autogenous bone...

To study the influence on the healing of the placement of particulate autogenous bone in the antrostomy and in the subjacent region after maxillary sinus elevation. Sixteen New Zealand rabbits were undergone to bilateral maxillary sinus floor augmentation with 4 × 4 mm antrostomy dimension. The sinus mucosa was elevated, and the space obtained was filled with xenograft. In the test site (tr...

Fig. 6. Graph representing new bone and composite ...

Fig. 6. Graph representing new bone and composite bone percentages within the elevated area Fig. 6. Graph representing new bone and composite bone percentages within the elevated area

Fig. 5. Graph representing the tissue percentages ...

Fig. 5. Graph representing the tissue percentages within the elevated area. No statistically significant differences were found Fig. 5. Graph representing the tissue percentages within the elevated area. No statistically significant differences were found

Fig. 4. Photomicrographs of ground sections after ...

Fig. 4. Photomicrographs of ground sections after 4 months of healing. a Bone formed from the base of the sinus. b Bone plate connected by bridges of the new bone to the close-to-window region. c Particle of the graft surrounded by new bone. d Overexposed image to show the new bone ingrowth within the granules of biomaterial Fig. 4. Photomicrographs of ground sections after 4 months of he...

Fig. 3. a The elevated area was divided into four ...

Fig. 3. a The elevated area was divided into four regions for morphometric analysis. RED: submucosa; GREEN: middle; YELLOW: base; PURPLE: close-to-window. INC: top of the infraorbital nerve canal Fig. 3. a The elevated area was divided into four regions for morphometric analysis. RED: submucosa; GREEN: middle; YELLOW: base; PURPLE: close-to-window. INC: top of the infraorbital nerve canal

Fig. 2. Clinical view at a bone plate site. a The ...

Fig. 2. Clinical view at a bone plate site. a The bone window was removed. b The sinus mucosa was carefully elevated, and a twisted wire was placed. c The elevated sinus was grafted. d The access bony window was repositioned and secured with cyanoacrylate Fig. 2. Clinical view at a bone plate site. a The bone window was removed. b The sinus mucosa was carefully elevated, and a twisted wire wa...

Fig. 1. Clinical view at a membrane site. a Skin a...

Fig. 1. Clinical view at a membrane site. a Skin and periosteum were separately elevated, and the facial sinus wall exposed. b A 12 × 8-mm window was cut and removed. c The Schneiderian membrane was carefully elevated. d A twisted wire was inserted in the middle of the long side of the window and the elevated sinus was grafted. e At the control site, a resorbable membrane was placed and secured...

Table 2 Percentages of various tissues in the antr...

 BoneSoft tissuePure graftInterpenetrated graftComposite boneReplaced windowCenter61.5 ± 46.982.5 (22.2; 96.9)21.7 ± 22.6*17.5 (3.1; 34.4)2.3 ± 4.3*0.0 (0.0; 2.3)7.9 ± 19.30.0 (0.0; 0.0)69.3 ± 38.582.5 (57.6; 96.9)Edge37.2 ± 37.021.6 (16.8; 55.8)41.0 ± 39.833.6 (9.2; 64.9)5.3 ± 7.31.6 (0.0; 9.1)13.8 ± 19.0*6.7 (0.0; 19.7)54.8 ± 34.162.9 (37.5; 69.7)MembraneCenter5.8 ± 2.1 (P = 0.116)5....

Table 1 Percentages of the various tissues within ...

 New boneSoft tissuePure graftInterpenetrated graftComposite boneReplaced windowTotal16.4 ± 5.618.8 (13.8; 20.3)32.9 ± 8.031.2 (27.7; 37.0)13.6 ± 4.212.0 (10.8; 16.2)37.1 ± 7.534.4 (31.7; 43.4)53.5 ± 7.652.4 (50.8; 57.8)Base15.0 ± 7.216.4 (10.1; 20.1)38.6 ± 14.334.5 (28.9; 47.1)13.4 ± 6.415.3 (13.1; 17.0)33.1 ± 11.133.1 (26.8; 40.0)48.0 ± 18.149.9 (36.9; 59.7)Middle16.9 ± 7.318.1 (11.2...

About this article : Bone plate repositioned over ...

Perini, A., Ferrante, G., Sivolella, S. et al. Bone plate repositioned over the antrostomy after sinus floor elevation: an experimental study in sheep. Int J Implant Dent 6, 11 (2020). https://doi.org/10.1186/s40729-020-0207-1 Download citation Received: 01 October 2019 Accepted: 04 February 2020 Published: 18 March 2020 DOI: https://doi.org/10.1186/s40729-020-0207-1

Rights and permissions : Bone plate repositioned o...

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...

Additional information : Bone plate repositioned o...

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Ethics declarations : Bone plate repositioned over...

The research protocol was submitted to and approved by the Ethical Committee of the University of Medical Sciences, School of Dentistry, Havana, Cuba (prot. 013/2013). All the authors consent to publication. Alessandro Perini, Giada Ferrante, Stefano Sivolella, Joaquín Urbizo Velez, Franco Bengazi, and Daniele Botticelli declare that they have no competing interests.

Author information : Bone plate repositioned over ...

Correspondence to Alessandro Perini.

Author information : Bone plate repositioned over ...

Department of Neuroscience, Division of Dentistry, University of Padua, Via Giustiniani 2, 35128, Padua, Italy Alessandro Perini, Giada Ferrante & Stefano Sivolella Faculty of Dentistry, University of Medical Science, Havana, Cuba Joaquín Urbizo Velez & Franco Bengazi ARDEC Academy, Ariminum Odontologica, Rimini, Italy Daniele Botticelli You can also search for this author in ...

Funding : Bone plate repositioned over the antrost...

This study was funded by ARDEC Academy, Ariminum Odontologica s.r.l., Rimini, Italy. Degradable Solutions AG, a Sunstar Group Company, CH-8952 Schlieren ZH, Switzerland, provided free of charge the biomaterials used.

Acknowledgements : Bone plate repositioned over th...

Not applicable

References : Bone plate repositioned over the antr...

Iida T. Carneiro Martins Neto E, Botticelli D, Apaza Alccayhuaman KA, Lang NP, Xavier SP. Influence of a collagen membrane positioned subjacent the sinus mucosa following the elevation of the maxillary sinus: a histomorphometric study in rabbits. Clin Oral Implants Res. 2017 Dec;28(12):1567–76. Inal S, Yilmaz N, Nisbet C, Güvenç T. Biochemical and histopathological findings of N-butyl-2-cyano...

References : Bone plate repositioned over the antr...

Russell WMS, Burch RL. The principles of human experimental technique. London: Methuen; 1959. Schroeder HE, Münzel-Pedrazzoli S. Correlated morphometric and biochemical analysis of gingival tissue: morphometric model, tissue sampling and test of stereologic procedures. J Microsc. 1973 Dec;99(3):301–29. Sohn DS, Kim WS, An KM, Song KJ, Lee JM, Mun YS. Comparative histomorphometric analysis of ...

References : Bone plate repositioned over the antr...

Nosaka Y, Nosaka H, Arai Y. Complications of postoperative swelling of the maxillary sinus membrane after sinus floor augmentation. J Oral Sci Rehab. 2015;1:26–33. Tawil G, Tawil P, Khairallah A. Sinus floor elevation using the lateral approach and bone window repositioning I: clinical and radiographic results in 102 consecutively treated patients followed from 1 to 5 years. Int J Oral Maxillof...

References : Bone plate repositioned over the antr...

Tatum H Jr. Maxillary sinus grafting for endosseous implants. Lecture presented at the Annual Meeting of the Alabama Implant Study Group (1977); cited in Smiler DG, Johnson PW, Lozada JL, Misch C, Rosenlicht JL, Tatum OH Jr., Wagner JR. Sinus lift grafts and endosseous implants. Treatment of the atrophic posterior maxilla. Dent Clin North Am. 1992;36:151–86. Boyne PJ, James RA. Grafting of the ...

Abbreviations : Bone plate repositioned over the a...

Biphasic calcium phosphate Deproteinized Bovine Bone Mineral Hydroxyapatite Infraorbital nerve canal Standard deviation Beta-tricalcium phosphate

Availability of data and materials : Bone plate re...

All data and materials are available for control and consultation contacting the first author (alexperini@studioschweiger.it).

Conclusion : Bone plate repositioned over the antr...

In conclusion, the repositioning of the bone window after sinus floor elevation in sheep, compared with the use of a resorbable membrane, improved the closure of the antrostomy and led to a greater amount of the newly formed bone in the close-to-window zone of the grafted area. The bone window appeared partially bonded to the newly formed bone. Bridges of new bone from the edges of the antrostomy ...

Discussion : Bone plate repositioned over the antr...

In the present study, a lesser amount of bone was registered subjacent to the sinus mucosa compared with the other regions. This is in agreement with another experiment, in which a similar material was used for sinus augmentation in sheep [24]. A similar outcome was also reported in another study [27] that used DBBM xenograft for sinus augmentation in sheep. In that study, a collagen membrane was ...

Discussion : Bone plate repositioned over the antr...

In another similar experiment in sheep, the sinuses were augmented using a similar biphasic calcium phosphate (60% HA, 40% β-TCP) [24], the biomaterial used in the present study. The perforation of the sinus mucosa was performed at the test sites and a collagen membrane was placed to protect the perforation, while at control sites the elevated mucosa was left unprotected. After 12 weeks of heal...

Discussion : Bone plate repositioned over the antr...

The aim of the present study was to compare the healing of the augmented sinus in large animals, where the antrostomy was covered by a polylactic membrane or a repositioned bone plate, both secured with cyanoacrylate. No statistically significant differences were found between test and control sites in the bone formation within the augmented space. This outcome is in agreement with a similar stud...

Results : Bone plate repositioned over the antrost...

In the centre of the window area, at the test sites, in the analysed histological sections, the bone plate was still visible in five out of six sheep. It appeared partly remodelled and connected by the new bone formed in the sub-window area. Out of the five bone plates still present, three were bridged to the edges of the antrostomy, while in the two cases no contact was achieved in the observed s...

Results : Bone plate repositioned over the antrost...

During surgery, one sheep showed acute sinusitis at the test site. The sinus mucosa was perforated to allow sinus drainage and surgery was completed. During the healing period, no evident clinical complications were observed. At the histomorphometric analysis, one sinus of the control group and one of the test group (corresponding to the sinusitis case) appeared to have lost almost all biomateria...

Materials and methods : Bone plate repositioned ov...

The percentages of the new mineralised bone, soft or connective tissue, pure graft, graft interpenetrated by bone, and remnants of cyanoacrylate were evaluated. The total tissue percentages in the elevated space that included submucosa, middle, base, and sub-window regions were also calculated. Mean values and standard deviations (SDs) as well as the 25th, 50th (median), and 75th percentiles were...

Materials and methods : Bone plate repositioned ov...

After 4 months, the animals were anaesthetised and then euthanised with an overdose of pentobarbital sodium and subsequently perfused with 10% formalin. The maxilla was retrieved en bloc, trimmed, and immersed in formalin solution. All histological procedures were performed in the Laboratorio de Histologıa de la Facultad de Odontologıa de la Universidad de Ciencia Medica in Havana, Cuba. Bila...

Materials and methods : Bone plate repositioned ov...

Through an extra-oral approach, an oblique incision was made bilaterally along the sagittal axis between the facial tuberosity and the inferior orbital rim. The skin and periosteum were elevated separately, and the bony facial sinus wall was exposed on both sides of the maxilla (Fig. 1a). A 12-mm large and 8-mm high antrostomy was prepared using a burr (H254E Komet Dental, Trophagener Weg 25, L...

Materials and methods : Bone plate repositioned ov...

The research protocol was submitted to and approved by the Ethical Committee of the University of Medical Sciences, School of Dentistry, Havana, Cuba (prot. 013/2013). Eight female Pelibuey sheep, with a mean body weight of approximately 35 kg and a mean age of approximately 3 years, were provided by the Centro Nacional para la Producción de Animales de Laboratorio (CENPALAB) in Havana, Cuba...

Introduction : Bone plate repositioned over the an...

To prevent the movement of the bony plate and to gain adequate stability, cyanoacrylate has been suggested to glue the plate to the bony edges of the antrostomy [17]. Cyanoacrylates (as methyl 2-cyanoacrylate or ethyl 2-cyanoacrylate) are widely used in surgery and have shown good compatibility [18] and biomechanical strength for fixation of grafts [19]. In an experiment in rabbits [17], the antro...

Introduction : Bone plate repositioned over the an...

Sinus floor elevation is a commonly used technique to increase bone volume in the posterior maxilla prior to implant placement. This procedure was first developed by Tatum in 1977 [1], modified by Boyne and James in 1980 [2], and further modified over time. In this well-described technique, a bony window is created on the lateral wall of the sinus with a round burr, and the membrane elevated. Diff...

Abstract : Bone plate repositioned over the antros...

The objective of this study was to compare the healing of the augmented sinus at which the antrostomy was covered with a membrane or the repositioned bone plate. Eight sheep underwent bilateral maxillary sinus floor augmentation. The control site was covered with a resorbable membrane, while at the experimental site the bone plate was repositioned, and both were secured with cyanoacrylate. Animal...

Fig. 8. Photomicrographs of decalcified sections. ...

Fig. 8. Photomicrographs of decalcified sections. a Untreated site. Woven bone formed from the sinus walls after 1 week of healing. b Treated site. After 8 weeks, woven bone was still found forming ridges towards residues of provisional matrix, showing that the healing was not completed yet. Scarlet-acid fuchsine and toluidine blue stain. a × 100 magnification. b × 20 magnification ...

Fig. 7. Box-plot representing the new bone percent...

Fig. 7. Box-plot representing the new bone percentage and standard deviations (whiskers) found in the various regions evaluated after 8 weeks of healing. (*), a statistical significant difference Fig. 7. Box-plot representing the new bone percentage and standard deviations (whiskers) found in the various regions evaluated after 8 weeks of healing. (*), a statistical significant difference

Fig. 6. Photomicrographs of decalcified sections i...

Fig. 6. Photomicrographs of decalcified sections illustrating the healing after 8 weeks. a Treated site. Most of the antrostomies presented remaining defects in the outer contour. b, c Untreated sites. Two antrostomies of the treated sites and four of the untreated sites appeared not closed with corticalized bone and presented connective tissue interposed between the edges of the antrostomy. S...

Fig. 5. Photomicrographs of decalcified sections i...

Fig. 5. Photomicrographs of decalcified sections illustrating the healing after 8 weeks. Both at the treated (a) and untreated (b) sites, the antrostomy was closed in most cases, presenting residual defects of various dimensions in the outer side. New bone was connecting the lateral and medial sinus walls. The middle and sub-mucosa regions were not healed completely yet. Scarlet-acid fuchsine ...

Fig. 4. Photomicrographs of ground sections. a) Tr...

Fig. 4. Photomicrographs of ground sections. a) Treated site. Bone residues (examples in yellow asterisks) included in soft tissue containing fibroblast-like cells and inflammatory cells. b) Untreated site. Xenograft residues (examples in red asterisks) surrounded by soft tissue rich in fibroblast-like cells. Scarlet-acid fuchsine and toluidine blue stain. a) 200 x magnification.; b) 100 x magni...

Fig. 3. Photomicrographs of decalcified sections i...

Fig. 3. Photomicrographs of decalcified sections illustrating the healing after 1 week. a Treated site. Bone strips occupying the antrostomy and the subjacent area (close-to-window region). b Untreated site. Note the new bone-forming from the sinus bone walls. Scarlet-acid fuchsine and toluidine blue stain. Images grabbed at × 20 magnification Fig. 3. Photomicrographs of decalcified sect...

Fig. 2. The various regions evaluated at the histo...

Fig. 2. The various regions evaluated at the histomorphometric analyses. Bone walls (red arrow); middle (white arrow); sub-mucosa (yellow arrow); close-to-window (orange arrow). The antrostomy region was also evaluated at the medial and lateral edges (dark green arrows) and in the middle aspect (light green arrow) Fig. 2. The various regions evaluated at the histomorphometric analyses. Bone w...

Fig. 1. Clinical view of the surgical procedures. ...

Fig. 1. Clinical view of the surgical procedures. a Tibial bone exposed for autogenous bone harvesting using a bone scraper. b Antrostomies prepared. c Autogenous bone particles placed in the antrostomy. d Xenograft and bone particles (red arrow) at the antrostomies. e Collagen membranes placed on the antrostomies. f Wounds closed with sutures Fig. 1. Clinical view of the surgical procedures....

Table 2 Histomorphometric analysis. Tissues evalua...

  AntrostomySinus regions  EdgesCenterTotalClose-to-windowMiddleSub-mucosaBone wallsTotalNew boneTreated sites40.3 ± 21.337.8 (27.0;56.0)24.3 ± 23.222.0 (3.4;42.2)35.5 ± 20.927.7 (23.3;52.0)25.8* ± 16.122.9 (15.2;39.7)19.5 ± 16.711.7 (10.1;22.3)22.5 ± 11.620.4 (12.6;31.3)38.0 ± 15.044.8 (31.8;47.5)27.9 ± 12.930.1 (19.6;34.5)Untreated sites32.2 ± 22....

Table 1 Histomorphometric analysis. Tissues evalua...

  AntrostomySinus regions  EdgesCenterTotalClose-to-windowMiddleSub-mucosaBone wallsTotalNew boneTreated sites9.2 ± 10.6 4.6 (3.2;12.5)5.2 ± 13.90.0 (0.0;0.5)7.7 ± 11.22.7 (1.9;7.9)0.6 ± 1.00.0 (0.0;0.7)0.0 ± 0.00.0 (0.0;0.0)1.4 ± 1.80.8 (0.0;2.2)7.7 ± 6.38.2 (1.3;11.1)2.8 ± 2.62.2 (0.7;4.0)Untreated sites8.9 ± 8.5 6.2 (4.0;10.8)1.0 ± 2.70.0 (0....

About this article : Influence of the use of autog...

Favero, G., Viña-Almunia, J., Carda, C. et al. Influence of the use of autogenous bone particles to close the access window after maxillary sinus floor augmentation: an experimental study in rabbits. Int J Implant Dent 6, 9 (2020). https://doi.org/10.1186/s40729-020-0206-2 Download citation Received: 20 October 2019 Accepted: 21 January 2020 Published: 04 March 2020 DOI:...

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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...

Additional information : Influence of the use of a...

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Ethics declarations : Influence of the use of auto...

The present research was approved by the Ethics Committee of Valencia University, Spain. Reference number: A1434714637496. Not applicable. Daniele Botticelli declares to be the co-owner of Ariminum Odontologica. Giacomo Favero, Jose Viña-Almunia, Carmen Carda, José Javier Martín de Llano, Berta García-Mira, David Soto-Peñaloza, Daniele Botticelli, and Miguel Peñarrocha-Diago declare that t...

Author information : Influence of the use of autog...

You can also search for this author in PubMed Google Scholar GF participated in the concept/design, data analysis/interpretation, drafting of the article and surgical procedures. JV-A performed the surgical procedures, made the follow up of the animals, participated in the manuscript revision and ethical committee redaction and approval. BG-M and DS-P performed the surgi...

Author information : Influence of the use of autog...

Private practice, London, UK Giacomo Favero Oral Surgery Unit. Department of Stomatology, Faculty of Medicine and Dentistry, Clinica Odontológica, University of Valencia, Valencia, Spain Jose Viña-Almunia, Berta García-Mira, David Soto-Peñaloza & Miguel Peñarrocha-Diago Department of Pathology and Health Research Institute of the Hospital Clínico (INCLIVA), Faculty of Medicine and De...

Funding : Influence of the use of autogenous bone ...

Funds from the present have been provided by ARDEC Academy, by Ariminum Odontologica s.r.l., Rimini, Italy and Tecnoss srl, Giaveno, Italy. The biomaterials use were provided free of charge by Tecnoss srl, Giaveno, Italy.

References : Influence of the use of autogenous bo...

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References : Influence of the use of autogenous bo...

Favero V, Lang NP, Canullo L, Urbizo Velez J, Bengazi F, Botticelli D. Sinus floor elevation outcomes following perforation of the Schneiderian membrane. An experimental study in sheep. Clin Oral Implants Res. 2016;27(2):233–40. Scala A, Lang NP, Velez JU, Favero R, Bengazi F, Botticelli D. Effects of a collagen membrane positioned between augmentation material and the sinus mucosa in the eleva...

References : Influence of the use of autogenous bo...

Kawakami S, Lang NP, Ferri M, Apaza Alccayhuaman KA, Botticelli D. Influence of the height of the antrostomy in sinus floor elevation assessed by cone beam computed tomography- a randomized clinical trial. Int J Oral Maxillofac Implants. 2019;34(1):223–32. Kawakami S, Lang NP, Iida T, Ferri M, Apaza Alccayhuaman KA, Botticelli D. Influence of the position of the antrostomy in sinus floor elevat...

References : Influence of the use of autogenous bo...

Tatum, H., Jr. Maxillary sinus grafting for endosseous implants. Lecture presented at the Annual Meeting of the Alabama Implant Study Group (1977); cited in Smiler, D.G., Johnson, P.W., Lozada, J.L., Misch, C., Rosenlicht, J.L., Tatum, O.H. Jr. & Wagner J.R. Sinus lift grafts and endosseous implants. Treatment of the atrophic posterior maxilla. Dental clinics of North America. 1992;36:151–186. ...

Abbreviations : Influence of the use of autogenous...

Animal Research Reporting In Vivo Experiments Cone beam computed tomography Deproteinized bovine bone mineral Tricalcium phosphate

Availability of data and materials : Influence of ...

The datasets used or analyzed during the current study are available from the corresponding author on reasonable request.

Discussion : Influence of the use of autogenous bo...

The lower phylogenetic level of the animals compared to humans was the main limitation of the present study. An increased number of animals might allow reaching a statistical difference in favor of the treated sites also in the antrostomy region. Nevertheless, the outcomes obtained, allow to performing studies in humans that might demonstrate the advantages of applying autologous bone on the antro...

Discussion : Influence of the use of autogenous bo...

In both studies presented above on sinus floor elevation in sheep, all the lateral windows were prepared using a piezoelectric device. In an experiment in rabbits [21], the antrostomies were done with either a sonic instrument or drills to evaluate differences in bone formation in the antrostomy. Elevated space is filled with a collagenated porcine bone similar that used in the present experiment,...

Discussion : Influence of the use of autogenous bo...

The present experiment aimed to study the influence on the healing after the placement of autogenous bone on the antrostomy and in the subjacent region after maxillary sinus elevation. After 8 weeks of healing, in the antrostomy region, a trend of higher bone formation in the treated compared to the untreated sites was observed. No statistically significant difference was found. In the subjacent ...

Results : Influence of the use of autogenous bone ...

After 1 week of healing (Table 1), in the close-to-window region, the proportions of xenograft were 21.3 ± 14.7% and 55.9 ± 19.0 (p = 0.012) in the treated and untreated sites, respectively. After 8 weeks of healing (Table 2), these values decreased to a similar percentage (15.5 ± 14.4% and to 15.5 ± 14.2%; p = 0.917, respectively). After 1 week of healing (Table...

Results : Influence of the use of autogenous bone ...

Biopsies could be harvested from all animals. However, histological sections could not be obtained from one rabbit of the 8 weeks group; therefore, eight and seven were achieved for the 1-week and 8-week periods, respectively. After 1 week of healing, at the treated sites, the antrostomy and close-to-windows regions were occupied by a high proportion of residues of autogenous bone (Fig. 3a),...

Materials and methods : Influence of the use of au...

Overlapping calibrated digital images of the tissues were recorded with Leica Applications Suite version 4.4.0 software from a bright field Leica DM4000 B microscope (Leica Microsystems GmbH, Wëtzlar, Germany) equipped with a 5× lens and DFC420 digital camera. Single images were pasted and merged to compose each elevated sinus using the program Photoshop (Adobe Photoshop CC 2015.0.0). The histo...

Materials and methods : Influence of the use of au...

Afterward, a trichotomy was performed in the nasal dorsum and, after disinfection of the experimental region using Betadine (MEDA Pharma®, Madrid, Spain), a sagittal incision was carried out. The skin and the periosteum were dissected and shifted laterally to expose the nasal bone. Antrostomies, 4 × 4 mm in dimensions, located about 3–4 mm laterally to the midline and about 10 mm in f...

Materials and methods : Influence of the use of au...

Prior to the experiment, the protocol was approved by the Ethics Committee of Valencia University, Spain (A1434714637496). The guidelines indicated by the Council Directive of the European Union (53/2013; February 1, 2013) for animal experimentation and the ethical rules proposed by Royal Decree 223, March 14 and October 13, 1988, were fulfilled. The study was reported following the ARRIVE guideli...

Introduction : Influence of the use of autogenous ...

Hence, the present experiment aimed to study the influence on healing, of the autogenous bone particle placement in the antrostomy and in the subjacent region after maxillary sinus elevation.

Introduction : Influence of the use of autogenous ...

Maxillary sinus floor elevation through lateral access was first proposed in 1977 [1], while the technique was published in 1984 [2]. Several modifications in the surgical approach and the biomaterials used have been introduced over time [3,4,5]. In a systematic review with meta-analysis, it was concluded that the best survival rate was observed when implants with rough surface and membrane to cov...

Abstract : Influence of the use of autogenous bone...

To study the influence on the healing of the placement of particulate autogenous bone in the antrostomy and in the subjacent region after maxillary sinus elevation. Sixteen New Zealand rabbits were undergone to bilateral maxillary sinus floor augmentation with 4 × 4 mm antrostomy dimension. The sinus mucosa was elevated, and the space obtained was filled with xenograft. In the test site (tr...

Fig. 6. Graph representing new bone and composite ...

Fig. 6. Graph representing new bone and composite bone percentages within the elevated area Fig. 6. Graph representing new bone and composite bone percentages within the elevated area

Fig. 5. Graph representing the tissue percentages ...

Fig. 5. Graph representing the tissue percentages within the elevated area. No statistically significant differences were found Fig. 5. Graph representing the tissue percentages within the elevated area. No statistically significant differences were found

Fig. 4. Photomicrographs of ground sections after ...

Fig. 4. Photomicrographs of ground sections after 4 months of healing. a Bone formed from the base of the sinus. b Bone plate connected by bridges of the new bone to the close-to-window region. c Particle of the graft surrounded by new bone. d Overexposed image to show the new bone ingrowth within the granules of biomaterial Fig. 4. Photomicrographs of ground sections after 4 months of he...

Fig. 3. a The elevated area was divided into four ...

Fig. 3. a The elevated area was divided into four regions for morphometric analysis. RED: submucosa; GREEN: middle; YELLOW: base; PURPLE: close-to-window. INC: top of the infraorbital nerve canal Fig. 3. a The elevated area was divided into four regions for morphometric analysis. RED: submucosa; GREEN: middle; YELLOW: base; PURPLE: close-to-window. INC: top of the infraorbital nerve canal

Fig. 2. Clinical view at a bone plate site. a The ...

Fig. 2. Clinical view at a bone plate site. a The bone window was removed. b The sinus mucosa was carefully elevated, and a twisted wire was placed. c The elevated sinus was grafted. d The access bony window was repositioned and secured with cyanoacrylate Fig. 2. Clinical view at a bone plate site. a The bone window was removed. b The sinus mucosa was carefully elevated, and a twisted wire wa...

Fig. 1. Clinical view at a membrane site. a Skin a...

Fig. 1. Clinical view at a membrane site. a Skin and periosteum were separately elevated, and the facial sinus wall exposed. b A 12 × 8-mm window was cut and removed. c The Schneiderian membrane was carefully elevated. d A twisted wire was inserted in the middle of the long side of the window and the elevated sinus was grafted. e At the control site, a resorbable membrane was placed and secured...

Table 2 Percentages of various tissues in the antr...

 BoneSoft tissuePure graftInterpenetrated graftComposite boneReplaced windowCenter61.5 ± 46.982.5 (22.2; 96.9)21.7 ± 22.6*17.5 (3.1; 34.4)2.3 ± 4.3*0.0 (0.0; 2.3)7.9 ± 19.30.0 (0.0; 0.0)69.3 ± 38.582.5 (57.6; 96.9)Edge37.2 ± 37.021.6 (16.8; 55.8)41.0 ± 39.833.6 (9.2; 64.9)5.3 ± 7.31.6 (0.0; 9.1)13.8 ± 19.0*6.7 (0.0; 19.7)54.8 ± 34.162.9 (37.5; 69.7)MembraneCenter5.8 ± 2.1 (P = 0.116)5....

Table 1 Percentages of the various tissues within ...

 New boneSoft tissuePure graftInterpenetrated graftComposite boneReplaced windowTotal16.4 ± 5.618.8 (13.8; 20.3)32.9 ± 8.031.2 (27.7; 37.0)13.6 ± 4.212.0 (10.8; 16.2)37.1 ± 7.534.4 (31.7; 43.4)53.5 ± 7.652.4 (50.8; 57.8)Base15.0 ± 7.216.4 (10.1; 20.1)38.6 ± 14.334.5 (28.9; 47.1)13.4 ± 6.415.3 (13.1; 17.0)33.1 ± 11.133.1 (26.8; 40.0)48.0 ± 18.149.9 (36.9; 59.7)Middle16.9 ± 7.318.1 (11.2...

About this article : Bone plate repositioned over ...

Perini, A., Ferrante, G., Sivolella, S. et al. Bone plate repositioned over the antrostomy after sinus floor elevation: an experimental study in sheep. Int J Implant Dent 6, 11 (2020). https://doi.org/10.1186/s40729-020-0207-1 Download citation Received: 01 October 2019 Accepted: 04 February 2020 Published: 18 March 2020 DOI: https://doi.org/10.1186/s40729-020-0207-1

Rights and permissions : Bone plate repositioned o...

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...

Additional information : Bone plate repositioned o...

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Ethics declarations : Bone plate repositioned over...

The research protocol was submitted to and approved by the Ethical Committee of the University of Medical Sciences, School of Dentistry, Havana, Cuba (prot. 013/2013). All the authors consent to publication. Alessandro Perini, Giada Ferrante, Stefano Sivolella, Joaquín Urbizo Velez, Franco Bengazi, and Daniele Botticelli declare that they have no competing interests.

Author information : Bone plate repositioned over ...

Correspondence to Alessandro Perini.

Author information : Bone plate repositioned over ...

Department of Neuroscience, Division of Dentistry, University of Padua, Via Giustiniani 2, 35128, Padua, Italy Alessandro Perini, Giada Ferrante & Stefano Sivolella Faculty of Dentistry, University of Medical Science, Havana, Cuba Joaquín Urbizo Velez & Franco Bengazi ARDEC Academy, Ariminum Odontologica, Rimini, Italy Daniele Botticelli You can also search for this author in ...

Funding : Bone plate repositioned over the antrost...

This study was funded by ARDEC Academy, Ariminum Odontologica s.r.l., Rimini, Italy. Degradable Solutions AG, a Sunstar Group Company, CH-8952 Schlieren ZH, Switzerland, provided free of charge the biomaterials used.

Acknowledgements : Bone plate repositioned over th...

Not applicable

References : Bone plate repositioned over the antr...

Iida T. Carneiro Martins Neto E, Botticelli D, Apaza Alccayhuaman KA, Lang NP, Xavier SP. Influence of a collagen membrane positioned subjacent the sinus mucosa following the elevation of the maxillary sinus: a histomorphometric study in rabbits. Clin Oral Implants Res. 2017 Dec;28(12):1567–76. Inal S, Yilmaz N, Nisbet C, Güvenç T. Biochemical and histopathological findings of N-butyl-2-cyano...

References : Bone plate repositioned over the antr...

Russell WMS, Burch RL. The principles of human experimental technique. London: Methuen; 1959. Schroeder HE, Münzel-Pedrazzoli S. Correlated morphometric and biochemical analysis of gingival tissue: morphometric model, tissue sampling and test of stereologic procedures. J Microsc. 1973 Dec;99(3):301–29. Sohn DS, Kim WS, An KM, Song KJ, Lee JM, Mun YS. Comparative histomorphometric analysis of ...

References : Bone plate repositioned over the antr...

Nosaka Y, Nosaka H, Arai Y. Complications of postoperative swelling of the maxillary sinus membrane after sinus floor augmentation. J Oral Sci Rehab. 2015;1:26–33. Tawil G, Tawil P, Khairallah A. Sinus floor elevation using the lateral approach and bone window repositioning I: clinical and radiographic results in 102 consecutively treated patients followed from 1 to 5 years. Int J Oral Maxillof...

References : Bone plate repositioned over the antr...

Tatum H Jr. Maxillary sinus grafting for endosseous implants. Lecture presented at the Annual Meeting of the Alabama Implant Study Group (1977); cited in Smiler DG, Johnson PW, Lozada JL, Misch C, Rosenlicht JL, Tatum OH Jr., Wagner JR. Sinus lift grafts and endosseous implants. Treatment of the atrophic posterior maxilla. Dent Clin North Am. 1992;36:151–86. Boyne PJ, James RA. Grafting of the ...

Abbreviations : Bone plate repositioned over the a...

Biphasic calcium phosphate Deproteinized Bovine Bone Mineral Hydroxyapatite Infraorbital nerve canal Standard deviation Beta-tricalcium phosphate

Availability of data and materials : Bone plate re...

All data and materials are available for control and consultation contacting the first author (alexperini@studioschweiger.it).

Conclusion : Bone plate repositioned over the antr...

In conclusion, the repositioning of the bone window after sinus floor elevation in sheep, compared with the use of a resorbable membrane, improved the closure of the antrostomy and led to a greater amount of the newly formed bone in the close-to-window zone of the grafted area. The bone window appeared partially bonded to the newly formed bone. Bridges of new bone from the edges of the antrostomy ...

Discussion : Bone plate repositioned over the antr...

In the present study, a lesser amount of bone was registered subjacent to the sinus mucosa compared with the other regions. This is in agreement with another experiment, in which a similar material was used for sinus augmentation in sheep [24]. A similar outcome was also reported in another study [27] that used DBBM xenograft for sinus augmentation in sheep. In that study, a collagen membrane was ...

Discussion : Bone plate repositioned over the antr...

In another similar experiment in sheep, the sinuses were augmented using a similar biphasic calcium phosphate (60% HA, 40% β-TCP) [24], the biomaterial used in the present study. The perforation of the sinus mucosa was performed at the test sites and a collagen membrane was placed to protect the perforation, while at control sites the elevated mucosa was left unprotected. After 12 weeks of heal...

Discussion : Bone plate repositioned over the antr...

The aim of the present study was to compare the healing of the augmented sinus in large animals, where the antrostomy was covered by a polylactic membrane or a repositioned bone plate, both secured with cyanoacrylate. No statistically significant differences were found between test and control sites in the bone formation within the augmented space. This outcome is in agreement with a similar stud...

Results : Bone plate repositioned over the antrost...

In the centre of the window area, at the test sites, in the analysed histological sections, the bone plate was still visible in five out of six sheep. It appeared partly remodelled and connected by the new bone formed in the sub-window area. Out of the five bone plates still present, three were bridged to the edges of the antrostomy, while in the two cases no contact was achieved in the observed s...

Results : Bone plate repositioned over the antrost...

During surgery, one sheep showed acute sinusitis at the test site. The sinus mucosa was perforated to allow sinus drainage and surgery was completed. During the healing period, no evident clinical complications were observed. At the histomorphometric analysis, one sinus of the control group and one of the test group (corresponding to the sinusitis case) appeared to have lost almost all biomateria...

Materials and methods : Bone plate repositioned ov...

The percentages of the new mineralised bone, soft or connective tissue, pure graft, graft interpenetrated by bone, and remnants of cyanoacrylate were evaluated. The total tissue percentages in the elevated space that included submucosa, middle, base, and sub-window regions were also calculated. Mean values and standard deviations (SDs) as well as the 25th, 50th (median), and 75th percentiles were...

Materials and methods : Bone plate repositioned ov...

After 4 months, the animals were anaesthetised and then euthanised with an overdose of pentobarbital sodium and subsequently perfused with 10% formalin. The maxilla was retrieved en bloc, trimmed, and immersed in formalin solution. All histological procedures were performed in the Laboratorio de Histologıa de la Facultad de Odontologıa de la Universidad de Ciencia Medica in Havana, Cuba. Bila...

Materials and methods : Bone plate repositioned ov...

Through an extra-oral approach, an oblique incision was made bilaterally along the sagittal axis between the facial tuberosity and the inferior orbital rim. The skin and periosteum were elevated separately, and the bony facial sinus wall was exposed on both sides of the maxilla (Fig. 1a). A 12-mm large and 8-mm high antrostomy was prepared using a burr (H254E Komet Dental, Trophagener Weg 25, L...

Materials and methods : Bone plate repositioned ov...

The research protocol was submitted to and approved by the Ethical Committee of the University of Medical Sciences, School of Dentistry, Havana, Cuba (prot. 013/2013). Eight female Pelibuey sheep, with a mean body weight of approximately 35 kg and a mean age of approximately 3 years, were provided by the Centro Nacional para la Producción de Animales de Laboratorio (CENPALAB) in Havana, Cuba...

Introduction : Bone plate repositioned over the an...

To prevent the movement of the bony plate and to gain adequate stability, cyanoacrylate has been suggested to glue the plate to the bony edges of the antrostomy [17]. Cyanoacrylates (as methyl 2-cyanoacrylate or ethyl 2-cyanoacrylate) are widely used in surgery and have shown good compatibility [18] and biomechanical strength for fixation of grafts [19]. In an experiment in rabbits [17], the antro...

Introduction : Bone plate repositioned over the an...

Sinus floor elevation is a commonly used technique to increase bone volume in the posterior maxilla prior to implant placement. This procedure was first developed by Tatum in 1977 [1], modified by Boyne and James in 1980 [2], and further modified over time. In this well-described technique, a bony window is created on the lateral wall of the sinus with a round burr, and the membrane elevated. Diff...

Abstract : Bone plate repositioned over the antros...

The objective of this study was to compare the healing of the augmented sinus at which the antrostomy was covered with a membrane or the repositioned bone plate. Eight sheep underwent bilateral maxillary sinus floor augmentation. The control site was covered with a resorbable membrane, while at the experimental site the bone plate was repositioned, and both were secured with cyanoacrylate. Animal...

Fig. 3. Postoperative radiograph of the resected d...

Fig. 3. Postoperative radiograph of the resected dental implant in the right anterior maxilla Fig. 3. Postoperative radiograph of the resected dental implant in the right anterior maxilla

Fig. 2. On radiological examination, it was confir...

Fig. 2. On radiological examination, it was confirmed that the dental implant had perforated the cortical bone of the right nasal floor Fig. 2. On radiological examination, it was confirmed that the dental implant had perforated the cortical bone of the right nasal floor

Fig. 1. On anterior rhinoscopy, the apical part of...

Fig. 1. On anterior rhinoscopy, the apical part of the titanium dental implant in the right anterior maxilla was seen in the nasal floor close to the nasal septum Fig. 1. On anterior rhinoscopy, the apical part of the titanium dental implant in the right anterior maxilla was seen in the nasal floor close to the nasal septum

About this article : Altered nasal airflow: an unu...

Wolff, J., Karagozoglu, K.H., Bretschneider, J.H. et al. Altered nasal airflow: an unusual complication following implant surgery in the anterior maxilla. Int J Implant Dent 2, 6 (2016). https://doi.org/10.1186/s40729-016-0045-3 Download citation Received: 24 August 2015 Accepted: 23 March 2016 Published: 29 March 2016 DOI: https://doi.org/10.1186/s40729-016-0045-3

Rights and permissions : Altered nasal airflow: an...

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...

Additional information : Altered nasal airflow: an...

Jan Wolff, Hakki Karagozoglu, Jochen Bretschneider, Tymour Forouzanfar, and Engelbert Schulten declare that they have no competing interests. JW gave substantial contributions to the conception or design of the work, drafted the work, and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately i...

Author information : Altered nasal airflow: an unu...

Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center/Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands Jan Wolff, K. Hakki Karagozoglu, Tymour Forouzanfar & Engelbert A. J. M. Schulten Department of Otorhinolaryngology-Head and Neck Surgery, VU University Medical Center, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands Jochen H...

References : Altered nasal airflow: an unusual com...

Esposito M, Grusovin MG, Kwan S, et al. Interventions for replacing missing teeth: bone augmentation techniques for dental implant treatment. Cochrane Database Syst Rev. 2008;16:CD003607. Raghoebar GM, van Weissenbruch R, Vissink A. Rhino-sinusitis related to endosseous implants extending into the nasal cavity. A case report. Int J Oral Maxillofac Surg. 2004;33:312–4. Zimbler MS, Lebowitz RA, ...

Consent : Altered nasal airflow: an unusual compli...

Since this is a case report, no approval of the Institutional Review Board was necessary. Written informed consent was obtained from the patient for publication of this Case report and any accompanying images

Conclusions : Altered nasal airflow: an unusual co...

In conclusion, dental implants protruding into the nasal cavity can cause alterations to the airflow. Dental implants partially residing in the nasal cavity can be minimal invasively treated by sectioning the apical part of the implant using a transnasal approach.

Case presentation : Altered nasal airflow: an unus...

No complications were apparent during the surgical procedure. Postoperative clinical and radiological examinations demonstrated an intact nasal mucosa and an adequate resection of the dental implant to the level of the nasal floor (Fig. 3). The patient had an uneventful recovery and at 2-, 6-, and 12-month follow-up, she reported having no altered nasal airflow. Insertion of endosseous dental im...

Case presentation : Altered nasal airflow: an unus...

A 50-year-old female patient was referred to the Department of Oral and Maxillofacial Surgery of the VU University Medical Center in Amsterdam with complaints of a long ongoing unpleasant altered nasal airflow after the placement of eight dental implants in the maxilla. Four months prior to implant surgery, a bony augmentation of the atrophic edentulous alveolar crest and a bilateral maxillary sin...

Background : Altered nasal airflow: an unusual com...

Endosseous dental implants are commonly used to rehabilitate fully or partially edentulous patients [1]. The insertion of such implants can in some cases cause complications, especially in the edentulous atrophic maxilla [2–4]. In this paper, an unusual complication of altered nasal airflow after the placement of an endosseous dental implant in the maxilla is presented. Subsequent treatment of t...

Abstract : Altered nasal airflow: an unusual compl...

Dental implants have been in routine clinical use for over three decades and are a predictable treatment modality. However, as with all other aspects of dentistry, complications occur. A 50-year-old female patient with complaints of a long ongoing unpleasant altered nasal airflow presented herself at the VU University Medical Center Amsterdam. Visual inspection of the right nasal cavity revealed t...

Fig. 6. Radiographic examination: The relationship...

Fig. 6. Radiographic examination: The relationship between changes in the maxillary sinus floor associated with a reduction in the grafted bone and the implant tip (a immediately after surgery, b 5 years after surgery) Fig. 6. Radiographic examination: The relationship between changes in the maxillary sinus floor associated with a reduction in the grafted bone and the implant tip (a immediat...

Fig. 5. Radiographic examination (long-term change...

Fig. 5. Radiographic examination (long-term changes in bone height surrounding the implant) n = 20 Number of implants. A total of 5 CBCT scans were taken prior to surgery, immediately after surgery, 6 months after surgery, 1–2 years after surgery, and 3–5 years after surgery Fig. 5. Radiographic examination (long-term changes in bone height surrounding the implant) n = 20 Numbe...

Fig. 4. Clinical findings of the second surgery on...

Fig. 4. Clinical findings of the second surgery on biopsy at 6 months. The degree of residual grafting materials varied depending on the patient. a most of the β-TCP remained. b Replacement of the β-TCP by new bone had progressed Fig. 4. Clinical findings of the second surgery on biopsy at 6 months. The degree of residual grafting materials varied depending on the patient. a most of the ...

Fig. 3. Radiographic examination of the height of ...

Fig. 3. Radiographic examination of the height of the bone surrounding the implant (BH): Measurement of changes in the height of the implant tip to the bone fixation part over time in the frontal plane: the distance measured from the intersecting point of the long axis of the implant and the maxillary sinus floor to the implant tip: +maxillary side, −alveolar crest side. The liner valuables: r...

Fig. 2. Radiographic examination of the volume of ...

Fig. 2. Radiographic examination of the volume of the bone graft (BV): Calculation of area on the frontal plane prior to and immediately after surgery using polygon tool. The polygon tool is included in the CT device, which was dragged around the perimeter of the target site to measure area. Graft volume calculation method (sum of the area and calculation of volume). Volume cm3 = area cm2 ...

Fig. 1. Treatment protocol for the present study. ...

Fig. 1. Treatment protocol for the present study. Postoperative CBCT was performed a minimum of three times, i.e., immediately, 6 months, and 2.5 years after implant placement Fig. 1. Treatment protocol for the present study. Postoperative CBCT was performed a minimum of three times, i.e., immediately, 6 months, and 2.5 years after implant placement

Table 8 Examination of the impact of RBH, IL, SW, ...

  Coefficient Standard error 95 % CI P value Time (months) −0.087 ...

Table 7 The radiographic measurements of liner par...

Parameter Mean (mm) SD (mm) RBH 4.48 1.51 ...

Table 6 Radiographic examination of BH (changes in...

NoneTable 6 Radiographic examination of BH (changes in bone height surrounding the implant)

Table 5 Radiographic examination of BV (volumetric...

BV Mean Reduction rate Immediately after surgery (n = 30) 1206 ...

Table 4 The distribution of CBCT examination after...

CBCT examination (year) Number of patients 0–1 0 1–2 14 ...

Table 3 The number of implants according to site :...

Implant site Number of implants 4 6 5 16 6 24 7 12 Total: 58 implants   Table 3 The number of implants according to site

Table 2 Observation period : Long-term radiographi...

Observation period (months) Number of patients 12–18 11 19–24 4 ...

Table 1 Age groups of the 30 patients : Long-term ...

Age group (years) Number of patients 40–49 7 50–59 10 ...

About this article : Long-term radiographic assess...

Okada, T., Kanai, T., Tachikawa, N. et al. Long-term radiographic assessment of maxillary sinus floor augmentation using beta-tricalcium phosphate: analysis by cone-beam computed tomography. Int J Implant Dent 2, 8 (2016). https://doi.org/10.1186/s40729-016-0042-6 Download citation Received: 25 November 2015 Accepted: 23 March 2016 Published: 01 April 2016 DOI: https://do...

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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...

Additional information : Long-term radiographic as...

Tsuneji Okada, Toru Kanai, Noriko Tachikawa, Motohiro Munakata, and Shohei Kasugai declare that they have no competing interests. TO performed the data acquisition, both of surgical and prosthodontic treatments, the data analysis, statistical analysis, and wrote the manuscript. TK performed the treatment plan, making of pictures, and collecting of references. NT and MM performed the data acquisit...

Author information : Long-term radiographic assess...

Clinic for Implant Dentistry, Dental Hospital, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan Tsuneji Okada, Toru Kanai & Noriko Tachikawa Oral Implantology Department of Prosthodontic Dentistry for Function of TMJ and Occlusion, Kanagawa Dental University, 82, Inaokachou, Yokosuka-shi, 238-8580, Kanagawa, Japan Motohiro Munakata Oral Implantology and...

Acknowledgements : Long-term radiographic assessme...

The bone grafting agent, β-TCP (OSferion), was kindly supplied by Olympus Terumo Biomaterials Corp.

References : Long-term radiographic assessment of ...

Boyne PJ, James RA. Grafting of the maxillary sinus floor with autogenous marrow and bone. J Oral Maxillofac Surg. 1980;38:613–6. Jensen OT, Shulman LB, Block MS, et al. Report of the sinus consensus conference of 1996. Int J Oral Maxillofac Implants. 1998;13:11–45. Artzi Z, Weinreb M, Givol N, et al. Biomaterial resorption rate and healing site morphology of inorganic bovine bone and β-tri...

References : Long-term radiographic assessment of ...

Chanavaz M. Maxillary sinus: anatomy, physiology, surgery, and bone grafting related to implantology: eleven years of surgical experience (1979–1990). J Oral Implantol. 1990;16:199–209. Misch CE. Maxillary sinus lift and elevation with subantral augmentation. In: Misch CE, editor. Contemporary implant dentistry. St. Louis, MO: Mosby; 1993. p. 545–74. Sharan A, Madjar D. Maxillary sinus pne...

Conclusions : Long-term radiographic assessment of...

Maxillary sinus graft augmentation using β-TCP is clinically effective. Analysis by CBCT provides superior spatial resolution and allows for extremely accurate postoperative evaluation of maxillary sinus floor augmentation and bone volume measurements. On the basis of CBCT examinations, although maxillary sinus pneumatization continues to progress ≥1 year after surgery, it stabilizes 3 year...

Discussion : Long-term radiographic assessment of ...

During the observation period, there was no clinical implant failure and the suvival rate for implantation and maxillary sinus floor augmentation was 100 %. Histological examination in a previous report on maxillary sinus augmentation using β-TCP (Cerasorb®), Szabo et al. compared bilateral maxillary sinus augmentation in the same patients using β-TCP and iliac bone at 6 months after surgery ...

Discussion : Long-term radiographic assessment of ...

As grafting materials for maxillary sinus floor augmentation, autogenous bone, which is considered as the gold standard and reported first by Boyne et al. using iliac bone graft, has been used as the first-choice material. In terms of osteogenic, osteoinductive, and osteoconductive properties, autogenous bone is considered ideal; however, the use of autogenous bone places great physical stress on ...

Results : Long-term radiographic assessment of max...

Change in height of bone surrounding the implant (height from the maxillary sinus floor to the implant tip): Immediately after surgery, all patients had grafted bone between the implant tip and the maxillary sinus floor, with a mean of 2.00 ± 1.51 mm. This height decreased to 0.73 ± 1.33 mm at 6 months after surgery and −0.72 ± 1.11 mm at 2.5 years after surgery (Fig. 5). 41...

Results : Long-term radiographic assessment of max...

The mean age of the 30 patients was 57.4 (40–75) years, and the male/female ratio was 4:26. The mean postoperative observation period was 3 years and 8 months (the maximum period was 5 years and 0 months; the minimum period was 2 years and 2 months). Total of 58 implants were placed at premolar and molar region. There were no dropouts, such as participants not visiting the clinic, during t...

Methods : Long-term radiographic assessment of max...

Residual bone height (RBH): existing bone height to the maxillary sinus at the implant site Implant length (IL): the length of the part of the implant that projects into the maxillary sinus Width of sinus (SW): the width of the maxillary sinus from lateral wall to medial wall at the height of the center of the IL In the present study, the radiographic examinations were statistically analyzed fo...

Methods : Long-term radiographic assessment of max...

In the present study, we used the superior spatial resolution of CBCT to measure changes over time in (a) the volume of the bone graft (BV) and (b) the height of the bone surrounding the implant (BH). The method of calculating the volume of the implant site is shown below (Fig. 2). The slice thickness (voxel value) was resized (0.146 mm → 1 mm) to derive the volume of the grafting agent...

Methods : Long-term radiographic assessment of max...

This study is a prospective observational study. The subjects included patients who had undergone maxillary sinus floor augmentation using β-TCP and implant placement at the Clinic for Implant Dentistry, Dental Hospital, Tokyo Medical and Dental University during the 3-year period from January 2009 to December 2011. All patients underwent maxillary sinus floor augmentation at the same time as imp...

Background : Long-term radiographic assessment of ...

Radiographic examinations to determine changes in bone mass in maxillary sinus floor augmentation have been conducted primarily using panoramic radiography [8–12], which allows for the assessment of the height of the maxillary sinus in only two dimensions. In addition, it does not allow for detailed examination or measurement of the interior of the maxillary sinus without factoring in magnificat...

Background : Long-term radiographic assessment of ...

The maxillary sinus gradually expands after birth and becomes fully pneumatized with the eruption of all permanent teeth. Although the physiological cause and maxillary sinus pneumatization are largely unknown, it is believed that genetics, atmospheric pressure, and hormones are involved in it. This sinus is closely related to the root apex of the premolar and molar teeth, and it is either separat...

Abstract : Long-term radiographic assessment of ma...

The long-term stability of maxillary sinus floor augmentation with β-TCP remains largely unknown. We report the long-term assessment of volumetric changes in maxillary sinus floor augmentation with β-TCP by cone-beam computed tomography (CBCT). The subjects included 30 patients who underwent maxillary sinus floor augmentation using β-TCP and 58 implant placement for unilateral maxillary defect...

Table 2 Included literature : Dental implants in p...

Implant Author Year Reference Study type Patients Primary disease in BP patients (n) ...

Table 1 PubMed literature search with the total nu...

Topic Identified (n) Included (n) Outcome osteonecrosis risk. ST (bisphosphonate OR denosumab) AND osteonecrosis jaw AND  ...

About this article : Dental implants in patients t...

Walter, C., Al-Nawas, B., Wolff, T. et al. Dental implants in patients treated with antiresorptive medication – a systematic literature review. Int J Implant Dent 2, 9 (2016). https://doi.org/10.1186/s40729-016-0041-7 Download citation Received: 26 September 2015 Accepted: 23 March 2016 Published: 04 April 2016 DOI: https://doi.org/10.1186/s40729-016-0041-7

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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...

Additional information : Dental implants in patien...

The authors Christian Walter, Bilal Al-Nawas, Tim Wolff, Eik Schiegnitz, and Knut A. Grötz declare that they have no competing interests. All authors designed the review. TW made the primary literature acquisition that was evaluated by the other others. All authors interpreted the data. CW drafted the manuscript that was revised by the other authors. All authors read and approved the final manus...

Author information : Dental implants in patients t...

Department of Oral and Maxillofacial Surgery – Plastic Surgery of the Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131, Mainz, Germany Christian Walter, Bilal Al-Nawas & Eik Schiegnitz Department of Oral and Maxillofacial Surgery of the Dr. Horst Schmidt Clinic, Ludwig-Erhard-Str. 100, 65199, Wiesbaden, Germany Tim Wolff & Knut A. Grötz You can also search for this author in...

References : Dental implants in patients treated w...

Krimmel M, Ripperger J, Hairass M, Hoefert S, Kluba S, Reinert S. Does dental and oral health influence the development and course of bisphosphonate-related osteonecrosis of the jaws (BRONJ)? Oral Maxillofac Surg. 2014;18(2):213–8. doi:10.1007/s10006-013-0408-3. Tsao C, Darby I, Ebeling PR, Walsh K, O'Brien-Simpson N, Reynolds E, et al. Oral health risk factors for bisphosphonate-associated jaw...

References : Dental implants in patients treated w...

DeBaz C, Hahn J, Lang L, Palomo L. Dental Implant Supported Restorations Improve Quality of Life in Osteoporotic Women. Int J Dent. 2015;2015:451923. doi:10.1155/2015/451923. Grötz KA, Al-Nawas B. Persisting alveolar sockets-a radiologic symptom of BP-ONJ? J Oral Maxillofac Surg. 2006;64(10):1571–2. doi:10.1016/j.joms.2006.05.041. Hutchinson M, O'Ryan F, Chavez V, Lathon PV, Sanchez G, Hatche...

References : Dental implants in patients treated w...

Carmagnola D, Celestino S, Abati S. Dental and periodontal history of oncologic patients on parenteral bisphosphonates with or without osteonecrosis of the jaws: a pilot study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;106(6):e10–5. doi:10.1016/j.tripleo.2008.07.011. Jabbour Z, El-Hakim M, Mesbah-Ardakani P, Henderson JE, Albuquerque Jr R. The outcomes of conservative and surgical ...

References : Dental implants in patients treated w...

Marx RE, Sawatari Y, Fortin M, Broumand V. Bisphosphonate-induced exposed bone (osteonecrosis/osteopetrosis) of the jaws: risk factors, recognition, prevention, and treatment. J Oral Maxillofac Surg. 2005;63(11):1567–75. doi:10.1016/j.joms.2005.07.010. Al-Sabbagh M, Robinson FG, Romanos G, Thomas MV. Osteoporosis and bisphosphonate-related osteonecrosis in a dental school implant patient popula...

References : Dental implants in patients treated w...

Javed F, Almas K. Osseointegration of dental implants in patients undergoing bisphosphonate treatment: a literature review. J Periodontol. 2010;81(4):479–84. doi:10.1902/jop.2009.090587. Bedogni A, Bettini G, Totola A, Saia G, Nocini PF. Oral bisphosphonate-associated osteonecrosis of the jaw after implant surgery: a case report and literature review. J Oral Maxillofac Surg. 2010;68(7):1662–6...

References : Dental implants in patients treated w...

Grötz KA, Piesold JU, Al-Nawas B. Bisphosphonat-assoziierte Kiefernekrose (BP-ONJ) und andere Medikamenten-assoziierte Kiefernekrosen. 2012. AWMF online. Walter C, Al-Nawas B, Frickhofen N, Gamm H, Beck J, Reinsch L, et al. Prevalence of bisphosphonate associated osteonecrosis of the jaws in multiple myeloma patients. Head Face Med. 2010;6:11. doi:10.1186/1746-160X-6-11. Walter C, Sagheb K, Bit...

Abbreviations : Dental implants in patients treate...

bisphosphonate bisphosphonate-associated osteonecrosis of the jaws C-terminal telopeptide of the type I collagen patients intervention control outcome preferred reporting items for systematic reviews and meta-analyses protocols quality of life search term temporomandibular joint

Conclusions : Dental implants in patients treated ...

Successful implant therapy is feasible in patients receiving antiresorptive therapy. The risk of osteonecrosis development needs to be explained to the patient. An individual risk assessment is essential, taking the primary disease with the medication and further wound-healing-compromising diseases and medications into account. If possible, bone augmentations should be avoided, and a perioperative...

Discussion : Dental implants in patients treated w...

The use of bone markers is discussed controversially in the literature, and no clear recommendation can be given at the moment [1, 8]. In these cases, where an implant is planned, a perioperative antimicrobial prophylaxis should be administered, similar to the prophylaxis suggested in other surgical procedures performed in these patients, since this seems to be a tool to decrease BP-ONJ frequency ...

Discussion : Dental implants in patients treated w...

Dental implants can improve the Qol in patients with antiresorptive therapy (bisphosphonate/denosumab) [44] analogous to patients without antiresorptive therapy [48]. A recently performed systematic review on masticatory performance, bite force, nutritional state and patient’s satisfaction showed that implant-supported dentures were associated with high patient satisfaction regarding denture com...

Discussion : Dental implants in patients treated w...

Even latest guidelines and statements dealing with medication associated osteonecrosis of the jaws such as the American [7, 8], Scottish [47], Swiss [6] or German [1] do not address implant therapy in these patients in detail. Due to this lack of data a systematic literature review was performed to fill this gap. Unfortunately the literature dealing with this topic is very sparse and consists main...

Results : Dental implants in patients treated with...

No articles could be found regarding the prognosis of the remaining dentition depending on implant therapy, neither for patients with bisphosphonate nor denosumab treatment. There are no reliable parameters indicating the success of implants in patients with anti-resorptive therapy. The risk of osteonecrosis development has already been described in the chapter referring to the osteonecrosis risk...

Results : Dental implants in patients treated with...

The literature dealing with this topic can be separated into two groups: BP-ONJ case series for which varying amounts are caused by dentures in patients with malignant and benign diseases [2, 33–42] and studies performed on BP patients with dentures analyzing the frequency of BP-ONJ [15, 43]. Here as well, no imbalance regarding the dignity of the primary disease could be found. Jabbour descr...

Results : Dental implants in patients treated with...

Out of 606 articles 556 articles were excluded because they were either duplicates, case reports, narrative reviews, case series with less than 5 cases or were not associated with the topic at all (Table 1 and Fig. 1). Some of the articles analyzed more than one outcome and are referred to several times. Since the available literature is very inhomogeneous with a low level of evidence a statisti...

Review : Dental implants in patients treated with ...

A table was generated and used to collect the relevant information.

Review : Dental implants in patients treated with ...

A systematic review was performed in accordance with the preferred reporting items for systematic reviews and meta-analyses protocols (PRISMA-P), The review was performed using the PICO design. Patients: For which subclientel of patients with antiresorptive therapy Intervention: do dental implants have a benefit Control: compared to forgoing dental implants Outcome: in regards to oral rehabil...

Introduction : Dental implants in patients treated...

A similar scenario is well known in patients with radiation of the jaws. Initially, radiation therapy was seen as a contraindication for implant insertion [14] because of osteoradionecrosis. In Germany meanwhile, implants are covered by the health insurance by law in some of these patients (§28 SGB V Sozialgesetzbuch). Due to xerostomia sufficient fixation of a denture is rather complicated, and ...

Introduction : Dental implants in patients treated...

Bisphosphonate-associated osteonecrosis of the jaws (BP-ONJ) is a well-known side effect in patients receiving bisphosphonates (BP) due to e.g. osteoporosis, multiple myeloma or malignant diseases with metastases to the bone; prevalences range between 0.1% for patients with primary osteoporosis to 1% in patients with secondary osteoporosis and up to about 20% for special high risk subpopulations o...

Abstract : Dental implants in patients treated wit...

Bisphosphonate-associated osteonecrosis of the jaws (BP-ONJ) is triggered by inflammatory processes. Typical trigger factors are periodontal disease, denture pressure sores, and surgical interventions such as tooth extractions. Unfortunately there is only little data on how to proceed with implant therapy in patients with bisphosphonate treatment. This topic is not addressed in the German guidelin...

Fig. 8. Postoperative panoramic radiograph taken a...

Fig. 8. Postoperative panoramic radiograph taken about 3 years after implant loading Fig. 8. Postoperative panoramic radiograph taken about 3 years after implant loading

Fig. 7. Radiographic findings on panoramic compute...

Fig. 7. Radiographic findings on panoramic computed tomography after nongrafted sinus lift with simultaneous implant placement. a Immediately. b At 6 months. c At 42 months Fig. 7. Radiographic findings on panoramic computed tomography after nongrafted sinus lift with simultaneous implant placement. a Immediately. b At 6 months. c At 42 months

Fig. 6. Radiographic findings on cross-sectional c...

Fig. 6. Radiographic findings on cross-sectional computed tomography in the right second molar region after nongrafted sinus lift with simultaneous implant placement. a Immediately. b At 6 months. c At 42 months Fig. 6. Radiographic findings on cross-sectional computed tomography in the right second molar region after nongrafted sinus lift with simultaneous implant placement. a Immediately....

Fig. 5. Clinical view of the repositioned bone win...

Fig. 5. Clinical view of the repositioned bone window with the HA/PLLA mesh plate device Fig. 5. Clinical view of the repositioned bone window with the HA/PLLA mesh plate device

Fig. 4. a Front view of the bone window with the H...

Fig. 4. a Front view of the bone window with the HA/PLLA mesh plate device fixed by a screw. b Lower view of the bone window with the HA/PLLA mesh plate device fixed by a screw Fig. 4. a Front view of the bone window with the HA/PLLA mesh plate device fixed by a screw. b Lower view of the bone window with the HA/PLLA mesh plate device fixed by a screw

Fig. 3. After the removal of the bone window, the ...

Fig. 3. After the removal of the bone window, the membrane was lifted upward, and the dental implants were placed without grafting materials Fig. 3. After the removal of the bone window, the membrane was lifted upward, and the dental implants were placed without grafting materials

About this article : Continuous intra-sinus bone r...

Kaneko, T., Nakamura, S., Hino, S. et al. Continuous intra-sinus bone regeneration after nongrafted sinus lift with a PLLA mesh plate device and dental implant placement in an atrophic posterior maxilla: a case report. Int J Implant Dent 2, 16 (2016). https://doi.org/10.1186/s40729-016-0049-z Download citation Received: 18 March 2016 Accepted: 01 June 2016 Published: 06 June 2016 DOI: https:/...

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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...

Additional information : Continuous intra-sinus bo...

Takahiro Kaneko, Satoshi Nakamura, Shunsuke Hino, Norio Horie, and Tetsuo Shimoyama declare that they have no competing interests. TK, SN, and SH were involved with the literature review and performance of the surgery. NH and TS suggested the treatment planning and were also involved with the surgeries. All authors read and approved the final manuscript.

Author information : Continuous intra-sinus bone r...

Department of Oral and Maxillofacial Surgery, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-8550, Japan Takahiro Kaneko, Satoshi Nakamura, Shunsuke Hino, Norio Horie & Tetsuo Shimoyama You can also search for this author in PubMed Google Scholar You can also search for this author in PubMed Google ...

Acknowledgements : Continuous intra-sinus bone reg...

None. None.

References : Continuous intra-sinus bone regenerat...

Atef M, Hakam MM, EIFaramawey MI, Abou EIFetouh A, Ekram M. Nongrafted sinus floor elevation with a space-maintaining titanium mesh: case-series study on four patients. Clin Oral Implants Res. 2011;23:100–5. Kaneko T, Masuda I, Horie N, Shimoyama T. New bone formation in nongrafted sinus lifting with space-maintaining management: a novel technique using a titanium bone fixation device. J Oral M...

References : Continuous intra-sinus bone regenerat...

Pjetursson BE, Tan WC, Zwahlen M, Lang NP. A systematic review of the success of sinus floor elevation and survival of implants inserted in combination with sinus floor elevation. J Clin Periodontol. 2008;35:216–40. Tan WC, Lang NP, Zwahlen M, Pjetursson BE. A systematic review of the success of sinus floor elevation and survival of implants inserted in combination with sinus floor elevation. P...

Abbreviations : Continuous intra-sinus bone regene...

computed tomography bioresorbable unsintered hydroxyapatite combined with poly l-lactide

Consent : Continuous intra-sinus bone regeneration...

Written informed consent was obtained from the patient for publication of this report and all accompanying images.

Conclusions : Continuous intra-sinus bone regenera...

This nongrafted sinus-lifting procedure using an HA/PLLA mesh plate device helps to attain predictable bone formation. Stable membrane elevation by the HA/PLLA device for the long term could contribute to predictable bone formation in the sinus. The source of cell supply could possibly be the Schneiderian membrane, reflecting its osteogenic potential.

Case presentation : Continuous intra-sinus bone re...

In nongrafted sinus-lifting procedure, several devices such as titanium [12–14], hollow hydroxyapatite [15], and bioresorbable materials [16] have been used for space retention to maintain the lifted sinus membrane and the results of predictable bone formation have been reported in addition to histological examination. In this case, a mesh plate device consisting of HA/PLLA materials was applied...

Case presentation : Continuous intra-sinus bone re...

A 60-year-old healthy female, who desired dental implant therapy in the right molar region of the maxilla, was referred to the Department of Oral and Maxillofacial Surgery. Clinical examination revealed an edentulous maxilla from the right first premolar to the second molar region. Panoramic radiography showed atrophy of the maxillary alveolar ridge in the same site (Fig. 1), and the need for sin...

Background : Continuous intra-sinus bone regenerat...

Maxillary sinus lift is a bone augmentation procedure in the sinus that improves the alveolar crest height in atrophic posterior maxilla by forming new bone in the space created under the elevated sinus membrane. To date, numerous grafting materials have been used as a scaffold for new bone regeneration, including autogenous bone, bone graft substitutes, or their combination [1, 2]. Autogenous bon...

Abstract : Continuous intra-sinus bone regeneratio...

Sinus lift is a bone augmentation procedure that improves the alveolar crest height in an atrophic posterior maxilla. However, the regenerated bone volume can vary and generally has a tendency to decrease after sinus operation. This article describes nongrafted maxillary sinus lift using a bioresorbable unsintered hydroxyapatite combined with poly l-lactide (HA/PLLA) mesh plate device and dental i...

Fig. 2. Figure illustrating the proposed mucosal t...

Fig. 2. Figure illustrating the proposed mucosal thickening index. A ≤1 mm, indicating no thickening; B >1 mm but ≤2 mm, indicating minimal thickening; C >2 mm but ≤5 mm, indicating moderate thickening; D >5 mm, indicating severe thickening Fig. 2. Figure illustrating the proposed mucosal thickening index. A ≤1 mm, indicating no thickening; B >1 mm but ≤2 mm, indicating min...

Fig. 1. Figure illustrating the reference points o...

Fig. 1. Figure illustrating the reference points of the CBCT measurements. A: most posterior point of the sinus wall; B: most anterior point of the sinus wall; C: mid-point between A and B; C1: measurement of mucosal thickening perpendicular to A–B line at point C; D: mid-point between A and C; D1: measurement of mucosal thickening perpendicular to A–B line at point D; E: mid-point between B...

Table 2 Statistical results after inter-variable a...

  Gender Respiratory diseases Cardio-vascular diseases Diabetes mellitus Smoking Hist...

Table 1 CBCT measurements of sinus mucosal thicken...

Patient Anterior (E1-floor of the sinus) Middle (C1-floor of the sinus) Posterior (D1-floor of the sinus) ...

About this article : Dental implants and grafting ...

Maska, B., Lin, GH., Othman, A. et al. Dental implants and grafting success remain high despite large variations in maxillary sinus mucosal thickening. Int J Implant Dent 3, 1 (2017). https://doi.org/10.1186/s40729-017-0064-8 Download citation Received: 18 October 2016 Accepted: 13 January 2017 Published: 18 January 2017 DOI: https://doi.org/10.1186/s40729-017-0064-8

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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 : Dental implants and grafting ...

You can also search for this author in PubMed Google Scholar Correspondence to Yvonne Kapila.

Author information : Dental implants and grafting ...

Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, 1011 N University Ave, Ann Arbor, MI, USA Bartosz Maska, Guo-Hao Lin, Abdullah Othman, Shabnam Behdin, Suncica Travan, Erika Benavides & Yvonne Kapila Department of Surgical Sciences, School of Dentistry, Marquette University, 1801 W Wisconsin Ave, Milwaukee, WI, USA Guo-Hao Lin Department of Peri...

Acknowledgements : Dental implants and grafting su...

The authors thank Ms. Victoria Zakrzewski for her help with the figure generation and preparation. Co-primary author BM contributed to the CBCT measurement and preparation of the manuscript. Co-primary author G-HL contributed to the data analysis and preparation of the manuscript. Second author AO contributed to the protocol preparation, case review, case selection, and preparation of the manuscr...

References : Dental implants and grafting success ...

Romanos GE, Froum S, Costa-Martins S, Meitner S, Tarnow DP. Implant periapical lesions: etiology and treatment options. J Oral Implantol. 2011;37:53–63. Acharya A, Hao J, Mattheos N, Chau A, Shirke P, Lang NP. Residual ridge dimensions at edentulous maxillary first molar sites and periodontal bone loss among two ethnic cohorts seeking tooth replacement. Clin Oral Implants Res. 2014;25:1386–94...

References : Dental implants and grafting success ...

Pazera P, Bornstein MM, Pazera A, Sendi P, Katsaros C. Incidental maxillary sinus findings in orthodontic patients: a radiographic analysis using cone-beam computed tomography (CBCT). Orthod Craniofac Res. 2011;14:17–24. Ritter L, Lutz J, Neugebauer J, et al. Prevalence of pathologic findings in the maxillary sinus in cone-beam computerized tomography. Oral Surg Oral Med Oral Pathol Oral Radiol...

References : Dental implants and grafting success ...

Gardner DG. Pseudocysts and retention cysts of the maxillary sinus. Oral Surg Oral Med Oral Pathol. 1984;58:561–7. Chiapasco M, Palombo D. Sinus grafting and simultaneous removal of large antral pseudocysts of the maxillary sinus with a micro-invasive intraoral access. Int J Oral Maxillofac Surg. 2015;44:1499–505. Cano J, Campo J, Alobera MA, Baca R. Surgical ciliated cyst of the maxilla. Cl...

References : Dental implants and grafting success ...

Beretta M, Poli PP, Grossi GB, Pieroni S, Maiorana C. Long-term survival rate of implants placed in conjunction with 246 sinus floor elevation procedures: results of a 15-year retrospective study. J Dent. 2015;43:78–86. Del Fabbro M, Corbella S, Weinstein T, Ceresoli V, Taschieri S. Implant survival rates after osteotome-mediated maxillary sinus augmentation: a systematic review. Clin Implant D...

Abbreviations : Dental implants and grafting succe...

Cone-beam computed tomographic Protected Health Information Sinus floor elevation

Conclusions : Dental implants and grafting success...

Our study found that the largest tissue thickening was present in the middle section of the maxillary sinus. This tissue thickening did not vary based on gender, age, or smoking status, nor did it relate to the underlying alveolar ridge height. However, patients with a history of periodontal diseases demonstrated a significant association with mucosal thickening. A mucosal thickening index was pro...

Discussion : Dental implants and grafting success ...

Although residual alveolar ridge height has been associated with sinus mucosal thickening [36], our study did not find a significant association between these two parameters. Acharya et al. [36] reported that lower available bone height in the subsinus region was related to thickened sinus membranes within an Asian-Indian and Hong Kong-based Chinese population. Differences in the ethnic compositio...

Discussion : Dental implants and grafting success ...

Based on the findings of the current study, a history of periodontal disease is the only identified parameter significantly associated with sinus mucosal thickening. This finding indicates that clinicians should expect some degree of mucosal thickening when performing sinus augmentation procedures in a previously periodontally involved site. This finding is consistent with several previously publi...

Discussion : Dental implants and grafting success ...

CBCT imaging has been recognized as a more sensitive imaging modality for identifying sinus thickening and pathoses in the posterior maxilla compared to panoramic radiography [21, 22]. This could explain why the current study identified a higher prevalence of mucosal thickening compared to earlier studies [23]. However, compared to other similar CBCT studies [21, 24, 25], the prevalence reported i...

Results : Dental implants and grafting success rem...

Twenty-nine CBCT images (11 females and 18 males) were included in this study. All the implants placed in these included cases survived, representing a 100% implant survival rate. With regards to measurements of mucosal thickening, the intra-examiner reproducibility revealed an exact intra-examiner correlation of 99%, with a p value of 0.40 for a t test for independent samples, indicating a high r...

Methods : Dental implants and grafting success rem...

The sites that were measured are specified in the image below (Fig. 1). The most posterior and anterior aspects of the visible maxillary sinus were measured. The ½ point along with the ¼ and ¾ points were then selected, and the measurements of the mucosal thickening were then completed at these three sites. The thickest portion of the mucosa was also measured if it did not coincide with one of...

Methods : Dental implants and grafting success rem...

The study required access to University of Michigan Protected Health Information (PHI). PHI was necessary in order to track and coordinate the CBCT data and dental and medical history for each subject. Corresponding subject charts and electronic records were reviewed for retrieval of relevant implant placement and restorative history, medical history, and demographic information, including gender ...

Methods : Dental implants and grafting success rem...

Our study hypothesis was that mucosal thickening of more than 2 mm and up to 1/3 of the volume of the sinus would not alter the predictability for SFE and dental implant placement. The primary outcome was to determine the success rate of dental implant placement in augmented maxillary sinus areas with mucosal thickening. A secondary outcome was to evaluate the effect of gender, age, and smoking o...

Background : Dental implants and grafting success ...

Despite the high survival rate of dental implants inserted in maxillary sinuses that have undergone sinus floor elevation (SFE) with bone grafting, complications still occur [1–3]. Sinus membrane perforation is reported to be the most common complication [4, 5]. Postoperative maxillary sinusitis is less common (0–22%) [6, 7]; nevertheless, it could potentially compromise the outcome of SFE and...

Abstract : Dental implants and grafting success re...

Although mucosal thickening is the most common radiographic finding observed regarding sinus pathology, the knowledge regarding its clinical significance on the outcomes of dental implants and grafting in the maxillary sinuses is still limited. We hypothesized that mucosal thickening would not alter the predictability for sinus floor augmentation and dental implant placement. The purpose of this r...

Fig. 7. Orthopantomograph 2 years after implant p...

Fig. 7. Orthopantomograph 2 years after implant placement

Fig. 6. Clinical picture 2 years after implant pl...

Fig. 6. Clinical picture 2 years after implant placement Fig. 6. Clinical picture 2 years after implant placement

Fig. 5. Occlusal view of implants after vertical r...

Fig. 5. Occlusal view of implants after vertical repositioning of the dental alveolus segment showing proper mesiodistal space and buccolingual spacing Fig. 5. Occlusal view of implants after vertical repositioning of the dental alveolus segment showing proper mesiodistal space and buccolingual spacing

Fig. 4. Vertical repositioning of dental alveolus ...

Fig. 4. Vertical repositioning of dental alveolus segment with placement of dental implants Fig. 4. Vertical repositioning of dental alveolus segment with placement of dental implants

Fig. 3. Direct sinus lift with implant osteotomy p...

Fig. 3. Direct sinus lift with implant osteotomy preparation Fig. 3. Direct sinus lift with implant osteotomy preparation

Fig. 2. Marked incision site for surgical access :...

Fig. 2. Marked incision site for surgical access Fig. 2. Marked incision site for surgical access

Fig. 1. Edentulous site with supra-eruption of opp...

Fig. 1. Edentulous site with supra-eruption of opposing dentition Fig. 1. Edentulous site with supra-eruption of opposing dentition

About this article : Maxillary segmental osteoperi...

Tsegga, T., Wright, T. Maxillary segmental osteoperiosteal flap with simultaneous placement of dental implants: case report of a novel technique. Int J Implant Dent 3, 2 (2017). https://doi.org/10.1186/s40729-017-0067-5 Download citation Received: 06 December 2016 Accepted: 13 January 2017 Published: 19 January 2017 DOI: https://doi.org/10.1186/s40729-017-0067-5

Rights and permissions : Maxillary segmental osteo...

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 : Maxillary segmental osteoperi...

Department of Oral & Maxillofacial Surgery, San Antonio Military Medical Center, 3551 Roger Brooke Dr., Ft. Sam Houston, 78234, TX, USA Tibebu Tsegga & Thomas Wright Department of Oral & Maxilofacial Surgery, Wilford Hall Ambulatory Surgical Center, 2200 Bergquist Dr, Suite 1, Lackland AFB, TX, 78236, USA Tibebu Tsegga & Thomas Wright You can also search for this author in PubMed Google S...

References : Maxillary segmental osteoperiosteal f...

Irinakis T. Efficacy of injectable demineralized bone matrix as graft material during sinus elevation surgery with simultaneous implant placement in the posterior maxilla: clinical evaluation of 49 sinuses. J Oral and Maxillofac Surg. 2011;69:134–41. Chiapasoo M, Casentini P, Zaniboni M. Bone augmentation procedures in implant dentistry. Int J Oral Maxillofac Implants. 2009;24:237–69. Jenson...

Conclusions : Maxillary segmental osteoperiosteal ...

This case highlights the evolving variations in dentoalveolar augmentation with an emphasis on concomitant implant placement. In the most traditional sense, a vertical osteoperiosteal flap technique would be bound with a stable basal bone that can be used to anchor simultaneous dental implant placement. Further refinement should consider minimizing crestal reflection and overall labial bone resorp...

Discussion : Maxillary segmental osteoperiosteal f...

A critical appraisal of the gingival architecture in the final end point of this case demonstrates some radiolucency through the soft tissue outlining the platform of the Nobel Biocare TiUnite implant. This would lead us to believe that either the transmucosal bone level placement attempt was inaccurate or excessive reflection of the labial tissue has caused some degree of resorption. This is anot...

Discussion : Maxillary segmental osteoperiosteal f...

A suitable alternative surgical management of this particular case might have been to simply perform an alveoloplasty to produce the desired inter-occlusal clearance and proceed with placement of implant and simultaneous direct sinus lift. That would have left more of the apical portion of the implant within the grafted sinus and possibly modified the location of keratinized band of tissue. The lo...

Case Presentation : Maxillary segmental osteoperio...

A 35-year-old female with a 10-year history of partial acquired edentulism at site numbers 3 and 4 presented to our clinic for dental implant evaluation. Preoperative clinical examination revealed a reproducible intercuspation, well-delineated band of keratinized tissue, and decreased inter-occlusal clearance to allow for optimal dimension of prosthetic crowns (Fig. 1). Radiographs demonstrated e...

Background : Maxillary segmental osteoperiosteal f...

Obtaining proper occlusal clearance to allow for a single unit crown restoration is a fundamental prerequisite for dental implant restoration. Long-standing edentulous sites are often fraught with disuse atrophy and unopposed supra-eruption of the opposing dentition. In the posterior maxillae/mandible, there are vital structures that have to be mobilized in order to allow space for either bone tra...

Abstract : Maxillary segmental osteoperiosteal fla...

Dental restorative space from the opposing dentition requires adequate distance for restorative material for an acceptable restoration. Typically, long-standing edentulous alveolar ridges will have vertical and or horizontal defects that require alveolar ridge augmentation for ideal dental implant restorations. Along with these defects, one will see the opposing dentition supra erupt which can obl...

Fig. 5. Total score for physical and psychological...

Fig. 5. Total score for physical and psychological disabilities before (gray) and after (hatched) sinus augmentation according to indications Fig. 5. Total score for physical and psychological disabilities before (gray) and after (hatched) sinus augmentation according to indications

Fig. 4. Total score for functional limitations bef...

Fig. 4. Total score for functional limitations before (gray) and after (hatched) sinus augmentation according to indications Fig. 4. Total score for functional limitations before (gray) and after (hatched) sinus augmentation according to indications

Fig. 3. Total score for complaints due to surgical...

Fig. 3. Total score for complaints due to surgical procedure pre-operative, post-operative, and recently Fig. 3. Total score for complaints due to surgical procedure pre-operative, post-operative, and recently

Fig. 2. Cumulative survival rate according to Kapl...

Fig. 2. Cumulative survival rate according to Kaplan–Meier and sinus augmentation procedure Fig. 2. Cumulative survival rate according to Kaplan–Meier and sinus augmentation procedure

Fig. 1. Flow chart of patients included in the stu...

Fig. 1. Flow chart of patients included in the study Fig. 1. Flow chart of patients included in the study

Table 3 Mean value and standard deviation for the ...

Item Mean ± SD pre-operative Mean ± SD post-operative Mean ± SD in the last time Have you felt pain in your mouth? ...

Table 2 Mean value and standard deviation for the ...

Item Mean ± SD before sinus lift Mean ± SD after sinus lift p value Have you felt tense because of problems with your teeth, mouth or dentures? ...

Table 1 Mean value and standard deviation for the ...

Item Mean ± SD before sinus lift Mean ± SD after sinus lift p value Have you had difficulty chewing any foods? ...

About this article : Impact of maxillary sinus aug...

Schiegnitz, E., Kämmerer, P.W., Sagheb, K. et al. Impact of maxillary sinus augmentation on oral health-related quality of life. Int J Implant Dent 3, 10 (2017). https://doi.org/10.1186/s40729-017-0072-8 Download citation Received: 20 November 2016 Accepted: 12 March 2017 Published: 28 March 2017 DOI: https://doi.org/10.1186/s40729-017-0072-8

Rights and permissions : Impact of maxillary sinus...

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 : Impact of maxillary sinus aug...

Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University, Augustusplatz 2, 55131, Mainz, Germany E. Schiegnitz, K. Sagheb, A. Pabst, B. Al-Nawas & M. O. Klein Department of Oral and Maxillofacial Surgery, Plastic Surgery, University of Rostock, Rostock, Germany P. W. Kämmerer Department of Prosthodontics, University of ...

References : Impact of maxillary sinus augmentatio...

Stellingsma K, Bouma J, Stegenga B, Meijer HJ, Raghoebar GM. Satisfaction and psychosocial aspects of patients with an extremely resorbed mandible treated with implant-retained overdentures. A prospective, comparative study. Clin Oral Implants Res. 2003;14(2):166–72. Heydecke G, Locker D, Awad MA, Lund JP, Feine JS. Oral and general health-related quality of life with conventional and implant d...

References : Impact of maxillary sinus augmentatio...

Locker D. Self-esteem and socioeconomic disparities in self-perceived oral health. J Public Health Dent. 2009 Winter;69(1):1-8. Allen PF, McMillan AS, Walshaw D. A patient-based assessment of implant-stabilized and conventional complete dentures. J Prosthet Dent. 2001;85(2):141–7. Ohrn K, Jonsson B. A comparison of two questionnaires measuring oral health-related quality of life before and aft...

References : Impact of maxillary sinus augmentatio...

Al-Nawas B, Schiegnitz E. Augmentation procedures using bone substitute materials or autogenous bone—a systematic review and meta-analysis. Eur J Oral Implantol. 2014 Summer;7 Suppl 2:S219-34. Derks J, Hakansson J, Wennstrom JL, Tomasi C, Larsson M, Berglundh T. Effectiveness of implant therapy analyzed in a Swedish population: early and late implant loss. J Dent Res. 2015;94(3 Suppl):44S–51S...

Conclusions : Impact of maxillary sinus augmentati...

Within the limitations of this study, the results demonstrated a high long-term survival for sinus augmentation procedures and significant improvement of OHRQoL after this procedure. Therefore, sinus augmentation procedures are highly valuable treatment options in implant dentistry.

Discussion : Impact of maxillary sinus augmentatio...

In order to measure OHRQoL in the present study, a specific and shortened questionnaire based on the validated and reliable OHIP score was developed to consider representative impairments of maxillary sinus augmentation like sinusitis and to relieve the clinical application. In a cross sectional study, Allen et McMillan proofed that a shortened OHIP-14 version showed a similar ability to assess OH...

Discussion : Impact of maxillary sinus augmentatio...

The clinical and radiological outcomes of sinus augmentation procedures have been published in several studies [1, 3, 6, 7]. However, little data on the physical and psychological impact of this procedure on the patient is available yet. The present study evaluated pre-operative and post-treatment OHRQoL self-assessment scores of patients treated with dental implants after sinus augmentation proce...

Results : Impact of maxillary sinus augmentation o...

Concerning functional limitations, all posed questions showed significant better values for OHRQoL after sinus augmentation procedure than before the treatment (p 

Results : Impact of maxillary sinus augmentation o...

After an average time in situ of 41.2 ± 27 months (3.4 years; range 0–96 months), 40 of the 863 implants were lost. These results indicated an in situ rate of 95.4%. One-year and five-year survival rate according to Kaplan–Meier were 95.4 and 94.4%. In patients receiving an external sinus lift an in situ rate of 95.1% and in patients with an internal sinus lift an in situ rate of 96.4%...

Methods : Impact of maxillary sinus augmentation o...

The Kaplan–Meier survival function was applied for the description of survival rates. To examine the statistical difference between survival rates, a log-rank test was used. Implant-related data were calculated. For statistical comparison of the paired questions and the total scores, a Wilcoxon test was applied. The intention of this study was descriptive, exploratory without a primary hypothesi...

Methods : Impact of maxillary sinus augmentation o...

This retrospective study addresses the oral health-related quality of life after maxillary sinus augmentation. Therefore, all patients that received an implantation after maxillary sinus augmentation in the Department of Oral and Maxillofacial Surgery of the University Medical Centre Mainz, Germany, between July 2002 and December 2007 were included in this study. There were no specific exclusion c...

Background : Impact of maxillary sinus augmentatio...

In conclusion, little information is available about patient’s perception of sinus augmentation procedures. The aim of the present study was to assess whether sinus augmentation procedures together with implant placement and prosthetic rehabilitation improve quality of life in dental patients using a modified German OHIP and to examine the survival rates after this procedure.

Background : Impact of maxillary sinus augmentatio...

Rehabilitation of completely and partial edentulous patients with dental implants has proved to be a safe and predictable procedure [1–3]. However, reduced bone height and the proximity of the maxillary sinus are challenging limitations for dental implant placement in the posterior maxilla [3]. Besides the use of short and tilted implants [4], one of the most frequently used surgical techniques ...

Abstract : Impact of maxillary sinus augmentation ...

The aim of this study was to measure the oral health-related quality of life (OHRQoL) after maxillary sinus augmentation to determine the physical and psychological impact of this procedure for the patient. Three hundred sixteen patients treated with an external or internal maxillary sinus augmentation and a total of 863 implants in the Department of Oral and Maxillofacial Surgery, Johannes Guten...

Fig. 2. a Panoramic radiography with area of inter...

Fig. 2. a Panoramic radiography with area of interest (maxillary sinus) and b, c examples of corresponding images in cone beam computed tomography Fig. 2. a Panoramic radiography with area of interest (maxillary sinus) and b, c examples of corresponding images in cone beam computed tomography

Fig. 1. a Panoramic radiography with area of inter...

Fig. 1. Fig. 1. a Panoramic radiography with area of interest (maxillary sinus) and b, c examples of corresponding images in cone beam computed tomography

Table 5 Results of the question “Is there an add...

Question General practitioner (n = 2) Junior maxillofacial surgeon (n = 2) Senior maxillofacial surgeon (n = 3) p value* ...

Table 4 Description of incidental findings in PAN ...

Additional incidental findings in panoramic radiography Relative incidence (%) in relation to total number of therapy affecting findings Retained third molar/follicular cyst 22 ...

Table 3 Number of additional incidental findings i...

Number of cases General practitioner (n = 2) Junior maxillofacial surgeon (n = 2) Senior maxillofacial surgeon (n = 3) p value*   ...

Table 2 Results of the question “An additional s...

Question General practitioner (n = 2) Junior maxillofacial surgeon (n = 2) Senior maxillofacial surgeon (n = 3) p value* ...

Table 1 Results of the question “Based on PAN, t...

Question General practitioner (n = 2) Junior maxillofacial surgeon (n = 2) Senior maxillofacial surgeon (n = 3) p value* ...

About this article : Evaluation of symptomatic max...

Dau, M., Marciak, P., Al-Nawas, B. et al. Evaluation of symptomatic maxillary sinus pathologies using panoramic radiography and cone beam computed tomography—influence of professional training. Int J Implant Dent 3, 13 (2017). https://doi.org/10.1186/s40729-017-0075-5 Download citation Received: 10 December 2016 Accepted: 12 March 2017 Published: 05 April 2017 DOI: http...

Rights and permissions : Evaluation of symptomatic...

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 : Evaluation of symptomatic max...

Department of Oral, Maxillofacial and Plastic Surgery, University Medical Center, Schillingallee 35, 18057, Rostock, Germany Michael Dau, Bernhard Frerich & Peer Wolfgang Kämmerer Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre, Mainz, Germany Paul Marciak & Bial Al-Nawas Private Dental Praxis Dr. Rossa, Ludwigshafen, Germany Henning Staedt Depa...

References : Evaluation of symptomatic maxillary s...

Quintero JC, et al. Craniofacial imaging in orthodontics: historical perspective, current status, and future developments. Angle Orthod. 1999;69(6):491–506. Tadinada A, et al. Radiographic evaluation of the maxillary sinus prior to dental implant therapy: a comparison between two-dimensional and three-dimensional radiographic imaging. Imaging Sci Dent. 2015;45(3):169–74. Ritter L, et al. Pre...

References : Evaluation of symptomatic maxillary s...

Rivis M, Valeanu AN. Giant maxillary cyst with intrasinusal evolution. Rom J Morphol Embryol. 2013;54(3 Suppl):889–92. Yilmaz SY, Misirlioglu M, Adisen MZ. A diagnosis of maxillary sinus fracture with cone-beam CT: case report and literature review. Craniomaxillofac Trauma Reconstr. 2014;7(2):85–91. Lana JP, et al. Anatomic variations and lesions of the maxillary sinus detected in cone beam ...

References : Evaluation of symptomatic maxillary s...

Gang TI, et al. The effect of radiographic imaging modalities and the observer’s experience on postoperative maxillary cyst assessment. Imaging Sci Dent. 2014;44(4):301–5. Batra PS, et al. Computed tomography imaging practice patterns in adult chronic rhinosinusitis: survey of the American Academy of Otolaryngology-Head and Neck Surgery and American Rhinologic Society Membership. Int Forum Al...

References : Evaluation of symptomatic maxillary s...

Dragan E, et al. Maxillary sinus anatomic and pathologic CT findings in edentulous patients scheduled for sinus augmentation. Rev Med Chir Soc Med Nat Iasi. 2014;118(4):1114–21. Raghav M, et al. Prevalence of incidental maxillary sinus pathologies in dental patients on cone-beam computed tomographic images. Contemp Clin Dent. 2014;5(3):361–5. Lyros I, et al. An incidental finding on a diagno...

Conclusions : Evaluation of symptomatic maxillary ...

Depending on the observers’ clinical and radiological experience, PAN alone may not be sufficient for evaluation of pathologies of the maxillary sinus. On the contrary, significant benefits of sFOV-CBCT for diagnosing symptomatic maxillary sinus pathologies were reported. Having sFOV-CBCT seems to have added additional information and confidence in comparison to PAN alone. Nonetheless, also with...

Discussion : Evaluation of symptomatic maxillary s...

The influence of clinical experience of evaluation of PAN [34] as well as the clinical experience and routine analysis of 3D radiographs (as assumed for maxillofacial surgeons when compared to those for general practitioners) strongly influence the diagnostic value of additional three-dimensional imaging. The number of incidental findings in CBCT in addition to those seen in PAN was not of major d...

Discussion : Evaluation of symptomatic maxillary s...

In dentistry, PAN is a widely available, useful, and important diagnostic tool for diagnosis and general preoperative planning [32] with less radiation exposure then CBCT [21]. While most dentists have used it routinely successful for years and gained significant experience in doing so [33], there are certain limitations in dependence of the region to be examined [10]. The high number of “not vi...

Results : Evaluation of symptomatic maxillary sinu...

This study focused on three different aspects in our analysis—PAN, PAN and CBCT, as well as the influence of the different clinical and radiological experience (examples in Figs. 1 and 2). Panoramic radiography (PAN) When assessing PAN, the ratings were significantly lower at “good visible and can be evaluated” (9.9%) compared to “visible but cannot be evaluated” (39.5%; p 

Methods : Evaluation of symptomatic maxillary sinu...

The first question for PAN addressed the imaging quality in the clinical relevant area of interest (clinical data were given). Three answers were possible: 1 = good visibility and can be evaluated, 2 = visible but cannot be evaluated, and 3 = not visible. The second question asked for an additional need for CBCT scans. Three answers were possible: 1 = required, 2 = reasonable, and 3 = not required...

Methods : Evaluation of symptomatic maxillary sinu...

In an experimental diagnostic comparison, radiographic images of 15 female and 13 male patients were assessed. Patients’ radiographs were selected from the Department of Oral, Maxillofacial and Facial Plastic Surgery of the University Medical Centre of Mainz and Rostock, Germany. All patients have had referrals to the hospitals with symptomatic maxillary sinus pathologies and received PAN (Ortho...

Background : Evaluation of symptomatic maxillary s...

In order to justify CBCT use for clinical examination and diagnosis of the maxillary sinus, the aim of this study was to compare the subjective quality rating of PAN and PAN together with a small field of view (sFOV) CBCT to evaluate symptomatic maxillary sinus by clinicians with different training and clinical experience.

Background : Evaluation of symptomatic maxillary s...

Non-symptomatic abnormalities of the maxillary sinus such as mucosal thickening, retention cysts, and opacification are reported to occur in up to 74% of all cases [1–6]. For diagnosis of symptomatic pathologies of the maxillary sinus like retention cysts, polyps, and tumors, panoramic radiographies (PAN) are commonly used and widely available. In PAN, not every area of interest is accurately de...

Abstract : Evaluation of symptomatic maxillary sin...

A comparison of panoramic radiography (PAN) alone and PAN together with small field of view cone beam computed tomography (sFOV-CBCT) for diagnosis of symptomatic pathologies of the maxillary sinus was carried out by clinicians of different experience. Corresponding radiographic images (PAN/sFOV-CBCT) of 28 patients with symptomatic maxillary sinus pathologies were chosen and analyzed by two gene...

Fig. 6. Histomorphometric evaluation results (cons...

Fig. 6. Histomorphometric evaluation results (considering six sections for each biopsy), for newly formed bone, soft tissues, and others Fig. 6. Histomorphometric evaluation results (considering six sections for each biopsy), for newly formed bone, soft tissues, and others

Fig. 5. Histomicrograph of a biopsy from the BC ...

Fig. 5. Histomicrograph of a biopsy from the BC + EMD group, showing an aspect of newly formed bone. Section stained with picrosirius-hematoxylin and digitalized with bright-field (d) and linearly polarized light (e and f). e, f Results of near 45° section rotation (between axes B–B’ and C–C’) to compensate some of the orientation-related effects associated with linearly polarized l...

Fig. 4. Histomicrograph of a biopsy from the BC gr...

Fig. 4. Histomicrograph of a biopsy from the BC group, showing an aspect of newly formed bone. Section stained with picrosirius-hematoxylin and digitalized with bright-field (a) and linearly polarized light (b and c). b, c Results of near 45° section rotation (between axes B–B’ and C–C’) to compensate some of the orientation-related effects associated with linearly polarized light. In a...

Fig. 3. Histomicrograph of a biopsy from the BC ...

Fig. 3. Histomicrograph of a biopsy from the BC + EMD group. Overview—×25 magnification; b ×30 magnification; c ×60 magnification. Areas corresponding to BC + EMD removed during histological processing (square) surrounded by newly formed bone (asterisk), with large numbers of osteocytes and soft tissue (arrow) can be observed. There is direct contact between the BC reminiscent, soft...

Fig. 2. Histomicrograph of a biopsy from the BC gr...

Fig. 2. Histomicrograph of a biopsy from the BC group. a Overview—×25 magnification; b ×30 magnification; c ×60 magnification. Areas corresponding to BC removed during histological processing (square) in direct contact with newly formed bone (asterisk), containing a large number of osteocytes, and with soft tissue (arrow) can be observed (hematoxylin-eosin stain) Fig. 2. Histomicrograph ...

Fig. 1. Histomicrograph illustrating the various t...

Fig. 1. Histomicrograph illustrating the various tissue areas measured on the sections: newly formed bone (green mask), soft tissues (purple mask), and “others”, including residual bone substitute particles and empty spaces either due to removal of the bone substitute particles during to the decalcification processing or due to artifacts (white mask) Fig. 1. Histomicrograph illustrating t...

About this article : β-TCP/HA with or without ena...

Nery, J.C., Pereira, L.A.V.D., Guimarães, G.F. et al. β-TCP/HA with or without enamel matrix proteins for maxillary sinus floor augmentation: a histomorphometric analysis of human biopsies. Int J Implant Dent 3, 18 (2017). https://doi.org/10.1186/s40729-017-0080-8 Download citation Received: 08 December 2016 Accepted: 22 April 2017 Published: 04 May 2017 DOI: https://do...

Rights and permissions : β-TCP/HA with or without...

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 : β-TCP/HA with or without ena...

You can also search for this author in PubMed Google Scholar Correspondence to James Carlos Nery.

Author information : β-TCP/HA with or without ena...

Department of Implantology, São Leopoldo Mandic Research Center, Brasília, DF, Brazil James Carlos Nery, George Furtado Guimarães & Fabiana Mantovani Gomes França Department of Biochemistry and Tissue Biology, UNICAMP – State University of Campinas, Institute of Biology, Campinas, São Paulo, Brazil Luís Antônio Violin Dias Pereira Department of Periodontology, UNESP – Univ. Estad...

References : β-TCP/HA with or without enamel matr...

Wikesjo UM, Sorensen RG, Kinoshita A, Wozney JM. RhBMP-2/alphaBSM induces significant vertical alveolar ridge augmentation and dental implant osseointegration. Clin Implant Dent Relat Res. 2002;4:174–82. Carinci F, Brunelli G, Franco M, Viscioni A, Rigo L, Guidi R, et al. A retrospective study on 287 implants installed in resorbed maxillae grafted with fresh frozen allogenous bone. Clin Implant...

References : β-TCP/HA with or without enamel matr...

Miron RJ, Sculean A, Cochran DL, Froum S, Zucchelli G, Nemcovsky C, et al. Twenty years of enamel matrix derivative: the past, the present and the future. J Clin Periodontol. 2016;43:668–83. Sculean A, Nikolidakis D, Nikou G, Ivanovic A, Chapple IL, Stavropoulos A. Biomaterials for promoting periodontal regeneration in human intrabony defects: a systematic review. Periodontol 2000. 2015;68:182...

References : β-TCP/HA with or without enamel matr...

Esposito M, Felice P, Worthington HV. Interventions for replacing missing teeth: augmentation procedures of the maxillary sinus. Cochrane Database Syst Rev. 2014;17:CD008397. Jungner M, Cricchio G, Salata LA, Sennerby L, Lundqvist C, Hultcrantz M, et al. On the early mechanisms of bone formation after maxillary sinus membrane elevation: an experimental histological and immunohistochemical study. ...

Conclusions : β-TCP/HA with or without enamel mat...

The present study showed that maxillary sinus floor augmentation with BC resulted in adequate amounts of new bone formation allowing successful implant installation, while adding EMD did not have a significant effect.

Discussion : β-TCP/HA with or without enamel matr...

Nevertheless, the amount of bone generated with BC or BC + EMD herein was adequate to support successful implant placement and osseointegration of implants. In fact, more or less similar amounts of bone formation have been reported in studies evaluating human sinus biopsies after grafting with a variety of biomaterials (bone formation ranging approximately from 30 to 50%) [19]. On the other ha...

Discussion : β-TCP/HA with or without enamel matr...

The present study compared the histological and histomorphometrical outcome of healing after maxillary sinus floor augmentation with BC with or without EMD, based on human biopsies. The results showed that addition of EMD did not enhance the outcome of healing, neither in terms of quality nor quantity of new bone. Nevertheless, the amount of bone generated after maxillary sinus floor augmentation ...

Results : β-TCP/HA with or without enamel matrix ...

All ten patients showed uneventful healing after the sinus floor augmentation procedure as well as after dental implant placement, with no overt postoperative inflammation or infection. Consistently, in all ten patients, no significant jiggling of the drill was noticed during biopsy harvesting, while subjective drilling resistance during implant placement was similar in both groups and all implant...

Methods : β-TCP/HA with or without enamel matrix ...

The data for each tissue component from the three histological sections were averaged to represent the biopsy. Commercially available software (GraphPad Prism 5.0 for Windows, GraphPad Software Inc., USA) was utilized for statistical comparisons between groups and for drawing the graphics. The assumption of normality was checked using D’Agostino & Pearson omnibus test. The data for each evaluate...

Methods : β-TCP/HA with or without enamel matrix ...

Six months after grafting, another CBCT examination was carried out for implant planning. In the sequence, following the previously described antiseptic and anesthetic procedures, two implants with a sand-blasted and acid etching surface were installed in each of the grafted sinuses, i.e., 40 implants in total (32—Neoporous, Neodent, Curitiba, Paraná, Brazil; 8—SLA, Straumann, Basel, Switzerl...

Methods : β-TCP/HA with or without enamel matrix ...

This research project was approved by the Ethics Committee of the School of Dentistry and Dental Research Center São Leopoldo Mandic, Brazil, under the protocol 2010/0360. Ten consecutive patients (age range 35–75 years) with the need of bilateral maxillary sinus floor augmentation prior to the placement of four dental implants (two in each side of posterior maxilla) were selected for the stu...

Background : β-TCP/HA with or without enamel matr...

The aim of the present study was to compare histomorphometrically the outcome of maxillary sinus floor augmentation with β-TCP/HA with or without enamel matrix proteins (BC + EMD and EMD, respectively) in humans.

Background : β-TCP/HA with or without enamel matr...

Reconstruction of the edentulous and severely atrophied posterior maxilla is often performed by means of maxillary sinus floor augmentation in combination with dental implants [1, 2]. Various bone graft materials are typically used for enhancing bone formation within the sinus cavity; autogenous bone (AB) is considered as the gold standard due to its osteogenic, osteoinductive, and osteoconductive...

Abstract : β-TCP/HA with or without enamel matrix...

It is still unclear whether enamel matrix proteins (EMD) as adjunct to bone grafting enhance bone healing. This study compared histomorphometrically maxillary sinus floor augmentation (MSFA) with β-TCP/HA in combination with or without EMD in humans. In ten systemically healthy patients needing bilateral MSFA, one side was randomly treated using β-TCP/HA mixed with EMD (BC + EMD) and the ot...

Fig. 6. Histomorphometric evaluation results (cons...

Fig. 6. Histomorphometric evaluation results (considering six sections for each biopsy), for newly formed bone, soft tissues, and others Fig. 6. Histomorphometric evaluation results (considering six sections for each biopsy), for newly formed bone, soft tissues, and others

Fig. 5. Histomicrograph of a biopsy from the BC ...

Fig. 5. Histomicrograph of a biopsy from the BC + EMD group, showing an aspect of newly formed bone. Section stained with picrosirius-hematoxylin and digitalized with bright-field (d) and linearly polarized light (e and f). e, f Results of near 45° section rotation (between axes B–B’ and C–C’) to compensate some of the orientation-related effects associated with linearly polarized l...

Fig. 4. Histomicrograph of a biopsy from the BC gr...

Fig. 4. Histomicrograph of a biopsy from the BC group, showing an aspect of newly formed bone. Section stained with picrosirius-hematoxylin and digitalized with bright-field (a) and linearly polarized light (b and c). b, c Results of near 45° section rotation (between axes B–B’ and C–C’) to compensate some of the orientation-related effects associated with linearly polarized light. In a...

Fig. 3. Histomicrograph of a biopsy from the BC ...

Fig. 3. Histomicrograph of a biopsy from the BC + EMD group. Overview—×25 magnification; b ×30 magnification; c ×60 magnification. Areas corresponding to BC + EMD removed during histological processing (square) surrounded by newly formed bone (asterisk), with large numbers of osteocytes and soft tissue (arrow) can be observed. There is direct contact between the BC reminiscent, soft...

Fig. 2. Histomicrograph of a biopsy from the BC gr...

Fig. 2. Histomicrograph of a biopsy from the BC group. a Overview—×25 magnification; b ×30 magnification; c ×60 magnification. Areas corresponding to BC removed during histological processing (square) in direct contact with newly formed bone (asterisk), containing a large number of osteocytes, and with soft tissue (arrow) can be observed (hematoxylin-eosin stain) Fig. 2. Histomicrograph ...

Fig. 1. Histomicrograph illustrating the various t...

Fig. 1. Histomicrograph illustrating the various tissue areas measured on the sections: newly formed bone (green mask), soft tissues (purple mask), and “others”, including residual bone substitute particles and empty spaces either due to removal of the bone substitute particles during to the decalcification processing or due to artifacts (white mask) Fig. 1. Histomicrograph illustrating t...

About this article : β-TCP/HA with or without ena...

Nery, J.C., Pereira, L.A.V.D., Guimarães, G.F. et al. β-TCP/HA with or without enamel matrix proteins for maxillary sinus floor augmentation: a histomorphometric analysis of human biopsies. Int J Implant Dent 3, 18 (2017). https://doi.org/10.1186/s40729-017-0080-8 Download citation Received: 08 December 2016 Accepted: 22 April 2017 Published: 04 May 2017 DOI: https://do...

Rights and permissions : β-TCP/HA with or without...

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 : β-TCP/HA with or without ena...

You can also search for this author in PubMed Google Scholar Correspondence to James Carlos Nery.

Author information : β-TCP/HA with or without ena...

Department of Implantology, São Leopoldo Mandic Research Center, Brasília, DF, Brazil James Carlos Nery, George Furtado Guimarães & Fabiana Mantovani Gomes França Department of Biochemistry and Tissue Biology, UNICAMP – State University of Campinas, Institute of Biology, Campinas, São Paulo, Brazil Luís Antônio Violin Dias Pereira Department of Periodontology, UNESP – Univ. Estad...

References : β-TCP/HA with or without enamel matr...

Wikesjo UM, Sorensen RG, Kinoshita A, Wozney JM. RhBMP-2/alphaBSM induces significant vertical alveolar ridge augmentation and dental implant osseointegration. Clin Implant Dent Relat Res. 2002;4:174–82. Carinci F, Brunelli G, Franco M, Viscioni A, Rigo L, Guidi R, et al. A retrospective study on 287 implants installed in resorbed maxillae grafted with fresh frozen allogenous bone. Clin Implant...

References : β-TCP/HA with or without enamel matr...

Miron RJ, Sculean A, Cochran DL, Froum S, Zucchelli G, Nemcovsky C, et al. Twenty years of enamel matrix derivative: the past, the present and the future. J Clin Periodontol. 2016;43:668–83. Sculean A, Nikolidakis D, Nikou G, Ivanovic A, Chapple IL, Stavropoulos A. Biomaterials for promoting periodontal regeneration in human intrabony defects: a systematic review. Periodontol 2000. 2015;68:182...

References : β-TCP/HA with or without enamel matr...

Esposito M, Felice P, Worthington HV. Interventions for replacing missing teeth: augmentation procedures of the maxillary sinus. Cochrane Database Syst Rev. 2014;17:CD008397. Jungner M, Cricchio G, Salata LA, Sennerby L, Lundqvist C, Hultcrantz M, et al. On the early mechanisms of bone formation after maxillary sinus membrane elevation: an experimental histological and immunohistochemical study. ...

Conclusions : β-TCP/HA with or without enamel mat...

The present study showed that maxillary sinus floor augmentation with BC resulted in adequate amounts of new bone formation allowing successful implant installation, while adding EMD did not have a significant effect.

Discussion : β-TCP/HA with or without enamel matr...

Nevertheless, the amount of bone generated with BC or BC + EMD herein was adequate to support successful implant placement and osseointegration of implants. In fact, more or less similar amounts of bone formation have been reported in studies evaluating human sinus biopsies after grafting with a variety of biomaterials (bone formation ranging approximately from 30 to 50%) [19]. On the other ha...

Discussion : β-TCP/HA with or without enamel matr...

The present study compared the histological and histomorphometrical outcome of healing after maxillary sinus floor augmentation with BC with or without EMD, based on human biopsies. The results showed that addition of EMD did not enhance the outcome of healing, neither in terms of quality nor quantity of new bone. Nevertheless, the amount of bone generated after maxillary sinus floor augmentation ...

Results : β-TCP/HA with or without enamel matrix ...

All ten patients showed uneventful healing after the sinus floor augmentation procedure as well as after dental implant placement, with no overt postoperative inflammation or infection. Consistently, in all ten patients, no significant jiggling of the drill was noticed during biopsy harvesting, while subjective drilling resistance during implant placement was similar in both groups and all implant...

Methods : β-TCP/HA with or without enamel matrix ...

The data for each tissue component from the three histological sections were averaged to represent the biopsy. Commercially available software (GraphPad Prism 5.0 for Windows, GraphPad Software Inc., USA) was utilized for statistical comparisons between groups and for drawing the graphics. The assumption of normality was checked using D’Agostino & Pearson omnibus test. The data for each evaluate...

Methods : β-TCP/HA with or without enamel matrix ...

Six months after grafting, another CBCT examination was carried out for implant planning. In the sequence, following the previously described antiseptic and anesthetic procedures, two implants with a sand-blasted and acid etching surface were installed in each of the grafted sinuses, i.e., 40 implants in total (32—Neoporous, Neodent, Curitiba, Paraná, Brazil; 8—SLA, Straumann, Basel, Switzerl...

Methods : β-TCP/HA with or without enamel matrix ...

This research project was approved by the Ethics Committee of the School of Dentistry and Dental Research Center São Leopoldo Mandic, Brazil, under the protocol 2010/0360. Ten consecutive patients (age range 35–75 years) with the need of bilateral maxillary sinus floor augmentation prior to the placement of four dental implants (two in each side of posterior maxilla) were selected for the stu...

Background : β-TCP/HA with or without enamel matr...

The aim of the present study was to compare histomorphometrically the outcome of maxillary sinus floor augmentation with β-TCP/HA with or without enamel matrix proteins (BC + EMD and EMD, respectively) in humans.

Background : β-TCP/HA with or without enamel matr...

Reconstruction of the edentulous and severely atrophied posterior maxilla is often performed by means of maxillary sinus floor augmentation in combination with dental implants [1, 2]. Various bone graft materials are typically used for enhancing bone formation within the sinus cavity; autogenous bone (AB) is considered as the gold standard due to its osteogenic, osteoinductive, and osteoconductive...

Abstract : β-TCP/HA with or without enamel matrix...

It is still unclear whether enamel matrix proteins (EMD) as adjunct to bone grafting enhance bone healing. This study compared histomorphometrically maxillary sinus floor augmentation (MSFA) with β-TCP/HA in combination with or without EMD in humans. In ten systemically healthy patients needing bilateral MSFA, one side was randomly treated using β-TCP/HA mixed with EMD (BC + EMD) and the ot...

Fig. 6. Patient # 1 (12-month healing time): incre...

Fig. 6. Patient # 1 (12-month healing time): increased bone formation following the shape of the grafted particles that are still present (magnification ×100) Fig. 6. Patient # 1 (12-month healing time): increased bone formation following the shape of the grafted particles that are still present (magnification ×100)

Fig. 5. Patient # 4 (9-month healing time): increa...

Fig. 5. Patient # 4 (9-month healing time): increased bone formation following the shape of the grafted particles stained with Goldner trichrome staining (magnification ×100) Fig. 5. Patient # 4 (9-month healing time): increased bone formation following the shape of the grafted particles stained with Goldner trichrome staining (magnification ×100)

Fig. 4. Patient # 1 (12-month healing time): overv...

Fig. 4. Patient # 1 (12-month healing time): overview of a typical example of a bone biopsy stained with Goldner trichrome staining (magnification ×10) Fig. 4. Patient # 1 (12-month healing time): overview of a typical example of a bone biopsy stained with Goldner trichrome staining (magnification ×10)

Fig. 3. Alveolar tissue height (in true mm) over a...

Fig. 3. Alveolar tissue height (in true mm) over a 5-year period in the 12-month group Fig. 3. Alveolar tissue height (in true mm) over a 5-year period in the 12-month group

Fig. 2. Aveolar tissue height (in true mm) over a ...

Fig. 2. Aveolar tissue height (in true mm) over a 5-year period in the 9-month group Fig. 2. Aveolar tissue height (in true mm) over a 5-year period in the 9-month group

Fig. 1. Images of patient # 5 (9-month healing tim...

Fig. 1. Images of patient # 5 (9-month healing time). a. Radiograph of the left maxillary sinus: situation 9 months after the maxillary sinus floor elevation procedure. b. With a trephine drill, the implant osteotomy is made and the biopsy is obtained. c. Clinical situation after placing two Straumann® SLA implants in the left posterior maxilla. d. Radiograph of two Straumann® SLA implants in...

Table 4 Histomorphometric evaluation of the biopsi...

Patient (N) Gender/age Retrieval location BV/TV (%) BS/TV (mm2/mm3) Tb.Th (μm) ...

Table 3 Histomorphometric evaluation of the biopsi...

Patient (N) Gender/age) Retrieval location BV/TV (%) BS/TV (mm2/mm3) Tb.Th (μm) ...

Table 1 Alveolar tissue height measurements on pan...

Patient Gender/age Implant site T0 T1 Increase ...

Rights and permissions : The use of a biphasic cal...

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...

Ethics declarations : The use of a biphasic calciu...

Authors W.F. Bouwman, N. Bravenboer, J.W.F.H. Frenken, C.M. ten Bruggenkate and E.A.J.M. Schulten state that there are no conflicts of interest, either directly or indirectly. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Author information : The use of a biphasic calcium...

Correspondence to E. A. J. M. Schulten.

Author information : The use of a biphasic calcium...

Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center/Academic Centre for Dentistry Amsterdam (ACTA), P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands W. F. Bouwman, C. M. ten Bruggenkate & E. A. J. M. Schulten Department of Clinical Chemistry, VU University Medical Center, Amsterdam, The Netherlands N. Bravenboer Department of Oral and Maxillofacial Su...

References : The use of a biphasic calcium phospha...

Groeneveld EH, van den Bergh JP, Holzmann P, ten Bruggenkate CM, Tuinzing DB, Burger EH. Mineralization processes in demineralized bone matrix grafts in human maxillary sinus floor elevations. J Biomed Mater Res. 1999;48:393–402. Schulten EAJM, Prins HJ, Overman JR, Helder MN, ten Bruggenkate CM, Klein-Nulend JA. Novel approach revealing the effect of collagenous membrane on osteoconduction in ...

References : The use of a biphasic calcium phospha...

Schopper C, Ziya-Ghazvini F, Goriwoda W, Moser D, Wanschitz F, Spassova E, Lagogiannis G, Auterith A, Ewers R. HA/TCP compounding of a porous CaP biomaterial improves bone formation and scaffold degradation—a long-term histological study. J Biomed Mater Res B Appl Biomater. 2005;74:458–67. Frenken JW, Bouwman WF, Bravenboer N, Zijderveld SA, Schulten EA, ten Bruggenkate CM. The use of Strauma...

References : The use of a biphasic calcium phospha...

Beirne JC, Barry HJ, Brady FA, Morris VB. Donor site morbidity of the anterior iliac crest following cancellous bone harvest. Int J Oral Maxillofac Surg. 1996;25:268–71. Vermeeren JIJF, Wismeijer D, van Waas MAJ. One-step reconstruction of the severely resorbed mandible with onlay bone grafts and endosteal implants: a 5-year follow-up. Int J Oral Maxillofac Surg. 1996;2:112–5. Nkenke E, Stel...

References : The use of a biphasic calcium phospha...

Boyne PJ, James RA. Grafting of the maxillary sinus floor with autogenous marrow and bone. J Oral Surg. 1980;38:613–6. Tatum H Jr. Maxillary and sinus implant reconstructions. Dent Clin N Am. 1986;30:207–29. Del Fabbro M, Rosano G, Taschieri S. Implant survival rates after maxillary sinus augmentation. Eur J Oral Sci. 2008;116:497–506. Pjetursson BE, Tan WC, Zwahlen M, Lang NP. A systemat...

Conclusions : The use of a biphasic calcium phosph...

Based on clinical, radiological, histological, and histomorphometric analysis, this study confirms the suitability of BCP for vertical augmentation of the posterior maxilla by means of an MSFE procedure, allowing dental implant placement after 9 and 12 months healing times. Yet, complete degradation of the BCP particles does not occur within a 12-month healing time. From a histological and histom...

Discussion : The use of a biphasic calcium phospha...

In the cranial part of the biopsy, some osteoid islands with osteogenic activity were detected, possibly caused by osteoinductive properties from the lifted bony trap-door. In the present study, histomorphometric analyses revealed that the vital bone volume was higher in the 9-month healing time group than in the 12-month healing time group, while one would expect to find more newly formed bone in...

Discussion : The use of a biphasic calcium phospha...

This study presents the clinical, radiological, histological and histomorphometric results on the use of a biphasic calcium phosphate (Straumann® bone ceramic) in a MSFE procedure with healing times of 9 and 12 months. During the clinical evaluation, it appeared that both 9-month and 12-month healing times resulted in integration of the grafted BCP with the original maxillary bone (sinus floor),...

Results : The use of a biphasic calcium phosphate ...

Histological observations did not show inflammatory cells in the tissue adjacent to the bone substitute particles. Bone marrow-like tissue, which included blood vessels, was observed in between the bone trabeculae (Fig. 4). Reinforcement by lamellar bone was shown in some areas after 9 and 12 months (Figs. 5 and 6). No Howship’s lacunae could be detected on the characteristic outlines of the su...

Results : The use of a biphasic calcium phosphate ...

None of the 10 patients showed postoperative inflammation or infection after the MSFE procedure nor during surgical re-entry for dental implant placement. When opening the area for dental implant insertion, the grafted area proved to be well vascularized and the tissue at the site of the former trap-door location was slightly flexible and had a fibrous aspect. Between the periosteum and the bone g...

Methods : The use of a biphasic calcium phosphate ...

Parameters evaluating vital bone mass/bone structure: 1: Vital bone volume (BV): percentage of the grafted section that is vital bone tissue (%) 2: Bone surface (BS): BS expressed as a fraction of the total vital bone volume (mm2/mm3) 3: Thickness of bone trabeculae (Tb.Th) (μm) Parameters evaluating bone turnover: 1: Osteoid volume (OV): fraction of the vital bone tissue section that is ost...

Methods : The use of a biphasic calcium phosphate ...

All 22 inserted dental implants were clinically tested for good primary stability. Osseointegration at abutment connection was tested with a 35-Ncm torque. One experienced oral and maxillofacial surgeon (CB) carried out all follow-up examinations. Panoramic radiographs were made at patient’s intake (T0); immediately after the MSFE procedure (T1); immediately after dental implant placement (T2);...

Methods : The use of a biphasic calcium phosphate ...

A midcrestal incision was made with vertical release incisions at the canine and tuberosity region. A full-thickness mucoperiosteal flap was elevated. The lateral maxillary sinus wall was prepared using a diamond burr with copious irrigation with sterile isotonic saline, regarding the contour of the maxillary sinus as observed on the preoperative panoramic radiograph. A bony top-hinge trap-door wa...

Methods : The use of a biphasic calcium phosphate ...

In this study, 10 consecutive healthy patients were selected for a unilateral MSFE procedure. Five patients received dental implants 9 months after MSFE and five patients underwent dental implant surgery 12 months after MSFE. In the 9-month group (three men and two women), the average age was 56.6 years (range 40 to 64 years); in the 12-month group (one man and four women), the average age was...

Background : The use of a biphasic calcium phospha...

β-TCP is a biocompatible osteoconductive calcium phosphate that may provide a scaffold for potential bony ingrowth [24]. β-TCP resorbs rather quickly but not necessarily at the same rate as new bone formation [25,26,27]. Most research focused on either using the relative unresorbable HA as a scaffold or β-TCP as a degradable component [19, 24,25,26, 28, 29]. Zerbo et al. [30] concluded that due...

Background : The use of a biphasic calcium phospha...

Maxillary sinus floor elevation (MSFE) is a surgical procedure to enhance the bone height in the posterior maxilla with graft material, allowing dental implant placement (later or at the same time) [1, 2]. This pre-implant procedure is predictable and results in a dental implant survival of more than 93.8% 3 years after dental implant placement [3]. According to Pjetursson [4] in his systematic r...

Abstract : The use of a biphasic calcium phosphate...

This study evaluates the clinical, radiological, histological, and histomorphometric aspects of a fully synthetic biphasic calcium phosphate (BCP) (60% hydroxyapatite and 40% ß-tricalcium phosphate), used in a human maxillary sinus floor elevation (MSFE) procedure with 9- and 12-month healing time. A unilateral MSFE procedure, using 100% BCP, was performed in two series of five patients with hea...

Fig. 6. The hydraulic lifter stabilized in the ost...

Fig. 6. The hydraulic lifter stabilized in the osteotomy before injecting the saline Fig. 6. The hydraulic lifter stabilized in the osteotomy before injecting the saline

Fig. 5. a The CAS drill has four blades and an inv...

Fig. 5. se conical shape. b The hydraulic lifter Fig. 5. a The CAS drill has four blades and an inverse conical shape. b The hydraulic lifter

Fig. 4. The inflated balloon while elevating the s...

Fig. 4. The inflated balloon while elevating the sinus membrane (The balloon is seen from the medial.) Fig. 4. The inflated balloon while elevating the sinus membrane (The balloon is seen from the medial.)

Fig. 3. a The balloon in a resting position. b The...

Fig. 3. Fig. 3. a The balloon in a resting position. b The inflated balloon [12]

Fig. 2. The exposed mesial aspect of the sinus : C...

Fig. 2. The exposed mesial aspect of the sinus Fig. 2. The exposed mesial aspect of the sinus

Fig. 1. Determination of the remaining bone height...

Fig. 1. Determination of the remaining bone height (RBH) on the CBCT image Fig. 1. Determination of the remaining bone height (RBH) on the CBCT image

Table 2 The results of logistic regression of meth...

Methods BAOFSE BALLOON CAS kit Number of cases 12 12 ...

Table 1 The association between the methods used t...

  BAOSFE BALLOON CAS kit Total Stats p value Occurrence of perforation ...

About this article : Comparison of three different...

Yassin Alsabbagh, A., Alsabbagh, M.M., Darjazini Nahas, B. et al. Comparison of three different methods of internal sinus lifting for elevation heights of 7 mm: an ex vivo study. Int J Implant Dent 3, 40 (2017). https://doi.org/10.1186/s40729-017-0103-5 Download citation Received: 13 March 2017 Accepted: 29 August 2017 Published: 04 September 2017 DOI: https://doi.org/10...

Rights and permissions : Comparison of three diffe...

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...

Ethics declarations : Comparison of three differen...

Aghiad Yassin Alsabbagh, Mohammed Monzer Alsabbagh, Batol Darjazini Nahas, and Salam Rajih declare that they have no competing interests. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Author information : Comparison of three different...

Department of Periodontology, Damascus University Dental School, Damascus, Syrian Arab Republic Aghiad Yassin Alsabbagh & Mohammed Monzer Alsabbagh Department of Orthodontics, Damascus University Dental School, Damascus, Syrian Arab Republic Batol Darjazini Nahas Temple university, Philadelphia, USA Salam Rajih You can also search for this author in PubMed Google ...

References : Comparison of three different methods...

Toffler M, Toscano N, Holtzclaw D. Osteotome-mediated sinus floor elevation using only platelet-rich fibrin: an early report on 110 patients. Implant Dent. 2010;19(5):447–56. Download references

References : Comparison of three different methods...

Zitzmann NU, Scharer P. Sinus elevation procedures in the resorbed posterior maxilla. Comparison of the crestal and lateral approaches. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998;85(1):8–17. Esposito M, Felice P, Worthington HV. Interventions for replacing missing teeth: augmentation procedures of the maxillary sinus. The Cochrane database of systematic reviews 2014(5):CD008397. Sc...

References : Comparison of three different methods...

Seong WJ, Barczak M, Jung J, Basu S, Olin PS, Conrad HJ. Prevalence of sinus augmentation associated with maxillary posterior implants. The Journal of oral implantology. 2013;39(6):680–8. Cawood JI, Howell RA. A classification of the edentulous jaws. Int J Oral Maxillofac Surg. 1988;17(4):232–6. Tan WC, Lang NP, Zwahlen M, Pjetursson BE. A systematic review of the success of sinus floor elev...

Change history : Comparison of three different met...

An amendment to this paper has been published and can be accessed via the original article.

Conclusions : Comparison of three different method...

Within the limitation of this study and that of an ex vivo study, we can accept our hypotheses that the balloon is better than the BAOSFE in elevating the membrane mucosa and the CAS kit is better than the BAOSFE in preparing the osteotomy and breaking the sinus floor for elevation heights of 7 mm. Further, in vivo studies need to be taken to prove these findings.

Discussion : Comparison of three different methods...

The BAOSFE technique caused perforations in the membrane in 7 out of 12 cases with a percentage of 58.4. This result is consistent with many previous studies which state that this technique has a high rate of perforations when the RBH is less than 5 mm [2, 7, 26]. Also, all the perforations happened during the elevation process; however, this percentage is different than that reported by Steltzle...

Discussion : Comparison of three different methods...

Using a reamer instead of the osteotomes for breaking the sinus floor has the advantage of creating a thin bone shell that prevents direct contact between the drill and the Schneiderian membrane [24]. Moreover, using a reamer has been shown to cause less discomfort and nausea when compared to the osteotome technique as a result of the constant tapping of the osteotomes [25]. As a result, the CAS k...

Discussion : Comparison of three different methods...

Although the lateral sinus floor elevation is a proven clinically successful technique [14], the indirect SFE approach is favorable among clinicians because it does not require a second surgery site and hence cause less trauma and discomfort for the patient [14,15,16]. However, this method has its drawbacks, such as a higher risk of membrane perforation, a decreased space for using surgical instru...

Results : Comparison of three different methods of...

For the entire sample, the mean perforation length was (0.711 mm, SD = 1.4) and the mean time required to perform the procedure was (5.65 min, SD = 2.26), and out of the entire sample (N = 36), perforations happened in nine cases for a percentage of 25%. Chi-square test showed a significant association between method used and the occurrence of perforation (chi-square statistic = 8.585, ...

Methods : Comparison of three different methods of...

This approach starts like BAOSFE. The osteotomy is enlarged to 5.0 mm before the balloon (Zimmer Sinus Lift Balloon, Zimmer Dental Inc., California, USA) is inserted (Fig. 3). The sinus floor was broken with the 5 mm osteotome after the addition of bone. The sleeve of the balloon was inserted 1 mm beyond the sinus floor. The saline was injected slowly from the syringe into the balloon, so the ...

Methods : Comparison of three different methods of...

To achieve our purposes, an experimental ex vivo study was carried. This research project was approved by the University of Damascus Local Research Ethics Committee (UDDS-3045PG.) and was funded by the Damascus University Postgraduate Research Budget (97687027834DEN). The sinus floor elevations were done on 18 bisected heads of lambs aged between 6 and 12 months that were slaughtered in a maximum...

Background : Comparison of three different methods...

Therefore, the two working hypotheses of our study were “the CAS-Kit is safer than BAOSFE in breaking the sinus floor and the balloon is safer than BAOSFE in elevating the Schneiderian membrane” for elevation heights of 7 mm.

Background : Comparison of three different methods...

More than half of the implants placed in the posterior maxilla require sinus floor elevation (SFE) [1]. The need for this procedure is explained by continuous ridge resorption in an apical direction after tooth extraction combined with progressive sinus pneumatization in addition to poor bone quality that is frequently seen in the maxilla [2]. Sinus membrane perforation is considered the most com...

Abstract : Comparison of three different methods o...

Various techniques are available for elevating the sinus membrane. The aim of this study is to evaluate three methods of indirect sinus floor elevation regarding elevation heights of 7 mm on the outcomes of membrane perforation, length of perforation, and time required to perform the procedure. Three different methods for indirect sinus lifting, bone added osteotome sinus floor elevation (BAOS...

Fig. 2. Figure illustrating the proposed mucosal t...

Fig. 2. Figure illustrating the proposed mucosal thickening index. A ≤1 mm, indicating no thickening; B >1 mm but ≤2 mm, indicating minimal thickening; C >2 mm but ≤5 mm, indicating moderate thickening; D >5 mm, indicating severe thickening Fig. 2. Figure illustrating the proposed mucosal thickening index. A ≤1 mm, indicating no thickening; B >1 mm but ≤2 mm, indicating min...

Fig. 1. Figure illustrating the reference points o...

Fig. 1. Figure illustrating the reference points of the CBCT measurements. A: most posterior point of the sinus wall; B: most anterior point of the sinus wall; C: mid-point between A and B; C1: measurement of mucosal thickening perpendicular to A–B line at point C; D: mid-point between A and C; D1: measurement of mucosal thickening perpendicular to A–B line at point D; E: mid-point between B...

Table 2 Statistical results after inter-variable a...

  Gender Respiratory diseases Cardio-vascular diseases Diabetes mellitus Smoking Hist...

Table 1 CBCT measurements of sinus mucosal thicken...

Patient Anterior (E1-floor of the sinus) Middle (C1-floor of the sinus) Posterior (D1-floor of the sinus) ...

About this article : Dental implants and grafting ...

Maska, B., Lin, GH., Othman, A. et al. Dental implants and grafting success remain high despite large variations in maxillary sinus mucosal thickening. Int J Implant Dent 3, 1 (2017). https://doi.org/10.1186/s40729-017-0064-8 Download citation Received: 18 October 2016 Accepted: 13 January 2017 Published: 18 January 2017 DOI: https://doi.org/10.1186/s40729-017-0064-8

Rights and permissions : Dental implants and graft...

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Author information : Dental implants and grafting ...

You can also search for this author in PubMed Google Scholar Correspondence to Yvonne Kapila.

Author information : Dental implants and grafting ...

Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, 1011 N University Ave, Ann Arbor, MI, USA Bartosz Maska, Guo-Hao Lin, Abdullah Othman, Shabnam Behdin, Suncica Travan, Erika Benavides & Yvonne Kapila Department of Surgical Sciences, School of Dentistry, Marquette University, 1801 W Wisconsin Ave, Milwaukee, WI, USA Guo-Hao Lin Department of Peri...

Acknowledgements : Dental implants and grafting su...

The authors thank Ms. Victoria Zakrzewski for her help with the figure generation and preparation. Co-primary author BM contributed to the CBCT measurement and preparation of the manuscript. Co-primary author G-HL contributed to the data analysis and preparation of the manuscript. Second author AO contributed to the protocol preparation, case review, case selection, and preparation of the manuscr...

References : Dental implants and grafting success ...

Romanos GE, Froum S, Costa-Martins S, Meitner S, Tarnow DP. Implant periapical lesions: etiology and treatment options. J Oral Implantol. 2011;37:53–63. Acharya A, Hao J, Mattheos N, Chau A, Shirke P, Lang NP. Residual ridge dimensions at edentulous maxillary first molar sites and periodontal bone loss among two ethnic cohorts seeking tooth replacement. Clin Oral Implants Res. 2014;25:1386–94...

References : Dental implants and grafting success ...

Pazera P, Bornstein MM, Pazera A, Sendi P, Katsaros C. Incidental maxillary sinus findings in orthodontic patients: a radiographic analysis using cone-beam computed tomography (CBCT). Orthod Craniofac Res. 2011;14:17–24. Ritter L, Lutz J, Neugebauer J, et al. Prevalence of pathologic findings in the maxillary sinus in cone-beam computerized tomography. Oral Surg Oral Med Oral Pathol Oral Radiol...

References : Dental implants and grafting success ...

Gardner DG. Pseudocysts and retention cysts of the maxillary sinus. Oral Surg Oral Med Oral Pathol. 1984;58:561–7. Chiapasco M, Palombo D. Sinus grafting and simultaneous removal of large antral pseudocysts of the maxillary sinus with a micro-invasive intraoral access. Int J Oral Maxillofac Surg. 2015;44:1499–505. Cano J, Campo J, Alobera MA, Baca R. Surgical ciliated cyst of the maxilla. Cl...

References : Dental implants and grafting success ...

Beretta M, Poli PP, Grossi GB, Pieroni S, Maiorana C. Long-term survival rate of implants placed in conjunction with 246 sinus floor elevation procedures: results of a 15-year retrospective study. J Dent. 2015;43:78–86. Del Fabbro M, Corbella S, Weinstein T, Ceresoli V, Taschieri S. Implant survival rates after osteotome-mediated maxillary sinus augmentation: a systematic review. Clin Implant D...

Abbreviations : Dental implants and grafting succe...

Cone-beam computed tomographic Protected Health Information Sinus floor elevation

Conclusions : Dental implants and grafting success...

Our study found that the largest tissue thickening was present in the middle section of the maxillary sinus. This tissue thickening did not vary based on gender, age, or smoking status, nor did it relate to the underlying alveolar ridge height. However, patients with a history of periodontal diseases demonstrated a significant association with mucosal thickening. A mucosal thickening index was pro...

Discussion : Dental implants and grafting success ...

Although residual alveolar ridge height has been associated with sinus mucosal thickening [36], our study did not find a significant association between these two parameters. Acharya et al. [36] reported that lower available bone height in the subsinus region was related to thickened sinus membranes within an Asian-Indian and Hong Kong-based Chinese population. Differences in the ethnic compositio...

Discussion : Dental implants and grafting success ...

Based on the findings of the current study, a history of periodontal disease is the only identified parameter significantly associated with sinus mucosal thickening. This finding indicates that clinicians should expect some degree of mucosal thickening when performing sinus augmentation procedures in a previously periodontally involved site. This finding is consistent with several previously publi...

Discussion : Dental implants and grafting success ...

CBCT imaging has been recognized as a more sensitive imaging modality for identifying sinus thickening and pathoses in the posterior maxilla compared to panoramic radiography [21, 22]. This could explain why the current study identified a higher prevalence of mucosal thickening compared to earlier studies [23]. However, compared to other similar CBCT studies [21, 24, 25], the prevalence reported i...

Results : Dental implants and grafting success rem...

Twenty-nine CBCT images (11 females and 18 males) were included in this study. All the implants placed in these included cases survived, representing a 100% implant survival rate. With regards to measurements of mucosal thickening, the intra-examiner reproducibility revealed an exact intra-examiner correlation of 99%, with a p value of 0.40 for a t test for independent samples, indicating a high r...

Methods : Dental implants and grafting success rem...

The sites that were measured are specified in the image below (Fig. 1). The most posterior and anterior aspects of the visible maxillary sinus were measured. The ½ point along with the ¼ and ¾ points were then selected, and the measurements of the mucosal thickening were then completed at these three sites. The thickest portion of the mucosa was also measured if it did not coincide with one of...

Methods : Dental implants and grafting success rem...

The study required access to University of Michigan Protected Health Information (PHI). PHI was necessary in order to track and coordinate the CBCT data and dental and medical history for each subject. Corresponding subject charts and electronic records were reviewed for retrieval of relevant implant placement and restorative history, medical history, and demographic information, including gender ...

Methods : Dental implants and grafting success rem...

Our study hypothesis was that mucosal thickening of more than 2 mm and up to 1/3 of the volume of the sinus would not alter the predictability for SFE and dental implant placement. The primary outcome was to determine the success rate of dental implant placement in augmented maxillary sinus areas with mucosal thickening. A secondary outcome was to evaluate the effect of gender, age, and smoking o...

Background : Dental implants and grafting success ...

Despite the high survival rate of dental implants inserted in maxillary sinuses that have undergone sinus floor elevation (SFE) with bone grafting, complications still occur [1–3]. Sinus membrane perforation is reported to be the most common complication [4, 5]. Postoperative maxillary sinusitis is less common (0–22%) [6, 7]; nevertheless, it could potentially compromise the outcome of SFE and...

Abstract : Dental implants and grafting success re...

Although mucosal thickening is the most common radiographic finding observed regarding sinus pathology, the knowledge regarding its clinical significance on the outcomes of dental implants and grafting in the maxillary sinuses is still limited. We hypothesized that mucosal thickening would not alter the predictability for sinus floor augmentation and dental implant placement. The purpose of this r...

About this article : Maxillary segmental osteoperi...

Tsegga, T., Wright, T. Maxillary segmental osteoperiosteal flap with simultaneous placement of dental implants: case report of a novel technique. Int J Implant Dent 3, 2 (2017). https://doi.org/10.1186/s40729-017-0067-5 Download citation Received: 06 December 2016 Accepted: 13 January 2017 Published: 19 January 2017 DOI: https://doi.org/10.1186/s40729-017-0067-5

Rights and permissions : Maxillary segmental osteo...

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Author information : Maxillary segmental osteoperi...

Department of Oral & Maxillofacial Surgery, San Antonio Military Medical Center, 3551 Roger Brooke Dr., Ft. Sam Houston, 78234, TX, USA Tibebu Tsegga & Thomas Wright Department of Oral & Maxilofacial Surgery, Wilford Hall Ambulatory Surgical Center, 2200 Bergquist Dr, Suite 1, Lackland AFB, TX, 78236, USA Tibebu Tsegga & Thomas Wright You can also search for this author in ...

References : Maxillary segmental osteoperiosteal f...

Irinakis T. Efficacy of injectable demineralized bone matrix as graft material during sinus elevation surgery with simultaneous implant placement in the posterior maxilla: clinical evaluation of 49 sinuses. J Oral and Maxillofac Surg. 2011;69:134–41. Chiapasoo M, Casentini P, Zaniboni M. Bone augmentation procedures in implant dentistry. Int J Oral Maxillofac Implants. 2009;24:237–69. Jenson...

Conclusions : Maxillary segmental osteoperiosteal ...

This case highlights the evolving variations in dentoalveolar augmentation with an emphasis on concomitant implant placement. In the most traditional sense, a vertical osteoperiosteal flap technique would be bound with a stable basal bone that can be used to anchor simultaneous dental implant placement. Further refinement should consider minimizing crestal reflection and overall labial bone resorp...

Discussion : Maxillary segmental osteoperiosteal f...

A critical appraisal of the gingival architecture in the final end point of this case demonstrates some radiolucency through the soft tissue outlining the platform of the Nobel Biocare TiUnite implant. This would lead us to believe that either the transmucosal bone level placement attempt was inaccurate or excessive reflection of the labial tissue has caused some degree of resorption. This is anot...

Discussion : Maxillary segmental osteoperiosteal f...

A suitable alternative surgical management of this particular case might have been to simply perform an alveoloplasty to produce the desired inter-occlusal clearance and proceed with placement of implant and simultaneous direct sinus lift. That would have left more of the apical portion of the implant within the grafted sinus and possibly modified the location of keratinized band of tissue. The lo...

Case Presentation : Maxillary segmental osteoperio...

A 35-year-old female with a 10-year history of partial acquired edentulism at site numbers 3 and 4 presented to our clinic for dental implant evaluation. Preoperative clinical examination revealed a reproducible intercuspation, well-delineated band of keratinized tissue, and decreased inter-occlusal clearance to allow for optimal dimension of prosthetic crowns (Fig. 1). Radiographs demonstrated e...

Background : Maxillary segmental osteoperiosteal f...

Obtaining proper occlusal clearance to allow for a single unit crown restoration is a fundamental prerequisite for dental implant restoration. Long-standing edentulous sites are often fraught with disuse atrophy and unopposed supra-eruption of the opposing dentition. In the posterior maxillae/mandible, there are vital structures that have to be mobilized in order to allow space for either bone tra...

Abstract : Maxillary segmental osteoperiosteal fla...

Dental restorative space from the opposing dentition requires adequate distance for restorative material for an acceptable restoration. Typically, long-standing edentulous alveolar ridges will have vertical and or horizontal defects that require alveolar ridge augmentation for ideal dental implant restorations. Along with these defects, one will see the opposing dentition supra erupt which can obl...

Fig. 2. a Panoramic radiography with area of inter...

Fig. 2. xillary sinus) and b, c examples of corresponding images in cone beam computed tomography Fig. 2. a Panoramic radiography with area of interest (maxillary sinus) and b, c examples of corresponding images in cone beam computed tomography

Fig. 1. a Panoramic radiography with area of inter...

Fig. 1. maxillary sinus) and b, c examples of corresponding images in cone beam computed tomography Fig. 1. a Panoramic radiography with area of interest (maxillary sinus) and b, c examples of corresponding images in cone beam computed tomography

Table 5 Results of the question “Is there an add...

Question General practitioner (n = 2) Junior maxillofacial surgeon (n = 2) Senior maxillofacial surgeon (n = 3) p value* ...

Table 4 Description of incidental findings in PAN ...

Additional incidental findings in panoramic radiography Relative incidence (%) in relation to total number of therapy affecting findings Retained third molar/follicular cyst 22 ...

Table 3 Number of additional incidental findings i...

Number of cases General practitioner (n = 2) Junior maxillofacial surgeon (n = 2) Senior maxillofacial surgeon (n = 3) p value*   ...

Table 2 Results of the question “An additional s...

Question General practitioner (n = 2) Junior maxillofacial surgeon (n = 2) Senior maxillofacial surgeon (n = 3) p value* ...

Table 1 Results of the question “Based on PAN, t...

Question General practitioner (n = 2) Junior maxillofacial surgeon (n = 2) Senior maxillofacial surgeon (n = 3) p value* ...

About this article : Evaluation of symptomatic max...

Dau, M., Marciak, P., Al-Nawas, B. et al. Evaluation of symptomatic maxillary sinus pathologies using panoramic radiography and cone beam computed tomography—influence of professional training. Int J Implant Dent 3, 13 (2017). https://doi.org/10.1186/s40729-017-0075-5 Download citation Received: 10 December 2016 Accepted: 12 March 2017 Published: 05 April 2017 DOI: http...

Rights and permissions : Evaluation of symptomatic...

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 : Evaluation of symptomatic max...

Department of Oral, Maxillofacial and Plastic Surgery, University Medical Center, Schillingallee 35, 18057, Rostock, Germany Michael Dau, Bernhard Frerich & Peer Wolfgang Kämmerer Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre, Mainz, Germany Paul Marciak & Bial Al-Nawas Private Dental Praxis Dr. Rossa, Ludwigshafen, Germany Henning Staedt Depa...

References : Evaluation of symptomatic maxillary s...

Quintero JC, et al. Craniofacial imaging in orthodontics: historical perspective, current status, and future developments. Angle Orthod. 1999;69(6):491–506. Tadinada A, et al. Radiographic evaluation of the maxillary sinus prior to dental implant therapy: a comparison between two-dimensional and three-dimensional radiographic imaging. Imaging Sci Dent. 2015;45(3):169–74. Ritter L, et al. Pre...

References : Evaluation of symptomatic maxillary s...

Rivis M, Valeanu AN. Giant maxillary cyst with intrasinusal evolution. Rom J Morphol Embryol. 2013;54(3 Suppl):889–92. Yilmaz SY, Misirlioglu M, Adisen MZ. A diagnosis of maxillary sinus fracture with cone-beam CT: case report and literature review. Craniomaxillofac Trauma Reconstr. 2014;7(2):85–91. Lana JP, et al. Anatomic variations and lesions of the maxillary sinus detected in cone beam ...

References : Evaluation of symptomatic maxillary s...

Gang TI, et al. The effect of radiographic imaging modalities and the observer’s experience on postoperative maxillary cyst assessment. Imaging Sci Dent. 2014;44(4):301–5. Batra PS, et al. Computed tomography imaging practice patterns in adult chronic rhinosinusitis: survey of the American Academy of Otolaryngology-Head and Neck Surgery and American Rhinologic Society Membership. Int Forum Al...

References : Evaluation of symptomatic maxillary s...

Dragan E, et al. Maxillary sinus anatomic and pathologic CT findings in edentulous patients scheduled for sinus augmentation. Rev Med Chir Soc Med Nat Iasi. 2014;118(4):1114–21. Raghav M, et al. Prevalence of incidental maxillary sinus pathologies in dental patients on cone-beam computed tomographic images. Contemp Clin Dent. 2014;5(3):361–5. Lyros I, et al. An incidental finding on a diagno...

Conclusions : Evaluation of symptomatic maxillary ...

Depending on the observers’ clinical and radiological experience, PAN alone may not be sufficient for evaluation of pathologies of the maxillary sinus. On the contrary, significant benefits of sFOV-CBCT for diagnosing symptomatic maxillary sinus pathologies were reported. Having sFOV-CBCT seems to have added additional information and confidence in comparison to PAN alone. Nonetheless, also with...

Discussion : Evaluation of symptomatic maxillary s...

The influence of clinical experience of evaluation of PAN [34] as well as the clinical experience and routine analysis of 3D radiographs (as assumed for maxillofacial surgeons when compared to those for general practitioners) strongly influence the diagnostic value of additional three-dimensional imaging. The number of incidental findings in CBCT in addition to those seen in PAN was not of major d...

Discussion : Evaluation of symptomatic maxillary s...

In dentistry, PAN is a widely available, useful, and important diagnostic tool for diagnosis and general preoperative planning [32] with less radiation exposure then CBCT [21]. While most dentists have used it routinely successful for years and gained significant experience in doing so [33], there are certain limitations in dependence of the region to be examined [10]. The high number of “not vi...

Results : Evaluation of symptomatic maxillary sinu...

This study focused on three different aspects in our analysis—PAN, PAN and CBCT, as well as the influence of the different clinical and radiological experience (examples in Figs. 1 and 2). Panoramic radiography (PAN) When assessing PAN, the ratings were significantly lower at “good visible and can be evaluated” (9.9%) compared to “visible but cannot be evaluated” (39.5%; p 

Methods : Evaluation of symptomatic maxillary sinu...

The first question for PAN addressed the imaging quality in the clinical relevant area of interest (clinical data were given). Three answers were possible: 1 = good visibility and can be evaluated, 2 = visible but cannot be evaluated, and 3 = not visible. The second question asked for an additional need for CBCT scans. Three answers were possible: 1 = required, 2 = reasonable, and 3 = not required...

Methods : Evaluation of symptomatic maxillary sinu...

In an experimental diagnostic comparison, radiographic images of 15 female and 13 male patients were assessed. Patients’ radiographs were selected from the Department of Oral, Maxillofacial and Facial Plastic Surgery of the University Medical Centre of Mainz and Rostock, Germany. All patients have had referrals to the hospitals with symptomatic maxillary sinus pathologies and received PAN (Ortho...

Background : Evaluation of symptomatic maxillary s...

In order to justify CBCT use for clinical examination and diagnosis of the maxillary sinus, the aim of this study was to compare the subjective quality rating of PAN and PAN together with a small field of view (sFOV) CBCT to evaluate symptomatic maxillary sinus by clinicians with different training and clinical experience.

Background : Evaluation of symptomatic maxillary s...

Non-symptomatic abnormalities of the maxillary sinus such as mucosal thickening, retention cysts, and opacification are reported to occur in up to 74% of all cases [1–6]. For diagnosis of symptomatic pathologies of the maxillary sinus like retention cysts, polyps, and tumors, panoramic radiographies (PAN) are commonly used and widely available. In PAN, not every area of interest is accurately de...

Abstract : Evaluation of symptomatic maxillary sin...

A comparison of panoramic radiography (PAN) alone and PAN together with small field of view cone beam computed tomography (sFOV-CBCT) for diagnosis of symptomatic pathologies of the maxillary sinus was carried out by clinicians of different experience. Corresponding radiographic images (PAN/sFOV-CBCT) of 28 patients with symptomatic maxillary sinus pathologies were chosen and analyzed by two gene...

About this article : β-TCP/HA with or without ena...

Nery, J.C., Pereira, L.A.V.D., Guimarães, G.F. et al. β-TCP/HA with or without enamel matrix proteins for maxillary sinus floor augmentation: a histomorphometric analysis of human biopsies. Int J Implant Dent 3, 18 (2017). https://doi.org/10.1186/s40729-017-0080-8 Download citation Received: 08 December 2016 Accepted: 22 April 2017 Published: 04 May 2017 DOI: https://do...

Rights and permissions : β-TCP/HA with or without...

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 : β-TCP/HA with or without ena...

You can also search for this author in PubMed Google Scholar Correspondence to James Carlos Nery.

Author information : β-TCP/HA with or without ena...

Department of Implantology, São Leopoldo Mandic Research Center, Brasília, DF, Brazil James Carlos Nery, George Furtado Guimarães & Fabiana Mantovani Gomes França Department of Biochemistry and Tissue Biology, UNICAMP – State University of Campinas, Institute of Biology, Campinas, São Paulo, Brazil Luís Antônio Violin Dias Pereira Department of Periodontology, UNESP – Univ. Estad...

References : β-TCP/HA with or without enamel matr...

Wikesjo UM, Sorensen RG, Kinoshita A, Wozney JM. RhBMP-2/alphaBSM induces significant vertical alveolar ridge augmentation and dental implant osseointegration. Clin Implant Dent Relat Res. 2002;4:174–82. Carinci F, Brunelli G, Franco M, Viscioni A, Rigo L, Guidi R, et al. A retrospective study on 287 implants installed in resorbed maxillae grafted with fresh frozen allogenous bone. Clin Implant...

References : β-TCP/HA with or without enamel matr...

Miron RJ, Sculean A, Cochran DL, Froum S, Zucchelli G, Nemcovsky C, et al. Twenty years of enamel matrix derivative: the past, the present and the future. J Clin Periodontol. 2016;43:668–83. Sculean A, Nikolidakis D, Nikou G, Ivanovic A, Chapple IL, Stavropoulos A. Biomaterials for promoting periodontal regeneration in human intrabony defects: a systematic review. Periodontol 2000. 2015;68:182...

References : β-TCP/HA with or without enamel matr...

Esposito M, Felice P, Worthington HV. Interventions for replacing missing teeth: augmentation procedures of the maxillary sinus. Cochrane Database Syst Rev. 2014;17:CD008397. Jungner M, Cricchio G, Salata LA, Sennerby L, Lundqvist C, Hultcrantz M, et al. On the early mechanisms of bone formation after maxillary sinus membrane elevation: an experimental histological and immunohistochemical study. ...

Conclusions : β-TCP/HA with or without enamel mat...

The present study showed that maxillary sinus floor augmentation with BC resulted in adequate amounts of new bone formation allowing successful implant installation, while adding EMD did not have a significant effect.

Discussion : β-TCP/HA with or without enamel matr...

Nevertheless, the amount of bone generated with BC or BC + EMD herein was adequate to support successful implant placement and osseointegration of implants. In fact, more or less similar amounts of bone formation have been reported in studies evaluating human sinus biopsies after grafting with a variety of biomaterials (bone formation ranging approximately from 30 to 50%) [19]. On the other ha...

Discussion : β-TCP/HA with or without enamel matr...

The present study compared the histological and histomorphometrical outcome of healing after maxillary sinus floor augmentation with BC with or without EMD, based on human biopsies. The results showed that addition of EMD did not enhance the outcome of healing, neither in terms of quality nor quantity of new bone. Nevertheless, the amount of bone generated after maxillary sinus floor augmentation ...

Results : β-TCP/HA with or without enamel matrix ...

All ten patients showed uneventful healing after the sinus floor augmentation procedure as well as after dental implant placement, with no overt postoperative inflammation or infection. Consistently, in all ten patients, no significant jiggling of the drill was noticed during biopsy harvesting, while subjective drilling resistance during implant placement was similar in both groups and all implant...

Methods : β-TCP/HA with or without enamel matrix ...

The data for each tissue component from the three histological sections were averaged to represent the biopsy. Commercially available software (GraphPad Prism 5.0 for Windows, GraphPad Software Inc., USA) was utilized for statistical comparisons between groups and for drawing the graphics. The assumption of normality was checked using D’Agostino & Pearson omnibus test. The data for each evaluate...

Methods : β-TCP/HA with or without enamel matrix ...

Six months after grafting, another CBCT examination was carried out for implant planning. In the sequence, following the previously described antiseptic and anesthetic procedures, two implants with a sand-blasted and acid etching surface were installed in each of the grafted sinuses, i.e., 40 implants in total (32—Neoporous, Neodent, Curitiba, Paraná, Brazil; 8—SLA, Straumann, Basel, Switzerl...

Methods : β-TCP/HA with or without enamel matrix ...

This research project was approved by the Ethics Committee of the School of Dentistry and Dental Research Center São Leopoldo Mandic, Brazil, under the protocol 2010/0360. Ten consecutive patients (age range 35–75 years) with the need of bilateral maxillary sinus floor augmentation prior to the placement of four dental implants (two in each side of posterior maxilla) were selected for the stu...

Background : β-TCP/HA with or without enamel matr...

The aim of the present study was to compare histomorphometrically the outcome of maxillary sinus floor augmentation with β-TCP/HA with or without enamel matrix proteins (BC + EMD and EMD, respectively) in humans.

Background : β-TCP/HA with or without enamel matr...

Reconstruction of the edentulous and severely atrophied posterior maxilla is often performed by means of maxillary sinus floor augmentation in combination with dental implants [1, 2]. Various bone graft materials are typically used for enhancing bone formation within the sinus cavity; autogenous bone (AB) is considered as the gold standard due to its osteogenic, osteoinductive, and osteoconductive...

Abstract : β-TCP/HA with or without enamel matrix...

It is still unclear whether enamel matrix proteins (EMD) as adjunct to bone grafting enhance bone healing. This study compared histomorphometrically maxillary sinus floor augmentation (MSFA) with β-TCP/HA in combination with or without EMD in humans. In ten systemically healthy patients needing bilateral MSFA, one side was randomly treated using β-TCP/HA mixed with EMD (BC + EMD) and the ot...

Fig. 6. Patient # 1 (12-month healing time): incre...

Fig. 6. Patient # 1 (12-month healing time): increased bone formation following the shape of the grafted particles that are still present (magnification ×100) Fig. 6. Patient # 1 (12-month healing time): increased bone formation following the shape of the grafted particles that are still present (magnification ×100)

Fig. 5. Patient # 4 (9-month healing time): increa...

Fig. 5. Patient # 4 (9-month healing time): increased bone formation following the shape of the grafted particles stained with Goldner trichrome staining (magnification ×100) Fig. 5. Patient # 4 (9-month healing time): increased bone formation following the shape of the grafted particles stained with Goldner trichrome staining (magnification ×100)

Fig. 4. Patient # 1 (12-month healing time): overv...

Fig. 4. Patient # 1 (12-month healing time): overview of a typical example of a bone biopsy stained with Goldner trichrome staining (magnification ×10) Fig. 4. Patient # 1 (12-month healing time): overview of a typical example of a bone biopsy stained with Goldner trichrome staining (magnification ×10)

Fig. 3. Alveolar tissue height (in true mm) over a...

Fig. 3. Alveolar tissue height (in true mm) over a 5-year period in the 12-month group Fig. 3. Alveolar tissue height (in true mm) over a 5-year period in the 12-month group

Fig. 2. Aveolar tissue height (in true mm) over a ...

Fig. 2. Aveolar tissue height (in true mm) over a 5-year period in the 9-month group Fig. 2. Aveolar tissue height (in true mm) over a 5-year period in the 9-month group

Fig. 1. Images of patient # 5 (9-month healing tim...

Fig. 1. Images of patient # 5 (9-month healing time). a. Radiograph of the left maxillary sinus: situation 9 months after the maxillary sinus floor elevation procedure. b. With a trephine drill, the implant osteotomy is made and the biopsy is obtained. c. Clinical situation after placing two Straumann® SLA implants in the left posterior maxilla. d. Radiograph of two Straumann® SLA implants in...

Table 4 Histomorphometric evaluation of the biopsi...

Patient (N) Gender/age Retrieval location BV/TV (%) BS/TV (mm2/mm3) Tb.Th (μm) ...

Table 3 Histomorphometric evaluation of the biopsi...

Patient (N) Gender/age) Retrieval location BV/TV (%) BS/TV (mm2/mm3) Tb.Th (μm) ...

Table 2 Radiological results (alveolar tissue heig...

Patient Gender/age Implant site T0 T1 Increase ...

Table 1 Alveolar tissue height measurements on pan...

Patient Gender/age Implant site T0 T1 Increase ...

About this article : The use of a biphasic calcium...

Bouwman, W.F., Bravenboer, N., Frenken, J.W.F.H. et al. The use of a biphasic calcium phosphate in a maxillary sinus floor elevation procedure: a clinical, radiological, histological, and histomorphometric evaluation with 9- and 12-month healing times. Int J Implant Dent 3, 34 (2017). https://doi.org/10.1186/s40729-017-0099-x Download citation Received: 22 May 2017 Accepted...

Rights and permissions : The use of a biphasic cal...

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...

Ethics declarations : The use of a biphasic calciu...

Authors W.F. Bouwman, N. Bravenboer, J.W.F.H. Frenken, C.M. ten Bruggenkate and E.A.J.M. Schulten state that there are no conflicts of interest, either directly or indirectly. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Author information : The use of a biphasic calcium...

Correspondence to E. A. J. M. Schulten.

Author information : The use of a biphasic calcium...

Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center/Academic Centre for Dentistry Amsterdam (ACTA), P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands W. F. Bouwman, C. M. ten Bruggenkate & E. A. J. M. Schulten Department of Clinical Chemistry, VU University Medical Center, Amsterdam, The Netherlands N. Bravenboer Department of Oral and Maxillofacial Su...

References : The use of a biphasic calcium phospha...

Groeneveld EH, van den Bergh JP, Holzmann P, ten Bruggenkate CM, Tuinzing DB, Burger EH. Mineralization processes in demineralized bone matrix grafts in human maxillary sinus floor elevations. J Biomed Mater Res. 1999;48:393–402. Schulten EAJM, Prins HJ, Overman JR, Helder MN, ten Bruggenkate CM, Klein-Nulend JA. Novel approach revealing the effect of collagenous membrane on osteoconduction in ...

References : The use of a biphasic calcium phospha...

Schopper C, Ziya-Ghazvini F, Goriwoda W, Moser D, Wanschitz F, Spassova E, Lagogiannis G, Auterith A, Ewers R. HA/TCP compounding of a porous CaP biomaterial improves bone formation and scaffold degradation—a long-term histological study. J Biomed Mater Res B Appl Biomater. 2005;74:458–67. Frenken JW, Bouwman WF, Bravenboer N, Zijderveld SA, Schulten EA, ten Bruggenkate CM. The use of Strauma...

References : The use of a biphasic calcium phospha...

Beirne JC, Barry HJ, Brady FA, Morris VB. Donor site morbidity of the anterior iliac crest following cancellous bone harvest. Int J Oral Maxillofac Surg. 1996;25:268–71. Vermeeren JIJF, Wismeijer D, van Waas MAJ. One-step reconstruction of the severely resorbed mandible with onlay bone grafts and endosteal implants: a 5-year follow-up. Int J Oral Maxillofac Surg. 1996;2:112–5. Nkenke E, Stel...

References : The use of a biphasic calcium phospha...

Boyne PJ, James RA. Grafting of the maxillary sinus floor with autogenous marrow and bone. J Oral Surg. 1980;38:613–6. Tatum H Jr. Maxillary and sinus implant reconstructions. Dent Clin N Am. 1986;30:207–29. Del Fabbro M, Rosano G, Taschieri S. Implant survival rates after maxillary sinus augmentation. Eur J Oral Sci. 2008;116:497–506. Pjetursson BE, Tan WC, Zwahlen M, Lang NP. A systemat...

Conclusions : The use of a biphasic calcium phosph...

Based on clinical, radiological, histological, and histomorphometric analysis, this study confirms the suitability of BCP for vertical augmentation of the posterior maxilla by means of an MSFE procedure, allowing dental implant placement after 9 and 12 months healing times. Yet, complete degradation of the BCP particles does not occur within a 12-month healing time. From a histological and histom...

Discussion : The use of a biphasic calcium phospha...

In the cranial part of the biopsy, some osteoid islands with osteogenic activity were detected, possibly caused by osteoinductive properties from the lifted bony trap-door. In the present study, histomorphometric analyses revealed that the vital bone volume was higher in the 9-month healing time group than in the 12-month healing time group, while one would expect to find more newly formed bone in...

Discussion : The use of a biphasic calcium phospha...

This study presents the clinical, radiological, histological and histomorphometric results on the use of a biphasic calcium phosphate (Straumann® bone ceramic) in a MSFE procedure with healing times of 9 and 12 months. During the clinical evaluation, it appeared that both 9-month and 12-month healing times resulted in integration of the grafted BCP with the original maxillary bone (sinus floor),...

Results : The use of a biphasic calcium phosphate ...

Histological observations did not show inflammatory cells in the tissue adjacent to the bone substitute particles. Bone marrow-like tissue, which included blood vessels, was observed in between the bone trabeculae (Fig. 4). Reinforcement by lamellar bone was shown in some areas after 9 and 12 months (Figs. 5 and 6). No Howship’s lacunae could be detected on the characteristic outlines of the su...

Results : The use of a biphasic calcium phosphate ...

None of the 10 patients showed postoperative inflammation or infection after the MSFE procedure nor during surgical re-entry for dental implant placement. When opening the area for dental implant insertion, the grafted area proved to be well vascularized and the tissue at the site of the former trap-door location was slightly flexible and had a fibrous aspect. Between the periosteum and the bone g...

Methods : The use of a biphasic calcium phosphate ...

Parameters evaluating vital bone mass/bone structure: 1: Vital bone volume (BV): percentage of the grafted section that is vital bone tissue (%) 2: Bone surface (BS): BS expressed as a fraction of the total vital bone volume (mm2/mm3) 3: Thickness of bone trabeculae (Tb.Th) (μm) Parameters evaluating bone turnover: 1: Osteoid volume (OV): fraction of the vital bone tissue section that is ost...

Methods : The use of a biphasic calcium phosphate ...

All 22 inserted dental implants were clinically tested for good primary stability. Osseointegration at abutment connection was tested with a 35-Ncm torque. One experienced oral and maxillofacial surgeon (CB) carried out all follow-up examinations. Panoramic radiographs were made at patient’s intake (T0); immediately after the MSFE procedure (T1); immediately after dental implant placement (T2);...

Methods : The use of a biphasic calcium phosphate ...

A midcrestal incision was made with vertical release incisions at the canine and tuberosity region. A full-thickness mucoperiosteal flap was elevated. The lateral maxillary sinus wall was prepared using a diamond burr with copious irrigation with sterile isotonic saline, regarding the contour of the maxillary sinus as observed on the preoperative panoramic radiograph. A bony top-hinge trap-door wa...

Methods : The use of a biphasic calcium phosphate ...

In this study, 10 consecutive healthy patients were selected for a unilateral MSFE procedure. Five patients received dental implants 9 months after MSFE and five patients underwent dental implant surgery 12 months after MSFE. In the 9-month group (three men and two women), the average age was 56.6 years (range 40 to 64 years); in the 12-month group (one man and four women), the average age was...

Background : The use of a biphasic calcium phospha...

β-TCP is a biocompatible osteoconductive calcium phosphate that may provide a scaffold for potential bony ingrowth [24]. β-TCP resorbs rather quickly but not necessarily at the same rate as new bone formation [25,26,27]. Most research focused on either using the relative unresorbable HA as a scaffold or β-TCP as a degradable component [19, 24,25,26, 28, 29]. Zerbo et al. [30] concluded that due...

Background : The use of a biphasic calcium phospha...

Maxillary sinus floor elevation (MSFE) is a surgical procedure to enhance the bone height in the posterior maxilla with graft material, allowing dental implant placement (later or at the same time) [1, 2]. This pre-implant procedure is predictable and results in a dental implant survival of more than 93.8% 3 years after dental implant placement [3]. According to Pjetursson [4] in his systematic r...

Abstract : The use of a biphasic calcium phosphate...

This study evaluates the clinical, radiological, histological, and histomorphometric aspects of a fully synthetic biphasic calcium phosphate (BCP) (60% hydroxyapatite and 40% ß-tricalcium phosphate), used in a human maxillary sinus floor elevation (MSFE) procedure with 9- and 12-month healing time. A unilateral MSFE procedure, using 100% BCP, was performed in two series of five patients with hea...

Fig. 6. The hydraulic lifter stabilized in the ost...

Fig. 6. The hydraulic lifter stabilized in the osteotomy before injecting the saline Fig. 6. The hydraulic lifter stabilized in the osteotomy before injecting the saline

Fig. 5. a The CAS drill has four blades and an inv...

Fig. 5. Fig. 5. a The CAS drill has four blades and an inverse conical shape. b The hydraulic lifter

Fig. 4. The inflated balloon while elevating the s...

Fig. 4. The inflated balloon while elevating the sinus membrane (The balloon is seen from the medial.) Fig. 4. The inflated balloon while elevating the sinus membrane (The balloon is seen from the medial.)

Fig. 3. a The balloon in a resting position. b The...

Fig. 3. 12] Fig. 3. a The balloon in a resting position. b The inflated balloon [12]

Fig. 2. The exposed mesial aspect of the sinus : C...

Fig. 2. The exposed mesial aspect of the sinus Fig. 2. The exposed mesial aspect of the sinus

Fig. 1. Determination of the remaining bone height...

Fig. 1. Determination of the remaining bone height (RBH) on the CBCT image Fig. 1. Determination of the remaining bone height (RBH) on the CBCT image

Table 2 The results of logistic regression of meth...

Methods BAOFSE BALLOON CAS kit Number of cases 12 12 ...

Table 1 The association between the methods used t...

  BAOSFE BALLOON CAS kit Total Stats p value Occurrence of perforation ...

About this article : Comparison of three different...

Yassin Alsabbagh, A., Alsabbagh, M.M., Darjazini Nahas, B. et al. Comparison of three different methods of internal sinus lifting for elevation heights of 7 mm: an ex vivo study. Int J Implant Dent 3, 40 (2017). https://doi.org/10.1186/s40729-017-0103-5 Download citation Received: 13 March 2017 Accepted: 29 August 2017 Published: 04 September 2017 DOI: https://doi.org/10...

Rights and permissions : Comparison of three diffe...

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...

Ethics declarations : Comparison of three differen...

Aghiad Yassin Alsabbagh, Mohammed Monzer Alsabbagh, Batol Darjazini Nahas, and Salam Rajih declare that they have no competing interests. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Author information : Comparison of three different...

Department of Periodontology, Damascus University Dental School, Damascus, Syrian Arab Republic Aghiad Yassin Alsabbagh & Mohammed Monzer Alsabbagh Department of Orthodontics, Damascus University Dental School, Damascus, Syrian Arab Republic Batol Darjazini Nahas Temple university, Philadelphia, USA Salam Rajih You can also search for this author in PubMed Google ...

References : Comparison of three different methods...

Toffler M, Toscano N, Holtzclaw D. Osteotome-mediated sinus floor elevation using only platelet-rich fibrin: an early report on 110 patients. Implant Dent. 2010;19(5):447–56. Download references

References : Comparison of three different methods...

Zitzmann NU, Scharer P. Sinus elevation procedures in the resorbed posterior maxilla. Comparison of the crestal and lateral approaches. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998;85(1):8–17. Esposito M, Felice P, Worthington HV. Interventions for replacing missing teeth: augmentation procedures of the maxillary sinus. The Cochrane database of systematic reviews 2014(5):CD008397. Sc...

References : Comparison of three different methods...

Seong WJ, Barczak M, Jung J, Basu S, Olin PS, Conrad HJ. Prevalence of sinus augmentation associated with maxillary posterior implants. The Journal of oral implantology. 2013;39(6):680–8. Cawood JI, Howell RA. A classification of the edentulous jaws. Int J Oral Maxillofac Surg. 1988;17(4):232–6. Tan WC, Lang NP, Zwahlen M, Pjetursson BE. A systematic review of the success of sinus floor elev...

Change history : Comparison of three different met...

An amendment to this paper has been published and can be accessed via the original article.

Conclusions : Comparison of three different method...

Within the limitation of this study and that of an ex vivo study, we can accept our hypotheses that the balloon is better than the BAOSFE in elevating the membrane mucosa and the CAS kit is better than the BAOSFE in preparing the osteotomy and breaking the sinus floor for elevation heights of 7 mm. Further, in vivo studies need to be taken to prove these findings.

Discussion : Comparison of three different methods...

The BAOSFE technique caused perforations in the membrane in 7 out of 12 cases with a percentage of 58.4. This result is consistent with many previous studies which state that this technique has a high rate of perforations when the RBH is less than 5 mm [2, 7, 26]. Also, all the perforations happened during the elevation process; however, this percentage is different than that reported by Steltzle...

Discussion : Comparison of three different methods...

Using a reamer instead of the osteotomes for breaking the sinus floor has the advantage of creating a thin bone shell that prevents direct contact between the drill and the Schneiderian membrane [24]. Moreover, using a reamer has been shown to cause less discomfort and nausea when compared to the osteotome technique as a result of the constant tapping of the osteotomes [25]. As a result, the CAS k...

Discussion : Comparison of three different methods...

Although the lateral sinus floor elevation is a proven clinically successful technique [14], the indirect SFE approach is favorable among clinicians because it does not require a second surgery site and hence cause less trauma and discomfort for the patient [14,15,16]. However, this method has its drawbacks, such as a higher risk of membrane perforation, a decreased space for using surgical instru...

Results : Comparison of three different methods of...

For the entire sample, the mean perforation length was (0.711 mm, SD = 1.4) and the mean time required to perform the procedure was (5.65 min, SD = 2.26), and out of the entire sample (N = 36), perforations happened in nine cases for a percentage of 25%. Chi-square test showed a significant association between method used and the occurrence of perforation (chi-square statistic = 8.585, ...

Methods : Comparison of three different methods of...

This approach starts like BAOSFE. The osteotomy is enlarged to 5.0 mm before the balloon (Zimmer Sinus Lift Balloon, Zimmer Dental Inc., California, USA) is inserted (Fig. 3). The sinus floor was broken with the 5 mm osteotome after the addition of bone. The sleeve of the balloon was inserted 1 mm beyond the sinus floor. The saline was injected slowly from the syringe into the balloon, so the ...

Methods : Comparison of three different methods of...

To achieve our purposes, an experimental ex vivo study was carried. This research project was approved by the University of Damascus Local Research Ethics Committee (UDDS-3045PG.) and was funded by the Damascus University Postgraduate Research Budget (97687027834DEN). The sinus floor elevations were done on 18 bisected heads of lambs aged between 6 and 12 months that were slaughtered in a maximum...

Background : Comparison of three different methods...

Therefore, the two working hypotheses of our study were “the CAS-Kit is safer than BAOSFE in breaking the sinus floor and the balloon is safer than BAOSFE in elevating the Schneiderian membrane” for elevation heights of 7 mm.

Background : Comparison of three different methods...

More than half of the implants placed in the posterior maxilla require sinus floor elevation (SFE) [1]. The need for this procedure is explained by continuous ridge resorption in an apical direction after tooth extraction combined with progressive sinus pneumatization in addition to poor bone quality that is frequently seen in the maxilla [2]. Sinus membrane perforation is considered the most com...

Abstract : Comparison of three different methods o...

Various techniques are available for elevating the sinus membrane. The aim of this study is to evaluate three methods of indirect sinus floor elevation regarding elevation heights of 7 mm on the outcomes of membrane perforation, length of perforation, and time required to perform the procedure. Three different methods for indirect sinus lifting, bone added osteotome sinus floor elevation (BAOS...

Fig. 8. The association between mean osseus sinus ...

Fig. 8. The association between mean osseus sinus volume of the maxillary sinus and gender. Men have a statistically significant higher mean osseus volume than women (p = 0.007) Fig. 8. The association between mean osseus sinus volume of the maxillary sinus and gender. Men have a statistically significant higher mean osseus volume than women (p = 0.007)

Fig. 7. The association between the mean osseus si...

Fig. 7. The association between the mean osseus sinus volume and age. No significant association between these parameters was found (p = 0.2) Fig. 7. The association between the mean osseus sinus volume and age. No significant association between these parameters was found (p = 0.2)

Fig. 6. No statistical significant association bet...

Fig. 6. No statistical significant association between a patient’s age and the presence of obliteration of at least one maxillary sinus was found (p = 0.92). For better visibility, the diagram has been jittered along the y-axis Fig. 6. No statistical significant association between a patient’s age and the presence of obliteration of at least one maxillary sinus was found (p = 0.92...

Fig. 5. The association between the obliterated vo...

Fig. 5. The association between the obliterated volume and sinus pathology. The presence of a pathology significantly increased the obliterated volume of a maxillary sinus (p 

Fig. 4. The association between the osseus volume ...

Fig. 4. The association between the osseus volume and the dentition. Edentulous, partly edentulous, and dentate patients showed no relevant difference in the size of the osseus sinus volume (p = 0.52) Fig. 4. The association between the osseus volume and the dentition. Edentulous, partly edentulous, and dentate patients showed no relevant difference in the size of the osseus sinus volume ...

Fig. 3. 3D view of osseus sinus volumes. Surface a...

Fig. 3. 3D view of osseus sinus volumes. Surface area (cm2) and volume (cm3) were calculated by the software Fig. 3. 3D view of osseus sinus volumes. Surface area (cm2) and volume (cm3) were calculated by the software

Fig. 2. View from the coronal plane. The marked cu...

Fig. 2. View from the coronal plane. The marked curves define the osseus and mucous boundaries of the maxillary sinuses. The hatched surface illustrates the measured remaining pneumatized cavity of an obliterated sinus and the filled (yellow) surface highlights the calculated obliterated volume Fig. 2. View from the coronal plane. The marked curves define the osseus and mucous boundaries of t...

Fig. 1. Calculation of the sinus body by interpola...

Fig. 1. Calculation of the sinus body by interpolating 15–25 curves at a distance of 2 mm, depending upon the size of the maxillary cavity Fig. 1. Calculation of the sinus body by interpolating 15–25 curves at a distance of 2 mm, depending upon the size of the maxillary cavity

Table 2 Frequency of pathologies in 128 maxillary ...

Frequency of pathologies n (%) Absence of alteration 73 (57.0) Mucosal thickening ...

Table 1 Mean, median minimum, maximum, and standar...

  Mean Median Minimum Maximum SD Osseus sinus surface area (cm2) ...

About this article : 3D-evaluation of the maxillar...

Luz, J., Greutmann, D., Wiedemeier, D. et al. 3D-evaluation of the maxillary sinus in cone-beam computed tomography. Int J Implant Dent 4, 17 (2018). https://doi.org/10.1186/s40729-018-0128-4 Download citation Received: 30 January 2018 Accepted: 20 March 2018 Published: 05 June 2018 DOI: https://doi.org/10.1186/s40729-018-0128-4

Rights and permissions : 3D-evaluation of the maxi...

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 : 3D-evaluation of the maxilla...

JL and CR are residents at the Clinic of Cranio-Maxillofacial and Oral Surgery, University of Zurich, University Hospital Zurich, Switzerland. DG is a master student at the Center of Dental Medicine, University of Zurich, Zurich, Switzerland. MR is the Chairman of the Clinic for Cranio-Maxillofacial and Oral Surgery, University of Zurich, University Hospital Zurich, Zurich, Switzerland. DW is t...

Author information : 3D-evaluation of the maxillar...

Correspondence to Julia Luz.

Author information : 3D-evaluation of the maxillar...

Clinic of Cranio-Maxillofacial and Oral Surgery, University of Zurich, University Hospital Zurich, Zurich, Switzerland Julia Luz, Dominique Greutmann, Claudio Rostetter, Martin Rücker & Bernd Stadlinger Statistical Services, Center of Dental Medicine, University of Zurich, Zurich, Switzerland Daniel Wiedemeier You can also search for this author in PubMed Google...

References : 3D-evaluation of the maxillary sinus ...

Ariji Y, Ariji E, Yoshiura K, Kanda S. Computed tomographic indices for maxillary sinus size in comparison with the sinus volume. Dento Maxillo Facial Radiology. 1996;25(1):19–24. Uchida Y, Goto M, Katsuki T, Akiyoshi T. A cadaveric study of maxillary sinus size as an aid in bone grafting of the maxillary sinus floor. J Oral Maxillofac Surg. 1998;56(10):1158–63. Uchida Y, Goto M, Katsuki T, ...

References : 3D-evaluation of the maxillary sinus ...

Lee KC, Lee SJ. Clinical features and treatments of odontogenic sinusitis. Yonsei Med J. 2010;51(6):932–7. Brook I. Sinusitis of odontogenic origin. Otolaryngology Head Neck Surgery. 2006;135(3):349–55. Nunes CA, Guedes OA, Alencar AH, Peters OA, Estrela CR, Estrela C. Evaluation of periapical lesions and their association with maxillary sinus abnormalities on cone-beam computed tomographic ...

References : 3D-evaluation of the maxillary sinus ...

Mozzo P, Procacci C, Tacconi A, Martini PT, Andreis IAB. A new volumetric CT machine for dental imaging based on the cone-beam technique: preliminary results. Eur Radiol. 1998;8(9):1558–64. Price JB, Thaw KL, Tyndall DA, Ludlow JB, Padilla RJ. Incidental findings from cone beam computed tomography of the maxillofacial region: a descriptive retrospective study. Clin Oral Implants Res. 2012;23(11...

Conclusions : 3D-evaluation of the maxillary sinus...

The present study showed the volume software to be a suitable tool for the measurement of the dimensions of the maxillary sinus. The results show that the osseus volume of the maxillary sinus varies on the base of gender and that the obliterated volume varies on the base of a present pathology. No statistically significant association between the patient’s age and the sinus volume or a present s...

Discussion : 3D-evaluation of the maxillary sinus ...

Velasco-Torres et al. [19] showed a larger sinus volume for dentate patients compared to edentulous and partially edentulous patients. This may be explained through the loss of posterior teeth in the maxilla, leading to the reduction of mechanical stimulation of the maxillary sinus. As a consequence, the sinus could expand (pneumatization) due to increased pressure and ostoclastic activity of the ...

Discussion : 3D-evaluation of the maxillary sinus ...

The aim of this study was to analyze volume parameters of the maxillary sinus based on CBCT data. Further, neighboring anatomical structures and related pathologies were recorded. Overall, the applied volume software used in this study allowed the calculation of the surface area and volume of maxillary sinuses. In clinics, the radiographic evaluation of the maxillary sinus is obligatory prior to ...

Results : 3D-evaluation of the maxillary sinus in ...

No relationship was observed between a patient’s age and the presence of partial or complete obliteration of at least one maxillary sinus (Fig. 6, p = 0.92). Patient’s age and the mean osseus sinus volume were also not associated significantly (Fig. 7, p = 0.20). Both maxillary sinuses (osseus borders) of each patient were quite similar in size (mean difference between left and right...

Results : 3D-evaluation of the maxillary sinus in ...

In total, 128 maxillary sinuses were analyzed. The mean surface area was found to be 39.7 cm2 and the mean volume 17.1 cm3. The mean surface area of the remaining pneumatized cavities of obliterated sinuses was found to be 36.4 cm2 and the mean volume 15 cm3 (Table 1). 42.2% of all sinuses showed an obliteration, and the mean volume of the obliterated sinuses was 5.1 cm3. If there was an obl...

Methods : 3D-evaluation of the maxillary sinus in ...

Patient-specific variables like gender, date of birth, and date of CBCT were recorded. The date of the CBCT image was further divided into either being in autumn/winter (1 January 2013–19 March 2013; 22 September 2013–31 December 2013) or spring/summer (20 March 2013–21 September 2013). The maxillary sinus was classified into obliterated or nonobliterated. It was also documented if there was...

Methods : 3D-evaluation of the maxillary sinus in ...

In the present study, 64 CBCT images (128 maxillary sinuses), taken between 1 January 2013 and 31 December 2013 at the Department of Cranio-Maxillofacial and Oral Surgery at the University of Zurich, were included. The inclusion criterion of each CBCT scan was the presence of two complete maxillary sinuses; the osseus borders of both sinuses had to be entirely visible. The scans were performed us...

Background : 3D-evaluation of the maxillary sinus ...

The precise assessment of the maxillary sinus is important in oral and maxillofacial surgery in cases of traumatology, sinusitis, and dental implantology. After the introduction of cone-beam computed tomography (CBCT) in dental medicine in 1998 [1], the number of clinicians using CBCTs increased constantly. Whereas in 2004, there were only three CBCTs registered in Switzerland, the current number ...

Abstract : 3D-evaluation of the maxillary sinus in...

There are few studies measuring the dimensions of the maxillary sinus, being mostly based on computed tomography imaging and rarely being based on cone-beam computed tomography (CBCT). The aim of this study was to measure the 3D osseous and soft tissue defined volume and surface area of the maxillary sinus. Further, possible associations with patient-specific and sinus-related variables were evalu...

Fig. 3. Forest plot of random effects meta-analysi...

Fig. 3. Forest plot of random effects meta-analysis of the incidence of Schneiderian membrane perforation using piezoelectric devices. The weighted average for the incidence rate of Schneiderian membrane perforation was 8% Fig. 3. Forest plot of random effects meta-analysis of the incidence of Schneiderian membrane perforation using piezoelectric devices. The weighted average for the incidenc...

Fig. 2. Forest plot of random effects meta-analysi...

Fig. 2. Forest plot of random effects meta-analysis of the incidence of Schneiderian membrane perforation using conventional rotative instruments. The weighted average for the incidence rate of Schneiderian membrane perforation was 24% Fig. 2. Forest plot of random effects meta-analysis of the incidence of Schneiderian membrane perforation using conventional rotative instruments. The weighted...

Fig. 1. Result of the search strategy and included...

Fig. 1. Result of the search strategy and included and excluded studies Fig. 1. Result of the search strategy and included and excluded studies

Table 2 Overview on the event rate (with lower and...

Piezoelectric Event rate Lower limit Upper limit z value p value ...

Table 1 Overview on the event rate (with lower and...

Conventional Event rate Lower limit Upper limit z value p value ...

About this article : Membrane perforation rate in ...

Jordi, C., Mukaddam, K., Lambrecht, J.T. et al. Membrane perforation rate in lateral maxillary sinus floor augmentation using conventional rotating instruments and piezoelectric device—a meta-analysis. Int J Implant Dent 4, 3 (2018). https://doi.org/10.1186/s40729-017-0114-2 Download citation Received: 28 September 2017 Accepted: 20 December 2017 Published: 29 January 20...

Rights and permissions : Membrane perforation rate...

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 : Membrane perforation rate in...

The authors Jordi Corinne, Mukaddam Khaled, Lambrecht Jörg Thomas and Kühl Sebastian state that they have no competing interests. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Author information : Membrane perforation rate in ...

Department of Oral Surgery, Oral Radiology and Oral Medicine, University Center for Dental Medicine, University of Basel, Basel, Switzerland Corinne Jordi, Khaled Mukaddam, Jörg Thomas Lambrecht & Sebastian Kühl You can also search for this author in PubMed Google Scholar You can also search for this author in PubMed Google Scholar You ...

Acknowledgements : Membrane perforation rate in la...

We would like to express our gratitude to Ms. Irene Mischak for the statistical support.

References : Membrane perforation rate in lateral ...

Delilbasi C, Gurler G. Comparison of piezosurgery and conventional rotative instruments in direct sinus lifting. Implant Dent. 2013;22(6):662–5. Becker ST, Terheyden H, Steinriede A, Behrens E, Springer I, Wiltfang J. Prospective observation of 41 perforations of the Schneiderian membrane during sinus floor elevation. Clin Oral Implants Res. 2008;19(12):1285–9. Hernandez-Alfaro F, Torradeflo...

References : Membrane perforation rate in lateral ...

Blus C, Szmukler-Moncler S, Salama M, Salama H, Garber D. Sinus bone grafting procedures using ultrasonic bone surgery: 5-year experience. Int J Periodontics Restorative Dent. 2008;28(3):221–9. Cortes AR, Cortes DN, Arita ES. Effectiveness of piezoelectric surgery in preparing the lateral window for maxillary sinus augmentation in patients with sinus anatomical variations: a case series. Int J ...

References : Membrane perforation rate in lateral ...

Froum SJ, Khouly I, Favero G, Cho SC. Effect of maxillary sinus membrane perforation on vital bone formation and implant survival: a retrospective study. J Periodontol. 2013;84(8):1094–9. Stricker A, Voss PJ, Gutwald R, Schramm A, Schmelzeisen R. Maxillary sinus floor augmentation with autogenous bone grafts to enable placement of SLA-surfaced implants: preliminary results after 15-40 months. C...

References : Membrane perforation rate in lateral ...

Wannfors K, Johansson B, Hallman M, Strandkvist T. A prospective randomized study of 1- and 2-stage sinus inlay bone grafts: 1-year follow-up. Int J Oral Maxillofac Implants. 2000;15(5):625–32. Hallman M, Nordin T. Sinus floor augmentation with bovine hydroxyapatite mixed with fibrin glue and later placement of nonsubmerged implants: a retrospective study in 50 patients. Int J Oral Maxillofac I...

References : Membrane perforation rate in lateral ...

Tawil G, Mawla M. Sinus floor elevation using a bovine bone mineral (Bio-Oss) with or without the concomitant use of a bilayered collagen barrier (Bio-Gide): a clinical report of immediate and delayed implant placement. Int J Oral Maxillofac Implants. 2001;16(5):713–21. Yilmaz HG, Tozum TF. Are gingival phenotype, residual ridge height, and membrane thickness critical for the perforation of max...

References : Membrane perforation rate in lateral ...

Geminiani A, Tsigarida A, Chochlidakis K, Papaspyridakos PV, Feng C, Ercoli C. A meta-analysis of complications during sinus augmentation procedure. Quintessence Int. 2017;48(3):231–40. Esposito M, Felice P, Worthington HV. Interventions for replacing missing teeth: augmentation procedures of the maxillary sinus. Cochrane Database Syst Rev. 2014;5:CD008397. Galindo-Moreno P, Avila G, Fernandez...

References : Membrane perforation rate in lateral ...

Tatum H. Maxillary and sinus implant reconstructions. Dent Clin N Am. 1986;30(2):207–29. Boyne PJ, James RA. Grafting of the maxillary sinus floor with autogenous marrow and bone. J Oral Surg. 1980;38(8):613–6. Khoury F. Augmentation of the sinus floor with mandibular bone block and simultaneous implantation: a 6-year clinical investigation. Int J Oral Maxillofac Implants. 1999;14(4):557–6...

Conclusions : Membrane perforation rate in lateral...

The aim of the present study was to resume in a review the literature evaluating the incidence of sinus membrane perforation comparing conventional rotating instruments with piezoelectric devices. Since only scarce studies exist comparing both techniques directly, we decided to additionally include any study on MSA in which information on the applied technique, e.g. conventional or piezosurgery, w...

Review : Membrane perforation rate in lateral maxi...

Atieh [11] found no significant difference in perforation risk. In these studies, occurred in the two groups of the RCTs are almost identical perforations. Maybe due to the fact that they included only one RS, while our study included 22, they see no deviation. The review of Stacchi [12] also described a lower incidence of membrane perforation during piezosurgery (10.9%) than during conventional ...

Review : Membrane perforation rate in lateral maxi...

Though both techniques exist more than 20 years, only single studies could be found in which the incidence of membrane perforation was focused comparing both operative techniques. This was the rationale for our meta-analysis. Principally, there is a controversy in the literature concerning the use of piezosurgical devices for MSA. Torrella et al. showed a reduced risk for perforations of the sinu...

Review : Membrane perforation rate in lateral maxi...

Finally, a significance analysis was performed between both groups in terms of a t test. The significance level was set at p 

Review : Membrane perforation rate in lateral maxi...

The database PubMed and the US National Library of Medicine were screened from January 8, 2012, to January 6, 2016, for potential studies reporting on membrane perforations during MSA from 1980 till 2015. The search was conducted independently and in duplicate by two authors (MK and JC). The following search terms were used: MeSH Terms: Piezo-surgery Ultrasound Ultrasonic Osteotomy Maxillary ...

Review : Membrane perforation rate in lateral maxi...

Atieh et al. [11] examined the intra- and postoperative events associated with the use of piezoelectric devices and conventional rotary instruments for lateral MSA in a systematic review. They included four studies with 178 lateral MSA in 120 participants. The meta-analysis did not show any significant difference between the two surgical techniques. Stacchi et al. [12] analysed the occurrence of i...

Review : Membrane perforation rate in lateral maxi...

Maxillary sinus augmentation (MSA) is a successful and predictable procedure to rehabilitate the atrophic edentulous posterior maxilla after postextractional pneumatisation of the sinus and bone loss with dental implants. Different approaches to elevate the maxillary sinus floor have been described and were originally introduced by Tatum [1, 2]. The lateral approach provides drilling a window in t...

Abstract : Membrane perforation rate in lateral ma...

Maxillary sinus augmentation (MSA) is a successful and predictable intervention with low complication rates. Perforations of the Schneiderian membrane may occur impairing the general success. The aim of this study was to compare the incidence of membrane perforations between conventional rotating instruments and piezoelectric devices in a meta-analysis. An electronic research on MEDLINE and PubMe...

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...

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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. Flow chart showing the search strategy : I...

Fig. 1. Flow chart showing the search strategy Fig. 1. Flow chart showing the search strategy

Table 2 Summary of the dental implants characteris...

Study N of patients Baseline bone height Total N of implants Implants survival rate % N of failed implants ...

Table 1 Descriptive statistics demonstrate patient...

Study Patients Age (years) N of sinus augmentation Sinus augmentation success rate % Baseline bone height ...

About this article : Is antral membrane balloon el...

Asmael, H.M. Is antral membrane balloon elevation truly minimally invasive technique in sinus floor elevation surgery? A systematic review. Int J Implant Dent 4, 12 (2018). https://doi.org/10.1186/s40729-018-0123-9 Download citation Received: 13 July 2017 Accepted: 08 February 2018 Published: 17 April 2018 DOI: https://doi.org/10.1186/s40729-018-0123-9

Rights and permissions : Is antral membrane balloo...

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 : Is antral membrane balloon e...

This is not applicable as this research was a systematic review of the previous studies utilizing the MIMBE technique in the sinus lift surgery. Not applicable. Huda M Asmael declares that she had no competing interests. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Author information : Is antral membrane balloon el...

Department of Oral & Maxillofacial Surgery, Dental Teaching Hospital, College of Dentistry, University of Baghdad, Bab- Almoadham, P.O.Box 1417, Baghdad, Iraq Huda Moutaz Asmael You can also search for this author in PubMed Google Scholar HMA performed all the aspects of this research which involved writing the research and collecting, interpreting, and analyzing data....

Acknowledgements : Is antral membrane balloon elev...

I would like to kindly thank the authors of the original articles who responded instantly upon communication with them to complete the missing data or to clarify the unexplained points in their studies. This research did not receive any funding from any funding resources.

References : Is antral membrane balloon elevation ...

Asmael HM, Lateef TA. An assessment of the efficacy of sinus balloon technique on transcrestal maxillary sinus floor elevation surgery. J Baghdad Coll Dent. 2016;28:109–13. Download references

References : Is antral membrane balloon elevation ...

Călin C, Petre A, Drafta S. Osteotome-mediated sinus floor elevation: a systematic review and meta-analysis. Int J Oral Maxillofac Implants. 2014;29:558–76. Starch-Jensen T, Jensen JD. Maxillary sinus floor augmentation: a review of selected treatment modalities. J Oral Maxillofac Implants. 2017;8:e3. Wallace SS, Mazor Z, Froum SJ, et al. Schneiderian membrane perforation rate during sinus el...

References : Is antral membrane balloon elevation ...

Ziv mazor. The use of minimally invasive antral membrane balloon elevation to treat the posterior maxilla: Aclinical presentation. J Implant Reconstr Dent. 2010;2:26-31. Kfir E, Kfir V, Kaluski E, et al. Minimally invasive antral membrane balloon elevation for single-tooth implant placement. Quintessence Int. 2011;42:645–50. Kfir E, Kfir V, Goldstein M, et al. Minimally invasive subnasal eleva...

References : Is antral membrane balloon elevation ...

Tatum H. Lecture presented to the Alabama Implant Congress 1976. Summers RB. The osteotome technique: part 3—less invasive methods of elevating the sinus floor. Compendium (Newtown, Pa). 1994;15:698–700. Muronoi M, Xu H, Shimizu Y, et al. Simplified procedure for augmentation of the sinus floor using a haemostatic nasal balloon. Br J Oral Maxillofac Surg. 2003;41:120–1. Soltan M, Smiler D...

Abbreviations : Is antral membrane balloon elevati...

Autogenous bone particles Antral membrane balloon elevation Mean Male:female numbers Minimally invasive antral membrane balloon elevation Number Not mentioned Perforation rate Platelets rich fibrin Platelets rich plasma Range Randomized clinical trial

Discussion : Is antral membrane balloon elevation ...

Sinus floor elevation surgery with balloon is said to be a minimally invasive technique [5], but to date, no systematic review was made to clearly present the study results, authors experience, and surgical outcomes. Results of studies that utilized MIAMBE technique could be discussed under these highlighted points. There are two critical points in sinus floor elevation surgery which include entr...

Results : Is antral membrane balloon elevation tru...

The total electronic search results were 5395 articles. The reviewed articles were 400, and the extracted articles which involved utilization of balloon technique in the maxillary sinus floor elevation surgery were 27 articles. Siventen articles were excluded from this study [6,7,8,9,10,11,12,13,14,15,16,17,18,19,20] and only 10 articles met the inclusion criteria. The results of the selected stu...

Materials and methods : Is antral membrane balloon...

This study was executed following the PRISMA criteria for the systematic review. An electronic search including MEDLINE (PubMed) and Cochrane database sites was conducted and supported by manual searching for targeted articles through the related journals and web sites from 1945 to 16 January 2017. Prospective, retrospective studies and randomized clinical trials. Articles published in English l...

Review : Is antral membrane balloon elevation trul...

Several sinus floor elevation techniques had been introduced as a minimally invasive surgical procedure. Among which, minimally invasive antral membrane balloon elevation technique was developed to achieve better results with minimal trauma to the patient also to reduce complications and intra-operative time. Conventionally, sinus augmentation procedure is performed either via lateral approach (mo...

Abstract : Is antral membrane balloon elevation tr...

Minimally invasive antral membrane balloon elevation was introduced as a less traumatic technique in sinus floor elevation surgery. This is the first systematic review to assess the results of previous studies utilizing this technique. The objectives of this study were to assess the bone gain, sinus augmentation success rate, implant survival rate, and complications with minimally invasive antral...

Fig. 7. Box and Whisker plot representing median a...

Fig. 7. Box and Whisker plot representing median and range values of membrane thicknesses with different morphologies Fig. 7. Box and Whisker plot representing median and range values of membrane thicknesses with different morphologies

Fig. 6. Box plot representing mean values of membr...

Fig. 6. Box plot representing mean values of membrane thicknesses for the investigated groups Fig. 6. Box plot representing mean values of membrane thicknesses for the investigated groups

Fig. 5. Endoscopic view from the crestal osteotomy...

Fig. 5. Endoscopic view from the crestal osteotomy site showing perforation of the sinus lining under the power of magnification and illumination of the endoscope Fig. 5. Endoscopic view from the crestal osteotomy site showing perforation of the sinus lining under the power of magnification and illumination of the endoscope

Fig. 4. Schematic drawing showing entrance of the ...

Fig. 4. Schematic drawing showing entrance of the endoscope from the crestal osteotomy site after sinus membrane elevation to assess the integrity of the membrane Fig. 4. Schematic drawing showing entrance of the endoscope from the crestal osteotomy site after sinus membrane elevation to assess the integrity of the membrane

Fig. 3. Endoscopic view from the lateral sinus wal...

Fig. 3. Endoscopic view from the lateral sinus wall showing the dome-shape elevation of sinus lining Fig. 3. Endoscopic view from the lateral sinus wall showing the dome-shape elevation of sinus lining

Fig. 2. Malleting instruments supplied from InnoBi...

Fig. 2. Malleting instruments supplied from InnoBioSurg (IBS) Company, Korea. a magic sinus splitter: used to widen and split the crest. b magic sinus lifter: used to lift the available bone with its attached membrane Fig. 2. Malleting instruments supplied from InnoBioSurg (IBS) Company, Korea. a magic sinus splitter: used to widen and split the crest. b magic sinus lifter: used to lift the a...

Fig. 1. A trephined hole (4 mm bone) in the later...

Fig. 1. A trephined hole (4 mm bone) in the lateral wall of the maxillary sinus to allow entrance of the endoscope Fig. 1. A trephined hole (4 mm bone) in the lateral wall of the maxillary sinus to allow entrance of the endoscope

Table 4 Chi square test showing perforation rate b...

Morphology No perforation Perforation P value No. (%) No. (%) Flat (n = 4) ...

Table 3 Descriptive statistics, results of Kruskal...

Morphology Mean ± SD (mm) Median (range) P value Perforation rate (%) Flat (n = 4) ...

Table 2 Chi square test showing perforation rate a...

Group No perforation Perforation P value No. (%) No. (%) Group (A) ...

Table 1 Descriptive statistics of membrane thickne...

Group Membrane thickness Mean ± SD (mm) Median (range) Percentage (%) (from total) Perforation rate (%...

About this article : Crestal endoscopic approach f...

Elian, S., Barakat, K. Crestal endoscopic approach for evaluating sinus membrane elevation technique. Int J Implant Dent 4, 15 (2018). https://doi.org/10.1186/s40729-018-0126-6 Download citation Received: 08 November 2017 Accepted: 20 March 2018 Published: 17 May 2018 DOI: https://doi.org/10.1186/s40729-018-0126-6

Rights and permissions : Crestal endoscopic approa...

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 : Crestal endoscopic approach ...

Faculty of Dentistry, Minia University ethics committee approved the study. All patients gave the consent to participate in the surgery. All patients approved for publications. The authors Samy Elian and Khaled Barakat declare that they have no competing interests. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Author information : Crestal endoscopic approach f...

Faculty of Dentistry, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland Samy Elian Faculty of Dental Surgery, Royal College of Physicians and Surgeons of Glasgow, Glasgow, Scotland Samy Elian Dentistry Department, Sohag University Hospital, Sohag, Egypt Samy Elian Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Minya University, Minya, Egypt Khaled Barakat You c...

Acknowledgements : Crestal endoscopic approach for...

We would like to express our gratitude to Ass. Prof. Hamed Gad for his clinical collaboration. This research was carried out without funding. The data supporting our findings can be requested for free at any time.

References : Crestal endoscopic approach for evalu...

Berengo M, Sivolella S, Majzoub Z, Cordioli G. Endoscopic evaluation of the bone-added osteotome sinus floor elevation procedure. Int J Oral Maxillofac Surg. 2004;33(2):189–94. Nkenke E, Schlegel A, Schultze-Mosgau S, Neukam FW, Wiltfang J. The endoscopically controlled osteotome sinus floor elevation: a preliminary prospective study. Int J Oral Maxillofac Implants. 2002;17(4):557–66. Nahlie...

References : Crestal endoscopic approach for evalu...

Summers RB. A new concept in maxillary implant surgery: the osteotome technique. Compendium. 1994;15(2):152. 54-6, 58 passim; quiz 62 Zitzmann NU, Scharer P. Sinus elevation procedures in the resorbed posterior maxilla. Comparison of the crestal and lateral approaches. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998;85(1):8–17. Ardekian L, Oved-Peleg E, Mactei EE, Peled M. The clinical ...

Discussion : Crestal endoscopic approach for evalu...

Crestal sinus lifting technique is a simple less invasive procedure. Nevertheless, it suffers a serious disadvantage of being a blind technique. Thus, perforation can easily occur without being detected which will lead to later implant failure especially when bone graft is added [1, 12,13,14]. We used endoscopic-assisted evaluation as a dependable method to assess the safety of the Schneiderian me...

Results : Crestal endoscopic approach for evaluati...

On the other hand, assessing the effect of membrane morphology pattern on the perforation risk revealed that the polyp type has the lowest risk of perforation, whereas the irregular type represents the most insecure pattern. There was a relation between different membrane morphology and perforation.

Results : Crestal endoscopic approach for evaluati...

All patients tolerated the procedure without major complications. Minor complications included postoperative swelling, edema, and pain that were managed by antibiotic and anti-inflammatory drugs. All implants were successfully osseo-integrated and loaded after about 6 months. The floor was lifted without perforation in 83.33% of cases. The lifter was able to raise and stretch the sinus membrane ...

Patients and methods : Crestal endoscopic approach...

After completing the elevation of the Schneiderian membrane, the endoscope (70° lens) was removed from the lateral wall of the maxillary sinus and re-inserted (with 0°) from the crestal osteotomy site of the implant (Fig. 4) to check the integrity of the Schneiderian membrane, as well as to ensure the absence of any undetected minor perforation (Fig. 5). The implant was finally inserted in the...

Patients and methods : Crestal endoscopic approach...

Twelve patients (4 males and 8 females) ranging in age from 25 to 60 years were included in the study. All patients have bone height ranging 3–5 mm below the sinus membrane. They all performed closed sinus lifting and simultaneous immediate implant insertion. Under local anesthesia, the flap was elevated and retracted exposing the crestal and buccal bone. A trephine bur 4 mm diameter on hand...

Introduction : Crestal endoscopic approach for eva...

The evolution of closed sinus lift techniques since 1994 [1] was proposed as a less invasive method for management of atrophic posterior maxillae [2]. However, it is a blind technique that lacks the ability to confirm an intact sinus floor elevation without perforation and thus represented a real shortcoming [3]. Various forms of osteotome lifters were designed to guarantee safe elevation of maxil...

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...

Table 7 All studies measuring the thickness of the...

Authors Year of study Method of study Results Tos and Mogesen et al. 1979 ...

Table 6 Results from a multivariable random effect...

Factor Difference 95% CI p value Age (years)   

Table 5 Angle of the walls of the sinus by age gro...

  Age (years)   

Table 4 Sinuses’ angles by gender and overall : ...

  Gender   Male Female Overall   N (%) N (%) N (%) p value ...

Table 3 Thickness by point of measurement (all mea...

  Position      1 (AR/AL) 2(BR/BL) 3 (CR/CL) Overall   N (%) N (%) N (%) ...

Table 2 Average thickness by age group : Thickness...

  Age (years)   

Table 1 Sinuses’ thickness by gender and overall...

  Sex   Male Female Overall   Mean (SD) Mean (SD) Mean...

Fig. 3. Demonstration of the method used to measur...

Fig. 3. Demonstration of the method used to measure the angle designated by the buccal and lingual walls of the sinus angle for each of the three fixed points in a given height Fig. 3. Demonstration of the method used to measure the angle designated by the buccal and lingual walls of the sinus angle for each of the three fixed points in a given height

Fig. 2. Demonstration of the method used to measur...

Fig. 2. Demonstration of the method used to measure the thickness of the Schneiderian membrane in the cross-sectional images for each of the three fixed points Fig. 2. Demonstration of the method used to measure the thickness of the Schneiderian membrane in the cross-sectional images for each of the three fixed points

Fig. 1. Demonstration of the method used in the pa...

Fig. 1. Demonstration of the method used in the panoramic image to divide the sinus in four equal parts and find three fixed points for the measurements. Also, these fixed points in the horizontal plane with and without sections Fig. 1. Demonstration of the method used in the panoramic image to divide the sinus in four equal parts and find three fixed points for the measurements. Also, these ...

About this article : Thickness of the Schneiderian...

Kalyvas, D., Kapsalas, A., Paikou, S. et al. Thickness of the Schneiderian membrane and its correlation with anatomical structures and demographic parameters using CBCT tomography: a retrospective study. Int J Implant Dent 4, 32 (2018). https://doi.org/10.1186/s40729-018-0143-5 Download citation Received: 29 January 2018 Accepted: 27 August 2018 Published: 19 October 2018 ...

Rights and permissions : Thickness of the Schneide...

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 : Thickness of the Schneideria...

Patient recruitment and data collection for this study took place at National and Kapodistrian University of Athens, School of Dentistry, Greece. The research was approved by the Ethics Committee of the National and Kapodistrian University of Athens, Greece, and all activities were conducted in full accordance with ethical principles, including the World Medical Association Declaration of Helsinki...

Author information : Thickness of the Schneiderian...

Department of Oral and Maxillofacial Surgery, School of Dentistry, National and Kapodistrian University of Athens, Greece, Thivon 2 str, 11527, Athens, Greece Demos Kalyvas, Andreas Kapsalas & Sofia Paikou Oral Diagnosis & Radiology Clinic, School of Dentistry, National and Kapodistrian University of Athens, Greece, Thivon 2 str, 11527, Athens, Greece Konstantinos Tsiklakis You can also sea...

Availability of data and materials : Thickness of ...

The data will not be shared, but are available upon request.

References : Thickness of the Schneiderian membran...

Wen S-C, Lin Y-H, Yang Y-C, Wang H-L. The influence of sinus membrane thickness upon membrane perforation during transcrestal sinus lift procedure. Clin. Oral Impl. Res. 2015;26:1158–64. Insua A, Monje-Gil F, García-Caballero L, Caballé-Serrano J, Wang HL, Monje A. Mechanical characteristics of the maxillary sinus Schneiderian membrane ex vivo. Clin Oral Investig. 2017; https://doi.org/10.100...

References : Thickness of the Schneiderian membran...

Cagici CA, Yilmazer C, Hurcan C, Ozer C, Ozer F. Appropriate interslice gap for screening coronal paranasal sinus tomography for mucosal thickening. Eur Arch Otorhinolaryngol. 2009;266(4):519–25. Eggesbø HB. Radiological imaging of inflammatory lesions in the nasal cavity and paranasal sinuses. Eur Radiol. 2006;16:872–88. Lozano-Carrascal N, Salomó-Coll O, Gehrke SA, Calvo-Guirado JL, Hern...

References : Thickness of the Schneiderian membran...

Testori T. Maxillary sinus surgery: Anatomy and advanced diagnostic imaging. J Implant and Reconstructive Dent. 2011;2:6-14. Sargi ZB, Casiano RR. Surgical anatomy of the paranasal sinuses. In: Kountakis SE, Onerci TM, editors. Rhinologic and sleep apnea surgical techniques. New York: Springer; 2007. p. 17–26. Bergh van den JPA, Bruggenkate ten CM, Disch FJM, Tuinzing DB. Anatomical aspects of...

Conclusions : Thickness of the Schneiderian membra...

In conclusion, the present study demonstrated that male patients tend to have a thicker membrane than female patients. The angles of the sinus seemed to increase in width from mesial to distal, and they have no significant correlation with any of our parameters. Thickness of the mucosa and width of the maxillary sinus did not seem to correlate. Future studies including larger groups of participant...

Discussion : Thickness of the Schneiderian membran...

In the present study, it was also concluded that the width of the sinus increases from mesial to distal. Male sinuses had higher prevalence of high angle values compared to female sinuses, but the majority of angle values and widths was characterized as moderate. In an attempt to correlate the membrane biotype regarding thickness with the sinus width, it was proven that there is no correlation be...

Discussion : Thickness of the Schneiderian membran...

Comparing the thickness of the membrane between the two genders, males seem to have thicker membranes than females. Vallo et al. 2010, Janner et al. 2011, Ji-Young Yoo et al. 2011, Cakur et al. 2013, and Jildirim et al. 2017 [9, 11, 12, 16, 17] also come to this conclusion. Our study assumed that this difference is of the order of 40%. On the contrary, Pazera et al. 2010 concluded that there is no...

Discussion : Thickness of the Schneiderian membran...

It is very important to pre-operatively evaluate the thickness of the Schneiderian membrane to plan the surgical procedure in the region that involves the membrane, such as a sinus lift augmentation, which increases the possibility of membrane perforation or other complications. The present study assumed that the average thickness of the Schneiderian membrane is 1.60 ± 1.20 mm. There are m...

Results : Thickness of the Schneiderian membrane a...

The mean value of the overall average thickness is 1.60 ± 1.20 mm (males 1.95 ± 1.28 mm and females 1.24 ± 1.02 mm) (Table 1). The average thickness of the membrane also showed no tendency for differentiation by age group (p = 0.878) (Table 2). The statistical analysis also shows a clear tendency towards lower values when checking from point AR to point CR and from point ...

Methods : Thickness of the Schneiderian membrane a...

These three cross-sectional images, in which the thickness of the Schneiderian membrane was previously measured, were also used for the measurement of the angle of the maxillary sinus. A segment DG (point D is the deepest point of the floor of the maxillary sinus) is created, vertical to the horizontal plane with stable length equal to 9.9 mm. The mean of 9.9 mm was chosen, because of a limitati...

Methods : Thickness of the Schneiderian membrane a...

The study sample included 76 patients, of which 39 were females and 37 were males. In total, 120 sinuses (44 both left- and right-sided, 21 right-sided, and 11 left-sided) were evaluated as suitable for the present study and were measured. The total sample was classified in four age groups (below 45 years, 45–54 years, 54–64 years, and over 65 years of age). The mean age value of the sampl...

Background : Thickness of the Schneiderian membran...

The maxillary sinus is the largest of the paranasal air-filled spaces, and it develops firstly in utero [1, 2]. Anatomically, the maxillary sinus is a pyramid-shaped cavity located in the facial skull with a mean volume of 12.5 mL (min 5 mL and max 22 mL) [2,3,4,5,6]. The size, the shape, and the wall thickness of every maxillary sinus not only vary among the population, but also between the tw...

Abstract : Thickness of the Schneiderian membrane ...

The aims of the present study were to determine the thickness of the Schneiderian membrane and identify the width of the maxillary sinus, which is indicated by the buccal and lingual walls of the sinus angle between. Furthermore, to investigate the possibility of a correlation between the aforementioned structures and also other anatomical and demographic parameters using CBCTs for dental implant ...

Fig. 4. Statistical analysis for different variabl...

Fig. 4. Statistical analysis for different variables. a Weighted mean survival rate. b Implant survival rate according to degree of penetration. c Analysis of clinical complications. d Analysis of radiographic complications Fig. 4. Statistical analysis for different variables. a Weighted mean survival rate. b Implant survival rate according to degree of penetration. c Analysis of clinical com...

Fig. 3. Graphic representation of group 1 ≤ 4...

Fig. 3. Graphic representation of group 1 ≤ 4 mm penetration and group 2 > 4 mm penetrations Fig. 3. Graphic representation of group 1 ≤ 4 mm penetration and group 2 > 4 mm penetrations

Fig. 1. Graphic representation of implants intrudi...

Fig. 1. Graphic representation of implants intruding sinus perforating or not the Schneiderian membrane Fig. 1. Graphic representation of implants intruding sinus perforating or not the Schneiderian membrane

Fig. 2. PRISMA flowchart of the screening process ...

Fig. 2. PRISMA flowchart of the screening process Fig. 2. PRISMA flowchart of the screening process

Table 3 Articles excluded and reasons for exclusio...

Reason for exclusion Investigations Study design (case series or case report) Kim et al. (2017), Hatano et al. (2007) Different grafting techn...

Table 2 Characteristics of the included investigat...

Author (year) Study design Follow-up (months) N of patients N of implants Smokers Le...

Table 1 Clinical and radiographic complications re...

Clinical complications Radiographic complications Sinusitis Thickening of Schneiderian membrane Nasal bleeding, nasal obstruction, nasal secre...

About this article : Influence of exposing dental ...

Ragucci, G.M., Elnayef, B., Suárez-López del Amo, F. et al. Influence of exposing dental implants into the sinus cavity on survival and complications rate: a systematic review. Int J Implant Dent 5, 6 (2019). https://doi.org/10.1186/s40729-019-0157-7 Download citation Received: 09 October 2018 Accepted: 06 January 2019 Published: 05 February 2019 DOI: https://doi.org/10...

Rights and permissions : Influence of exposing den...

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 : Influence of exposing dental...

Not applicable Not applicable Gian Maria Ragucci, Basel Elnayef, Fernando Suárez López del Amo, Hom-Lay Wang, Federico Hernández-Alfaro, and Jordi Gargallo-Albiol declare that they have no competing interests. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Author information : Influence of exposing dental ...

Correspondence to Basel Elnayef.

Author information : Influence of exposing dental ...

Department of Oral and Maxillofacial Surgery, International University of Catalonia, C/Josep Trueta Sn, Sant Cugat del Vallés, C.P 08195, Barcelona, Spain Gian Maria Ragucci, Basel Elnayef, Federico Hernández-Alfaro & Jordi Gargallo-Albiol Department of Periodontics, University of Oklahoma Health Sciences Center – College of Dentistry, Oklahoma City, OK, USA Fernando Suárez-López del ...

Acknowledgements : Influence of exposing dental im...

The authors want to thank Mr Juan Luis Gómez Martínez for the support in the statistical analysis. Not applicable Not applicable The authors do not have any financial interests, either directly or indirectly, in the products or information listed in the paper.

References : Influence of exposing dental implants...

Schwarz L, Schiebel V, Hof M, Ulm C, Watzek G, Pommer B. Risk factors of membrane perforation and postoperative complications in sinus floor elevation surgery: review of 407 augmentation procedures. J Oral Maxillofac Surg. 2015;73:1275–82. Jung JA, Choi BH, Zhu SJ, Lee SH, Huh JY, You TM, Lee HJ, Li J. The effects of exposing dental implants to the maxillary sinus cavity on sinus complications....

References : Influence of exposing dental implants...

Ardekian L, Oved-Peleg E, Mactei EE, Peled M. The clinical significance of sinus membrane perforation during augmentation of the maxillary sinus. J Oral Maxillofac Surg. 2006 Feb;64(2):277–82. Anavi Y, Allon DM, Avishai G, Calderon S. Complications of maxillary sinus augmentations in a selective series of patients. Oral Surg Oral Med Oral Patho Oral RadiolEndod. 2008;106(1):34–8. Van den Ber...

References : Influence of exposing dental implants...

Curi MM, Cardoso CL, de Ribeiro C. Retrospective study of pterygoid implants in the atrophic posterior maxilla: implant and prosthesis survival rates up to 3 years. Int J Oral Maxillofac Implants. 2015;30(2):378–83. Boyne PJ, James RA. Grafting of the maxillary sinus floor with autogenous marrow and bone. J Oral Surg. 1980;38(8):613–6. Tatum H.Jr. Maxillary and sinus implant reconstructions....

References : Influence of exposing dental implants...

Roccuzzo M, Bonino L, Dalmasso P, Aglietta M. Long-term results of a three arms prospective cohort study on implants in periodontally compromised patients: 10-year data around sandblasted and acid-etched (SLA) surface. Clin Oral Implants Res. 2014;25(10):1105–12. Esposito M, Grusovin MG, Rees J, Karasoulos D, Felice P, Alissa R, Worthington H, Coulthard P. Effectiveness of sinus lift procedures...

Conclusions : Influence of exposing dental implant...

The current review showed that the exposure of dental implants in the sinus cavity without the augmentation procedure or graft materials shows a high survival rate of 95.6%, without statistically significant differences according to the level of penetration (lower or higher to 4 mm). Changes in maxillary sinuses in relation to protruding implants within the sinus cavity do not statically affect ...

Discussion : Influence of exposing dental implants...

Consequently, it seems that maxillary sinus changes in relation to protruded implants inside the sinus cavity and does not statically affect to implant survival rate neither to clinical nor radiographic complications. Several limitations could be described for the present review. Firstly, there is a lack of a control group in the included studies, to compare outcomes and complications, with impla...

Discussion : Influence of exposing dental implants...

Pneumatization of the maxillary sinus and resorption of the residual alveolar ridge following tooth extraction can compromise the dental implant placement. Similarly, extension of the dental implants inside the maxillary sinus cavity is not rare. Some studies have observed some differences in relation to the depth of the implant extension inside the sinus cavity. When the implants penetrate inside...

Results : Influence of exposing dental implants in...

Seven studies [27,28,29,30,31,32,33] provide information on clinical complications with a global sample of 232 patients. Clinical complications among the different authors range from 0 to 14.3%, being the weighted mean complication rate 3.4% with an IC 95% [0 7.5] (Fig. 4c) Clinical complications analyzed in the studies were sinusitis, nasal bleeding, nasal obstruction, nasal secretion, mucopurul...

Results : Influence of exposing dental implants in...

An initial screening yielded a total of 3551 publications of which 26 potentially relevant articles were selected after an evaluation of their titles and abstracts. Full text of these articles was obtained and evaluated thoroughly. Of these, eight articles [26,27,28,29,30,31,32,33] (Table 2) fulfilled the inclusion criteria and subsequently were included in the qualitative analysis (Fig. 2). Rea...

Materials and methods : Influence of exposing dent...

Heterogeneity was assessed based on calculation of the I2 statistic (percentage variability of estimated effect that can be attributed to the heterogeneity of the effects) and the null statistic test. Galbraith graphs displayed the degree of heterogeneity. In studies where great heterogeneity was detected, a sensitivity analysis was performed to determine its source. Funnel plots and the Egger tes...

Materials and methods : Influence of exposing dent...

Articles were included in this systematic review if they met the following inclusion criteria: human prospective or retrospective studies, reporting outcomes of implant placed perforating the sinus floor with implant burs, and without regenerative procedure (lateral sinus lift or transalveolar technique) and graft material. The intrusion into the sinus cavity can occur during drilling or implant p...

Materials and methods : Influence of exposing dent...

This systematic review and subsequent meta-analysis follow the guidelines of the PRISMA statement. The following focus question was developed: Is the intrusion of dental implants into the sinus cavity during implant drilling or implant placement, without regenerative procedure (lateral sinus lift or transalveolar technique) and graft material, has an effect on implant survival or increase clinica...

Introduction : Influence of exposing dental implan...

Intrusion of dental implants into the maxillary sinus perforating through the Schneiderian membrane is considered a cause of undesirable complications [24, 25]. However, this phenomenon has never been properly evaluated and systematically studied. For this reason, the aim of this systematic review was to assess the implant survival and complication rates of implants intruding into the sinus cavity...

Introduction : Influence of exposing dental implan...

The edentulous posterior maxillary region often presents with unique challenging conditions in implant dentistry [1]. Limited bone height secondary to pneumatization of the maxillary sinus and the resorption of the alveolar ridge preclude in many instances the installation of dental implants. To compensate for the lack of bone height, several treatment options have been proposed. The most conserv...

Abstract : Influence of exposing dental implants i...

The overall survival rate of the implants into the sinus cavity was 95.6%, without statistical differences according to the level of penetration. The clinical and radiological complications were 3.4% and 14.8% respectively. The most frequent clinical complication was the epistaxis, and the radiological complication was thickening of the Schneiderian membrane, without reaching statistical significa...

Abstract : Influence of exposing dental implants i...

After tooth loss, the posterior maxilla is usually characterized by limited bone height secondary to pneumatization of the maxillary sinus and/or collapse of the alveolar ridge that preclude in many instances the installation of dental implants. In order to compensate for the lack of bone height, several treatment options have been proposed. These treatment alternatives aimed at the installation o...

Table 3 Mean value and standard deviation for the ...

Item Mean ± SD pre-operative Mean ± SD post-operative Mean ± SD in the last time Have you felt pain in your mouth? 0.9 ± 1.1 1.2 ± 1.0 0.3 ± 0.6 Have you had difficulties with your mouth opening? 0.2 ± 0.6 0.5 ± 0.9 0.1 ± 1.0 Have you had painful gums? 0.9 ± 1.0 1.0 ± 1.1 0.5 ± 0.8 Have you had a ...

Table 2 Mean value and standard deviation

Item Mean ± SD before sinus lift Mean ± SD after sinus lift p value Have you felt tense because of problems with your teeth, mouth or dentures? 1.8 ± 1.1 0.8 ± 1.0

Table 1 Mean value and standard deviation

Item Mean ± SD before sinus lift Mean ± SD after sinus lift p value Have you had difficulty chewing any foods? 1.6 ± 1.2 0.4 ± 0.7

Figure 5. Total score for physical and psychologic...

  Figure 5. Total score for physical and psychological disabilities before (gray) and after (hatched) sinus augmentation according to indications

Figure 4. Total score for functional limitations b...

  Figure 4. Total score for functional limitations before (gray) and after (hatched) sinus augmentation according to indications

Figure 3. Total score for complaints

  Figure 3. Total score for complaints due to surgical procedure pre-operative, post-operative, and recently

Figure 2. Cumulative survival rate

  Figure 2. Cumulative survival rate according to Kaplan–Meier and sinus augmentation procedure  

Figure 1. Flow chart of patients included in the s...

Figure 1. Flow chart of patients included in the study Figure 1. Flow chart of patients included in the study

References : Impact of maxillary sinus augmentatio...

References Al-Nawas B, Schiegnitz E. Augmentation procedures using bone substitute materials or autogenous bone—a systematic review and meta-analysis. Eur J Oral Implantol. 2014 Summer;7 Suppl 2:S219-34. Derks J, Hakansson J, Wennstrom JL, Tomasi C, Larsson M, Berglundh T. Effectiveness of implant therapy analyzed in a Swedish population: early and late implant loss. J Dent Res. 2015;94(...

Discussion : Impact of maxillary sinus augmentatio...

  The authors concluded that in clinical decision-making regarding donor site for bone graft harvesting, patients and clinicians should consider expected decrease in HRQoL if deciding to use extra-oral donor sites. Therefore, the authors recommended to prefer intra-oral donor sites whenever possible. In a recent study of Nickenig et al., OHIP-G 21 was evaluated in 8689 patients with variou...

Discussion : Impact of maxillary sinus augmentatio...

In this prospective study, health-related quality of life questionnaire was given to 76 patients evaluating patient perception of recovery in the four areas pain, oral function, general activity, and other symptoms. The results showed that average and maximal pain peaked on post-operative day 1 and improved on post-operative days 4 and 5. Difficulty in mouth opening was greatest on pos...

Discussion : Impact of maxillary sinus augmentatio...

Discussion The clinical and radiological outcomes of sinus augmentation procedures have been published in several studies. However, little data on the physical and psychological impact of this procedure on the patient is available yet. The present study evaluated pre-operative and post-treatment OHRQoL self-assessment scores of patients treated with dental implants after sinus augmentation ...

Results : Impact of maxillary sinus augmentation (...

In the subcategory physical and psychological disabilities, all questions had significant better values after the sinus lift (p 

Results : Impact of maxillary sinus augmentation (...

Results Survival analysis After an average time in situ of 41.2 ± 27 months (3.4 years; range 0–96 months), 40 of the 863 implants were lost. These results indicated an in situ rate of 95.4%. One-year and five-year survival rate according to Kaplan–Meier were 95.4 and 94.4%. In patients receiving an external sinus lift an in situ rate of 95.1% and in patients with an internal sinus...

Methods : Impact of maxillary sinus augmentation o...

Methods Study design and subjects This retrospective study addresses the oral health-related quality of life after maxillary sinus augmentation. Therefore, all patients that received an implantation after maxillary sinus augmentation in the Department of Oral and Maxillofacial Surgery of the University Medical Centre Mainz, Germany, between July 2002 and December 2007 were included in this stu...

Background : Impact of maxillary sinus augmentatio...

Background Rehabilitation of completely and partial edentulous patients with dental implants has proved to be a safe and predictable procedure. However, reduced bone height and the proximity of the maxillary sinus are challenging limitations for dental implant placement in the posterior maxilla. Besides the use of short and tilted implants, one of the most frequently used surgical techniques fo...

Impact of maxillary sinus augmentation on oral hea...

Abstract Background The aim of this study was to measure the oral health-related quality of life (OHRQoL) after maxillary sinus augmentation to determine the physical and psychological impact of this procedure for the patient. Methods Three hundred sixteen patients treated with an external or internal maxillary sinus augmentation and a total of 863 implants in the Department of Oral and Maxi...

Reference : Dental implants in patients treated wi...

Abbreviations BP: bisphosphonate BP-ONJ: bisphosphonate-associated osteonecrosis of the jaws CTX: C-terminal telopeptide of the type I collagen PICO: patients intervention control outcome PRISMA-P: preferred reporting items for systematic reviews and meta-analyses protocols QoL: quality of life ST: search term TMJ: temporomandibular joint ...

Discussion : Dental implants in patients treated w...

Next to this, the patients need to be compliant with an appropriate motivation for oral hygiene and the necessary skills to transfer this. Infectious foci should be treated before implant therapy to further reduce the risk of osteonecrosis development. The surgical sites should be followed up clinically (persisting sharp bone edges without any tendency to remodel) and radiologically (e...

Discussion : Dental implants in patients treated w...

Although there are only very few cases in the literature with augmentation of bone/sinus lift, these procedures are linked to a functioning vascular recipient site with working osteoclastic resorption and osteoblastic bone formation, and this is compromised in patients with antiresorptive therapy. Due to the denudation of the bone at the recipient site the vascular situation might be e...

Discussion : Dental implants in patients treated w...

Discussion Even latest guidelines and statements dealing with medication associated osteonecrosis of the jaws such as the American, Scottish, Swiss or German do not address implant therapy in these patients in detail. Due to this lack of data a systematic literature review was performed to fill this gap. Unfortunately the literature dealing with this topic is very sparse and consists mainl...

Results : Dental implants in patients treated with...

Nibbe analyzed 128 patients with IV BP or denosumab separated into 3 groups. In the first group 5 out of 60 patients with no denture had an osteonecrosis (8%), in the 2nd group 5 out of 34 patients with a fixed partial denture had an osteonecrosis 15%, and in the 3rd group 11 out of 34 patients with a removable denture had an osteonecrosis (32%). Kyrgidis determined that dentures increase the ris...

Results : Dental implants in patients treated with...

Results Out of 606 articles 556 articles were excluded because they were either duplicates, case reports, narrative reviews, case series with less than 5 cases or were not associated with the topic at all (Table 1 and Fig. 1). Some of the articles analyzed more than one outcome and are referred to several times. Since the available literature is very inhomogeneous with a low level of evidence a...

Introduction : Dental implants in patients treated...

Introduction Bisphosphonate-associated osteonecrosis of the jaws (BP-ONJ) is a well-known side effect in patients receiving bisphosphonates (BP) due to e.g. osteoporosis, multiple myeloma or malignant diseases with metastases to the bone; prevalences range between 0.1% for patients with primary osteoporosis to 1% in patients with secondary osteoporosis and up to about 20% for special high risk ...

Dental implants in patients treated with antiresor...

Dental implants in patients treated with antiresorptive medication – a systematic literature review Abstract Objective Bisphosphonate-associated osteonecrosis of the jaws (BP-ONJ) is triggered by inflammatory processes. Typical trigger factors are periodontal disease, denture pressure sores, and surgical interventions such as tooth extractions. Unfortunately there is only little data on how...

Figure 3. Postoperative radiograph of the resected...

Figure 3. Postoperative radiograph of the resected dental implant in the right anterior maxilla

Figure 2. On radiological examination

  Figure 2. On radiological examination, it was confirmed that the dental implant had perforated the cortical bone of the right nasal floor

Figure 1. On anterior rhinoscopy, the apical part ...

  Figure 1. On anterior rhinoscopy, the apical part of the titanium dental implant in the right anterior maxilla was seen in the nasal floor close to the nasal septum

Discussion

Discussion Insertion of endosseous dental implants is usually associated with a low incidence of complications and excellent prognosis. However, physiologic changes following tooth loss may complicate or even impede insertion of dental implants in the upper jaw. Furthermore dental implants can only be inserted if there is sufficient bone for adequate stabilization. Therefore, in severely at...

Background & case presentation

Background Endosseous dental implants are commonly used to rehabilitate fully or partially edentulous patients. The insertion of such implants can in some cases cause complications, especially in the edentulous atrophic maxilla. In this paper, an unusual complication of altered nasal airflow after the placement of an endosseous dental implant in the maxilla is presented. Subsequent treatmen...

Altered nasal airflow: an unusual complication fol...

Altered nasal airflow: an unusual complication following implant surgery in the anterior maxilla Abstract Dental implants have been in routine clinical use for over three decades and are a predictable treatment modality. However, as with all other aspects of dentistry, complications occur. A 50-year-old female patient with complaints of a long ongoing unpleasant altered nasal airflow presented...

Figure 2. Figure illustrating the proposed mucosal...

  Figure 2. Figure illustrating the proposed mucosal thickening index. A ≤1 mm, indicating no thickening; B >1 mm but ≤2 mm, indicating minimal thickening; C >2 mm but ≤5 mm, indicating moderate thickening; D >5 mm, indicating severe thickening

Table 2 Statistical results after inter-variable a...

Table 2 Statistical results after inter-variable adjustment showing the association between recorded parameters and sinus mucosal thickening; p values that showed statistically significant differences are italicized       Gender Respiratory diseases Cardio-vascular diseases Diabetes mellitus Smoking History of periodontal diseases Endodontic treatment History of orthodontic t...

Table 1 CBCT measurements of sinus mucosal thicken...

Table 1 CBCT measurements of sinus mucosal thickening Patient Anterior(E1-floor of the sinus) Middle(C1-floor of the sinus) Posterior(D1-floor of the sinus) Thickest(F-floor of the sinus) 1 3.06 0.32 0.76 4.59 2 0.34 0.21 0.20 0.34 3 0.39 0.54 1.38 1.66 4 4.15 3.79 0.61 6.36 5 5.64 1.33 3.73 8.42 6 7.34 0.77 0.86 7.66 7 1.9...

Figure 1. Figure illustrating the reference points...

  Figure 1. Figure illustrating the reference points of the CBCT measurements. A: most posterior point of the sinus wall; B: most anterior point of the sinus wall; C: mid-point between A and B; C1: measurement of mucosal thickening perpendicular to A–B line at point C; D: mid-point between A and C; D1: measurement of mucosal thickening perpendicular to A–B line at point D...

Reference : Dental implants and grafting success r...

Shahbazian M, Vandewoude C, Wyatt J, Jacobs R. Comparative assessment of panoramic radiography and CBCT imaging for radiodiagnostics in the posterior maxilla. Clin Oral Investig. 2014;18:293–300. Logan GM, Brocklebank LM. An audit of occipitomental radiographs. Dentomaxillofac Radiol. 1999;28:158–61. Pazera P, Bornstein MM, Pazera A, Sendi P, Katsaros C. Incidental maxillary sinus findings...

Reference : Dental implants and grafting success r...

Shanbhag S, Karnik P, Shirke P, Shanbhag V. Cone-beam computed tomographic analysis of sinus membrane thickness, ostium patency, and residual ridge heights in the posterior maxilla: implications for sinus floor elevation. Clin Oral Implants Res. 2014;25:755–60. Gardner DG. Pseudocysts and retention cysts of the maxillary sinus. Oral Surg Oral Med Oral Pathol. 1984;58:561–7. Chiapasco M, Pa...

Reference : Dental implants and grafting success r...

References Beretta M, Poli PP, Grossi GB, Pieroni S, Maiorana C. Long-term survival rate of implants placed in conjunction with 246 sinus floor elevation procedures: results of a 15-year retrospective study. J Dent. 2015;43:78–86. Del Fabbro M, Corbella S, Weinstein T, Ceresoli V, Taschieri S. Implant survival rates after osteotome-mediated maxillary sinus augmentation: a systematic revi...

Discussion : Dental implants and grafting success ...

This study presents new data on maxillary sinus mucosal thickening derived from a carefully defined data set; however, there were some limitations in the study. One limitation was the limited sample size. However, as discussed, our stringent case selection criteria yielded a more uniform data set for analyses. Other limitations were related to the actual measurements of the maxillary sinus. ...

Discussion : Dental implants and grafting success ...

Our study did not find a significant association between endodontically treated teeth and mucosal thickening. Though this finding is consistent with some previously published studies, other studies did report an association. These discrepant findings could be the result of different inclusion criteria in the study design. Since our study did not include any patients with radiographic signs o...

Discussion : Dental implants and grafting success ...

The current study demonstrated that sinus mucosal thickening does not correlate with implant survival. This result is consistent with a previously published report by Jungner et al. In their study, the presence of sinus thickening was not significantly associated with implant failure. Similarly, our study found a 100% implant survival rate for both patients with and without sinus mucosal thi...

Discussion : Dental implants and grafting success ...

Discussion CBCT imaging has been recognized as a more sensitive imaging modality for identifying sinus thickening and pathoses in the posterior maxilla compared to panoramic radiography. This could explain why the current study identified a higher prevalence of mucosal thickening compared to earlier studies. However, compared to other similar CBCT studies, the prevalence reporte...

Results : Dental implants and grafting success rem...

Results Twenty-nine CBCT images (11 females and 18 males) were included in this study. All the implants placed in these included cases survived, representing a 100% implant survival rate. With regards to measurements of mucosal thickening, the intra-examiner reproducibility revealed an exact intra-examiner correlation of 99%, with a p value of 0.40 for a t test for independen...

Methods : Dental implants and grafting success rem...

In order to standardize the measurements for each sinus, each scan was carefully oriented in the axial, coronal, and sagittal plane. In the axial plane, a horizontal line from the right and left zygoma was chosen as the standard. Orienting the hard palate horizontally was the standard in the coronal plane as well as in the sagittal plane. The specific teeth that were to be replaced by implants wer...

Methods : Dental implants and grafting success rem...

Given these specific inclusion and exclusion criteria and the specific purpose of this study, only 29 cases qualified for inclusion from an original screen of approximately 4000 cases. An initial search of our database resulted in a larger number of cases that would theoretically qualify; however, further investigation revealed the need to exclude a great number of cases. The reasons for exclusion...

Methods : Dental implants and grafting success rem...

Methods Study design Our study hypothesis was that mucosal thickening of more than 2 mm and up to 1/3 of the volume of the sinus would not alter the predictability for SFE and dental implant placement. The primary outcome was to determine the success rate of dental implant placement in augmented maxillary sinus areas with mucosal thickening. A secondary outcome was to evaluate the effect of g...

Background : Dental implants and grafting success ...

Background Despite the high survival rate of dental implants inserted in maxillary sinuses that have undergone sinus floor elevation (SFE) with bone grafting, complications still occur. Sinus membrane perforation is reported to be the most common complication. Postoperative maxillary sinusitis is less common (0–22%); nevertheless, it could potentially compromise the outcome of...

Dental implants and grafting success remain high

Dental implants and grafting success remain high despite large variations in maxillary sinus mucosal thickening Abstract Background Although mucosal thickening is the most common radiographic finding observed regarding sinus pathology, the knowledge regarding its clinical significance on the outcomes of dental implants and grafting in the maxillary sinuses is still limited. We hypothesized th...

Table 3 Articles excluded and reasons for exclusio...

Reason for exclusion Investigations Study design (case series or case report) Kim et al. (2017), Hatano et al. (2007) Different grafting technique (lateral sinus lift or transalveolar technique) Jensen et al. (1994), Winter et al. (2002), Toffler et al. (2004), Chappuis et al. (2009), Soltan et al. (2011), Xiao et al. (2011), Cricchio et al. (2011), Scala et al. (2012), Brus...

Table 2 Characteristics of the included investigat...

Author (year) Study design Follow-up (months) N of patients N of implants Smokers Length and diameter (mm) Implant system  Shihab 2017 Retrospective 60 35 70 NA 5–12 × 3.0–5.7 IDI FMD Nucleoss  Ghanem 2014 Retrospective 72 10 10 NA NA NA  Nooh 2013 Prospective 12 56 63 0 4 × 8 4.3 × 10 5 × 8 5 × 10 Nobel Biocare ...

Table 1 Clinical and radiographic complications re...

Clinical complications Radiographic complications Sinusitis Thickening of Schneiderian membrane Nasal bleeding, nasal obstruction, nasal secretion Bone reaction to the implants Headache and pain or tenderness in the region of the sinus Sinus pathology Decreased sense of smell  

Figure 4. Statistical analysis for different varia...

  Figure 4. Statistical analysis for different variables. a Weighted mean survival rate. b Implant survival rate according to degree of penetration. c Analysis of clinical complications. d Analysis of radiographic complications

Figure 3. Graphic representation of group 1 ≤ ...

  Figure 3. Graphic representation of group 1 ≤ 4 mm penetration and group 2 > 4 mm penetrations    

Figure 2. PRISMA flowchart of the screening proces...

  Figure 2. PRISMA flowchart of the screening process

Discussion : Influence of exposing dental implants...

The secondary outcome of this review was the analysis of the clinical and radiological complications related to the penetration of implants in the maxillary sinus. Clinical complication among the different authors ranges from 0 to 14.3%, with a weighted mean complication rate of 3.4%, without finding statistical difference according to the level of implant penetration. The most common clinic...

Figure 1. Graphic representation of implants intru...

  Figure 1. Graphic representation of implants intruding sinus perforating or not the Schneiderian membrane

Results : Influence of exposing dental implants in...

  Analysis of clinical complications Seven studies provide information on clinical complications with a global sample of 232 patients. Clinical complications among the different authors range from 0 to 14.3%, being the weighted mean complication rate 3.4% with an IC 95% [0 7.5] (Fig. 4c) Clinical complications analyzed in the studies were sinusitis, nasal bleeding, nasal obstruction, nasal sec...

Results : Influence of exposing dental implants in...

Results Study screening An initial screening yielded a total of 3551 publications of which 26 potentially relevant articles were selected after an evaluation of their titles and abstracts. Full text of these articles was obtained and evaluated thoroughly. Of these, eight articles (Table 2) fulfilled the inclusion criteria and subsequently were included in the qualitative analysis (Fig. 2). Re...

Materials & methods : Influence of exposing dental...

  Eligibility criteria Articles were included in this systematic review if they met the following inclusion criteria: human prospective or retrospective studies, reporting outcomes of implant placed perforating the sinus floor with implant burs, and without regenerative procedure (lateral sinus lift or transalveolar technique) and graft material. The intrusion into the sinus cavity can occur du...

Materials & methods : Influence of exposing dental...

Materials and methods This systematic review and subsequent meta-analysis follow the guidelines of the PRISMA statement. Focus question The following focus question was developed: Is the intrusion of dental implants into the sinus cavity during implant drilling or implant placement, without regenerative procedure (lateral sinus lift or transalveolar technique) and graft material, has an effec...

Introduction ; Influence of exposing dental implan...

Introduction The edentulous posterior maxillary region often presents with unique challenging conditions in implant dentistry. Limited bone height secondary to pneumatization of the maxillary sinus and the resorption of the alveolar ridge preclude in many instances the installation of dental implants. To compensate for the lack of bone height, several treatment options have been proposed. The ...

Influence of exposing dental implants into the sin...

Influence of exposing dental implants into the sinus cavity on survival and complications rate: a systematic review   Abstract Background After tooth loss, the posterior maxilla is usually characterized by limited bone height secondary to pneumatization of the maxillary sinus and/or collapse of the alveolar ridge that preclude in many instances the installation of dental implants. In order ...