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The purpose of this systematic review was to perform a comparative analysis of the use or not of graft material in maxillary sinus lift surgery. Relevant studies published in the last 10 years were identified through a search of the PubMed/MEDLINE, ScienceDirect, and Cochrane Library databases and were assessed against the study inclusion and exclu...
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... perforation was the most reported complication associated with the surgery in both groups, with 64 cases. This resulted in two cases of sinusitis in patients who underwent sinus lift with biomaterial. Other reported complications were one case of chronic oral fistula and one case of peri-implantitis in the group in which graft material was used (Fig. ...
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Maxillary sinus augmentation is critical to oral implantology, particularly in some cases. The morphology of the sinus floor reflects the lifting effect to a certain extent; however, there has been limited research on the morphology after sinus augmentation. The present study aims to investigate the relationship between residual bone height (RBH) a...
Background
Currently, insufficient bone volume always occurs in the posterior maxilla which makes implantation difficult. Short implants combined with transcrestal sinus floor elevation (TSFE) may be an option to address insufficient bone volume.
Purpose
The clinical performance of short implants combined with TSFE was compared with that of conven...
Introduction: Maxillary sinus pneumatization and alveolar ridge resorption following the extraction of posterior teeth make the installation of dental implants in the maxillary posterior region challenging. The direct sinus lift procedure proved to be a viable treatment option for such conditions. Aim of the study: to evaluate the mineralized plasm...
The aim of this study was to perform a timewise meta-analysis of randomized clinical trials (RCTs) comparing the outcomes of short implants (≤6 mm) versus lateral sinus floor augmentation followed by regular implants (≥10 mm) in the deficient posterior maxilla. Eleven RCTs with 1, 3, and 5 years of follow-up were reported in 21 articles. There was...
The aim of this comparative study was to evaluate, at one and five years, the implant success rate in the resorbed maxilla after sinus augmentation with platelet-rich plasma (PRP)/deproteinized bovine bone mineral (DBBM) versus DBBM/collagen membrane (CM). Using a split-mouth design, 10 patients with ≤5 mm of residual alveolar bone were treated wit...
Citations
... The graft's volume contraction rate reported in the literature ranges from 20% to 50% for both autogenous bone and bone substitutes, such as demineralized freeze-dried bone allograft (DFDBA), mineralized freeze-dried bone allograft (FDBA), and xenografts. In more recent studies, resorbable bioceramics, made of a mixture of hydroxyapatite and beta-tricalcium phosphate, have gained popularity, demonstrating bioactivity and osteoconductive properties for vertical bone augmentation of the atrophied maxilla in different histological studies [36,37]. ...
This pilot study aimed to evaluate the level of implant success after transcrestal sinus floor elevation (tSFE) using the osseodensification technique (OD) combined with beta-tricalcium phosphate (β-TCP) by analyzing clinical and radiographic results. Moreover, the increase in bone height was analyzed immediately after surgery, 3 months after, and before loading by taking standardized radiographic measurements. Thirteen patients, four males and nine females, with a mean age of 54.69 ± 5.86 years, requiring the placement of one implant in the upper posterior maxilla, with a residual bone height of <8 mm and a minimum bone width of 5 mm, participated in the study. The bone gain data was obtained using cone-beam computed tomography (CBCT) immediately after surgery and twelve months after the placement. The correlation between initial and final bone height with implant stability was also assessed. The results were analyzed using SPSS 23 software (p < 0.05). The results of the study indicated a 100% implant success rate after a follow-up period of twelve months. Preoperative main bone height was 5.70 ± 0.95 mm. The osseodensification technique allowed a significant increase of 6.65 ± 1.06 mm immediately after surgery. After a twelve-month follow-up, a graft material contraction of 0.90 ± 0.49 mm was observed. No correlation was observed between the bone height at the different times of the study and the primary stability of the implant. Considering the limitations of the size sample of this study, the osseodensification technique used for transcrestal sinus lift with the additional bone graft material (β-TCP) may provide a predictable elevation of the maxillary sinus floor, allowing simultaneous implant insertion with adequate stability irrespective of bone height limitations.
... In order to obtain greater bone gain during sinus augmentation procedures, different graft materials mixed with or without autologous bone have been frequently used [27,28]. Autogenous bone grafts are considered the gold standard, owing to their maintenance of cellular and osteogenic viability [29]. ...
The study aimed to evaluate implant success and bone height variations after transcrestal sinus floor elevation (tSFE) using the osseodensification technique (OD) combined with beta-tricalcium phosphate (β-TCP), as bone graft material and simultaneous implant placement. Thirteen patients requiring the placement of one implant in the upper posterior maxilla, with a residual bone height of
... Significant vertical maxillary defects create a challenging situation to rehabilitate edentulous posterior maxilla, which is a consequence of maxillary sinus hyper-pneumatization and long-term alveolar ridge resorption. This situation indicates a necessity to restore the bone crest anatomy accompanying with sinus floor elevation [1,2]. There are many surgical options using different biomaterials of different components to reestablish an adequate bone volume for implant placement. ...
Maxillary sinus lift is a common procedure to achieve adequate alveolar bone height in patients with sinus hyper-pneumatization. Simultaneous implant placement with sinus floor augmentations is possible when appropriate primary stability could be achieved. In severe atrophic posterior maxillary ridge, vertical bone height is sometimes less than 4mm, which may hinder simultaneous implant placements and necessitate two stage procedure. In current study, a novel technique is described to perform a single stage implant placement with bicortical stability in severe atrophic maxilla that can shorten the treatment time of an edentulous patient. During the procedure, to achieve an adequate access a conventional lateral window osteotomy is performed. After elevating the Schneiderian membrane using conventional instruments, an autologous ramus block is harvested from the mandible and then the block will be fixed in correct location in the sinus using screws with appropriate length to build sufficient stability as superior cortex for simultaneous implant insertion.
... Furthermore, combining bone grafting for maxillary sinus augmentation (MSA) is suggested to increase the alveolar ridge volume, yet more research has demonstrated outcomes of graftless sinus augmentation. [2][3][4] Transcrestal sinus lift utilizing Densah burs was first proposed by Huwais et al in 2018. 5 These specific burs compact autogenous grafting during the osteotomy in reverse-cutting, as the osseodensification method (OD), 6 compresses the osseous tissue into lateral walls and the apex of the preparation, increasing the alveolar bone density favorable to implant primary stability and creating a hydrodynamic compression toward the sinus floor and then causes a greenstick fracture and elevating the Schneiderian sinus membrane as an indirect sinus lift. ...
Maxillary sinus lift is a reliable surgical procedure that helps establish oral rehabilitation using implant prostheses in the atrophic maxilla. However, sinus perforation and grafting failures should be addressed to ensure successful results. A novel transcrestal sinus lift technique has been introduced, which uses hydrodynamic compression through osseous densifying burs to elevate the sinus membrane and compact autogenous grafting particulates at the exact moment, allowing achieving better outcomes and placing dental implants simultaneously.
... 3,16 Moreover, in clinical studies published in the literature, implant survival rates have been shown to be comparable to sinus lift procedures performed with and without graft material. [17][18][19][20][21] Therefore, the preference for the tenting effect provided by dental implant placement in sinus lift procedures has increased. [4][5][6]22,23 In contrast, Greison et al. suggested in a clinical study that the tenting effect did not This peer-reviewed, accepted manuscript will undergo final editing and production prior to publication in JOMI. ...
Purpose:
The aim of this study was to investigate the effects of membrane stabilization by suturing the sinus membrane and dental implant insertion on endo-sinus bone formation in lateral sinus lifting performed without grafting.
Materials and methods:
Maxillary sinus lift surgery using the lateral approach was performed bilaterally in 30 New Zealand white rabbits. The maxillary sinus areas were divided into control and test groups. In the control group, a titanium screw was placed after sinus membrane elevation, while in the test group, the sinus membrane was sutured to the lateral walls and a titanium screw was placed in the center of the alveolar crest. The animals were sacrificed at 4 and 8 weeks. Samples were collected, and micro-computed tomography (micro-CT) analysis was performed. The volume of newly formed bone, percentage of osseointegration, sinus volume, residual bone height, and protrusion length of the implants were measured using micro-CT analysis.
Results:
The sinus volume, volume of newly formed bone, and percentage of osseointegration in the test group were significantly higher than those in the control group at 4 weeks (p = 0.01, p = 0.04, p = 0.02, respectively) While the volume of newly formed bone was 17.1 ± 3.08 mm3 in the control group, it was 26.9 ± 14.26 mm3 in the test group at 4 weeks. The volume of newly formed bone was significantly decreased from 26.9 ± 14.26 mm3 to 17 ± 3.66 mm3 at 8 weeks (p = 0.02). No significant difference in residual bone height was found at 4 and 8 weeks (p = 0.07). No significant difference in implant protrusion length was found between the control and test groups (p = 0.18). Protrusion length and new bone formation in the sinus showed a negative relationship (p = 0.01).
Conclusion:
Suturing the sinus membrane to the lateral sinus wall is an effective approach for increasing osseointegration, bone volume, and sinus volume in the short-term. A slow-absorbing suture material can be used to maintain sinus and bone volumes in the long-term.
... Na dećada de 90, a tećnica de Summers foi elaborada, usando osteotomos (instrumentais de forma cilíndrica, com a ponta em um formato concavo), deslocando o osso alveolar para dentro da cavidade sinusal, permitindo elevar o assoalho, o periośteo e a membrana do seio maxilar; é uma manobra com pouco trauma ciruŕgico. Evita uma perfuracaõ da membrana sinusal, pois naõ se tem um contato direto entre a membrana e os osteotomos (Silva, et al., 2016). Essa manobra é utilizada em locais onde o tecido ośseo apresenta uma altura mínima entre cinco a seis milímetros, sendo poss vel por conta da baixa densidade ośsea do local, permitindo um ganho ośseo de até quatro milímetros em altura. ...
No âmbito da física, em 1881, o conceito do sistema piezolétrico começou a ser estudado. Esse sistema é utilizado amplamente em diversas cirurgias na odontologia, bem como na medicina. O aparato piezolétrico usa uma agitação ultrassônica específica, possibilitando o corte somente em tecido duro, preservando ao máximo os tecidos moles, o que é muito satisfatório, dependendo da situação clínica. Ele possibilita uma secção segura e específica, sendo muito útil em manobras delicadas; logo, ele pode apresentar diversas vantagens. Na implantodontia, a piezocirurgia foi usada primeiramente para levantamento do seio maxilar, alterando a maneira de acesso da parede lateral do seio maxilar. O artigo apresenta como objetivo executar uma revisão de literatura, envolvendo dados atuais, sobre a cirurgia piezoelétrica no levantamento do seio maxilar. Verifica-se que a piezocirurgia é uma alternativa positiva, mesmo tendo pontos negativos; mas pode ser empregada em manobras no seio maxilar. No entanto, mais análises devem ser feitas, para entender ainda mais esse sistema e resolver suas desvantagens.
... The remaining height of the crestal bone orients the practitioner for lateral or crestal approaches with bone substitute graft [3][4][5] or without bone material [3,6] with immediate [1,2] or delayed implant placement [2,7]. ...
... The remaining height of the crestal bone orients the practitioner for lateral or crestal approaches with bone substitute graft [3][4][5] or without bone material [3,6] with immediate [1,2] or delayed implant placement [2,7]. ...
Sinus lift augmentation techniques, lateral or crestal approaches, have been well documented, with bone substitute graft, or without bone material, with immediate or delayed implant placement as a treatment option for the atrophic maxilla in the posterior area. However, the sinus lift procedures performed in the presence of cysts, mucoceles, mucous retention cysts (MRCs), and antral pseudo-cysts could mainly decrease the sinus cavity volume and could increase the possibility of ostium obstruction and might lead to infection followed by failure of the grafting procedure. A radiological assessment should be made with computerized tomography (CT) or cone-beam CT to evaluate the remaining bone volume and to detect any pathology in the sinus. Different techniques were described in the literature for sinus lifting and bone grafting in patients with cysts. For some authors, cysts should be treated before sinus grafting and six months later, the procedure could be performed. For others, sinus lifting can be performed without lesion removal. At this time, controversy exists regarding the decision on whether lesions must be removed/aspirated or not before sinus grafting. In this study, we report a case where an MRC was aspirated and instantaneously, the sinus membrane was lifted and grafted, and implants were installed with 1-year follow-up after loading. Identifying lesions in the maxillary sinus is essential before planning any type of sinus augmentation and implant placement.
... 12 Systematic reviews have revealed high survival rates of suprastructures and implants, ESBR, diminutive PIMBL, and low frequency of complications after SME and coagulum. [13][14][15][16] However, SME using coagulum as a graft has solely been compared with MSA and a graft in a limited number of short-term randomized controlled trials (RCTs) (≤7 months) focusing on clinical and radiographic implant outcomes, and without reporting patient-related outcome measures (PROMs). [17][18][19][20][21] The aim of the present single-blinded RCT is therefore to evaluate the 1-year implant outcome and PROMs after SME and coagulum compared with MSA and a 1:1 ratio of ABG and deproteinised porcine bone mineral (DPBM). ...
... survival rates with both treatment methods, [17][18][19][20][21] which is in accordance with the results of the present RCT and previous systematic reviews. [13][14][15][16] A recent published long-term cross-sectional study reported an overall implant survival rate of 95.9%. 29 Hence, the longterm implant survival rate after SME and coagulum seems comparable with previous reported implant survival rates after MSA and a graft. 1 However, long-term RCTs are needed to verify this assumption. ...
Objective:
The aim was to evaluate the 1-year implant outcome and patient-related outcome measures (PROMs) after maxillary sinus membrane elevation and coagulum (test) compared with maxillary sinus floor augmentation and a 1:1 ratio of autogenous bone graft from the buccal antrostomy and deproteinised porcine bone mineral (DPBM) (control).
Materials and methods:
Forty patients (30 female, 10 male) with a mean age of 50 years (range 25-71 years) and an alveolar ridge height between 4 and 7 mm were randomly allocated to test or control. Outcome measures included survival of suprastructures and implants, implant stability quotient, health status of the peri-implant tissue, peri-implant marginal bone loss, frequency of complications and PROMs using Oral Health Impact Profile-14 combined with questionnaires assessing patient´s perception of the peri-implant soft tissue, implant crown, function of the implant, and total implant treatment outcome using visual analogue scale. Mean differences were expressed with standard deviation and 95% confidence interval. Level of significance was 0.05.
Results:
All suprastructures and implants were well-functioning after 1-year of functional implant loading. No significant difference in any of the applied outcome measures was observed between test and control. Both treatments revealed high patient satisfaction scores and significant improvement in oral health-related quality of life.
Conclusion:
There were no significant differences in implant outcome and PROMs between test and control, after 1-year of functional implant loading. Neither of the treatments can therefore be considered better than the other. Thus, long-term randomized controlled trials are needed before definitive conclusions can be provided about the two treatment modalities.
... 34 In 2016, Silva et al reviewed 30 articles with 868 implants installed in 397 maxillary sinuses from 6 months to 11 years and concluded 96 % of implant survival rate in graftless procedures without major post-operative complications. 25 In the same year, Falah et al analyzed and proposed that blood clots induced new bone formation and considered autologous osteogenic grafting in MSA. 37 In 2017, Parra et al reviewed maxillary sinus lifting without grafting for up to four years. ...
Maxillary sinus floor elevation is a reliable surgical procedure to establish oral rehabilitation using implant prostheses in the atrophic maxilla. Both lateral sinus floor elevation (LSFE) and crestal sinus floor elevation (CSFE) are viable to augment inadequate alveolar bone height. Still, the results of post-surgical trauma, complications, and patient-reported outcome measures (PROMs) vary. Furthermore, combining bone grafting for maxillary sinus augmentation (MSA) is suggested to increase the volume of the alveolar ridge, yet more researches have demonstrated outcomes of the graftless method. This clinical report describes a graftless sinus augmentation with simultaneous implant placement utilizing Densah burs implementing CSFE through the osseodensification method.
... After the sinus membrane lifting a variety of bone grafting materials can be used. [20][21][22] Since different techniques sinus lifting were evaluated in different trials, for implant failures and complications. Based on relevance question in focus in this study is the antral membrane balloon elevation technique effective in the terms of sinus augmentation success rate, survival rate of dental implants, bone gain, and complication rate compared with the traditional sinus floor elevation technique. ...
Background: The posterior maxillary area sometimes has insufficient bone mass for dental implants. The augmentation of the sinus floor allows the implant to be placed in the posterior of the upper jaw. Purpose: The aim of this study was to compare the effectiveness antral balloon- assisted maxillary sinus elevation and traditional sinus floor elevation followed by bone graft and delayed implant placement the posterior maxillary area. Material and methods: A total of 68 patients, (aged 27 to 56 years, 32 women and 36 men), without any systemic diseases with unilateral/bilateral missing teeth and atrophy of the posterior maxillary area, who required an enlargement of the sinus prior to implant placement, whom the location of the sinus floor from the crest was 3-5mm, width ≥5 mm were included in the study between 2018 and 2021. Patients underwent a thorough clinical examination according to the generally accepted scheme. All patients were selected after meticulous evaluation of their medical histories and dental examinations, including OPG and dental Computed Tomography (CT) scans. Results: The sinus lift using balloon technique was performed successfully in patients 1 group, with no complications. In 9 patients 2 group, perforation of the sinus membrane occurred during the operation, sinusitis in 4 patients, graft failure in 3 patients. Regardless of the approach used, both approaches showed significant increases in bone mass gain. Though not statistically significant difference, balloon-assisted procedure showed more mean bone gain (8.4 mm) compared to osteotome -assisted procedure (8.1 mm). The mean amount of Marginal Bone Loss (MBL) in patients 1 group 3 years follow-up was 0.86 mm in patients 2 group showed significantly less marginal bone loss 1,16mm. The implant survival rate 3 years follow-up was in patients 1 group was 97.62%, in patients 2 groups was 95.2%. Conclusions: Research has shown that the balloon sinus lifting offers predictable, safe and effective results, and eliminates the complications associated with traditional side window techniques. However, further controlled clinical trials are needed to evaluate the efficacy and safety of these technique for their appropriate implementation in the field of oral implanotology.
