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Maxillary Sinus Floor (maxillary + sinus_floor)

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Medical Sciences85%

Terms modified by Maxillary Sinus Floor

  • maxillary sinus floor augmentation
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  • maxillary sinus floor elevation surgery
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    Selected Abstracts

    Effects of maxillary sinus floor elevation surgery on maxillary sinus physiology

    EUROPEAN JOURNAL OF ORAL SCIENCES, Issue 3 2003
    Nicolaas M. Timmenga
    In a prospective study, the effects of elevation surgery of the maxillary sinus floor on maxillary sinus physiology were assessed. Seventeen consecutive patients without preoperative anamnestic, clinical and radiological signs of maxillary sinusitis underwent sinus floor elevation surgery with iliac crest bone grafts. All patients were subjected to unilateral endoscopic examination of the maxillary sinus, taking of a biopsy specimen from the sinus floor mucosa, and collection of a sinus lavage-fluid aspirate. This triad of evaluations was performed immediately preceding the elevation procedure, and 3 months (at implant insertion) and 9 months (at uncovering of implants) postoperatively. All procedures were performed under general anesthesia. Preoperatively, three out of 17 patients showed pre-existing mucosal pathology endoscopically, while the 3- and 9-month results revealed the presence of mucosal pathology in four and two patients, respectively. The 3-month microbiological evaluation showed a significant increase in cultures with bacterial growth, while the 9-month culture results were comparable to the preoperative status of the maxillary sinus. Morphologically, neither fibrosis nor an altered inflammatory response or thickening of the epithelium and lamina propria was observed postoperatively. The number of goblet cells in the epithelial layer was increased. From this study it is concluded that the effect of maxillary sinus floor elevation surgery with autogenous bone grafts does not appear to have clinical consequences in patients without signs of pre-existing maxillary sinusitis. [source]

    Bone regeneration in rabbit sinus lifting associated with bovine BMP

    JOURNAL OF BIOMEDICAL MATERIALS RESEARCH, Issue 2 2004
    Sergio Allegrini Jr.
    Abstract Autogenous bone is considered the optimal grafting material for sinus lifting, although its harvesting causes great patient discomfort. Various approaches have been taken in order to obtain sinus lifting with preexisting tissue. However, because of the unsuitability of such tissue, additional materials have been required. Alternatively, biomaterials from humans or other animals are used. In this study, the efficacy of using morphogenetic bovine bone protein (BMPb) to augment the maxillary sinus floor was examined. Four grafting materials were employed: lyophilized bovine bone powder, absorbable collagen flakes, natural hydroxylapatite, and synthetic hydroxylapatite. Two groups of rabbits were studied. In one group, graft material only was used. In the other, graft material was combined with 0.5 mg BMPb. During 8 weeks of observation, polyfluorochrome tracers were injected in subcutaneous tissue to evaluate new bone- deposition periods. Following sacrifice, the samples were examined under fluorescent and light microscopes. Results indicated 33.34% more newly formed bone in BMPb animals than in controls. Graft-material resorption increased, but natural HA showed no significant alterations. The results show that the use of BMPb, although providing osteoinduction, might not promote sufficient bone formation. Nonetheless, this material could provide an alternative to autogenous grafts, thereby avoiding patient discomfort. © 2003 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 68B: 127,131, 2004 [source]

    Evaluation and donor site morbidity of tibial bone graft in sinus lift operation

    ORAL SURGERY, Issue 3 2008
    S.L. Miranda
    Abstract Aim:, The use of autologous bone is a good option for bone grafts in implantology. The purpose of this study was to present advantages in harvesting the proximal tibial cancellous bone as an alternative in the sinus floor lifting procedure, seeking future installation of osseointegraded implants. Materials and methods:, Between 2002 and 2006, 19 patients were attended, with age between 41 and 77, being 9 males and 10 females, in order to lift the maxillary sinus floor. The approach to the donor site was medial, because of the fact that this method brings minor risk of injury to anatomical structures. Results:, All cases allowed the installation of osseointegraded implants. Only minor complications occurred, such as local ecchymosis and ecchymosis extending to foot. In all cases, ambulation was immediate. Conclusions:, A good amount of bone could be harvested; scarce pain symptomatology was detected, and risk of complications could be considered very low in the donor site. [source]

    Sinus Lift Using a Nanocrystalline Hydroxyapatite Silica Gel in Severely Resorbed Maxillae: Histological Preliminary Study

    CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 2009
    Luigi Canullo DDS
    ABSTRACT Purpose: The aim of this preliminary study was to evaluate histologically a nanocrystalline hydroxyapatite silica gel in maxillary sinus floor grafting in severely resorbed maxillae. Materials and Methods: A total of 16 consecutive patients scheduled for sinus lift were recruited during this study. Patients were randomly divided in two groups, eight patients each. In both groups, preoperative residual bone level ranged between 1 and 3 mm (mean value of 2.03 mm). No membrane was used to occlude the buccal window. Second surgery was carried out after a healing period of 3 months in Group 1 and 6 months in Group 2. Using a trephine bur, one bone specimen was harvested from each augmented sinus and underwent histological and histomorphometric analysis. Results: Histological analysis showed significant new bone formation and remodeling of the grafted material. In the cores obtained at 6 months, regenerated bone, residual NanoBone, and bone marrow occupied respectively 48 ± 4.63%, 28 ± 5.33%, and 24 ± 7.23% of the grafted volume. In the specimens taken 3 months after grafting, mean new bone was 8 ± 3.34%, mean NanoBone was 45 ± 5.10%, and mean bone marrow was 47 ± 6.81% of the bioptical volume. Conclusions: Within the limits of this preliminary prospective study, it was concluded that grafting of maxillary sinus using nanostructured hydroxyapatite silica gel as only bone filler is a reliable procedure also in critical anatomic conditions and after early healing period. [source]

    Histologic Analysis of Clinical Biopsies Taken 6 Months and 3 Years after Maxillary Sinus Floor Augmentation with 80% Bovine Hydroxyapatite and 20% Autogenous Bone Mixed with Fibrin Glue

    CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 2 2001
    Mats Hallman DDS
    Abstract: Background: Bovine hydroxyapatite (Bio-Oss®, Geistlich Pharmaceutical, Wollhausen, Switzerland) has been suggested to be used in maxillary sinus floor augmentation procedures prior to or in conjunction with implant placement. However, the long-term histologic fate of this material is not well understood. Purpose: The aim with this study was to histologically evaluate the tissue response in patients to a mixture of bovine hydroxyapatite (BH), autogenous bone, and fibrin glue 6 months and 3 years after a maxillary sinus floor augmentation procedure. Materials and Method: Biopsies were taken from a group of 20 consecutive patients 6 months (n = 16) and 3 years (n = 12) after maxillary sinus floor augmentation with a mixture of BH (80%), autogenous bone (20%), and fibrin glue and prepared for histologic analysis. Results: Light microscopy and morphometry from biopsies taken after 6 months showed various amounts of mineralized bone tissue. The specimen area was occupied by 54.1 ± 12.6% nonmineralized tissue, followed by 21.2 ± 24.5% lamellar bone, 14.5 ± 10.3% BH particles, and 10.2 ± 13.4% woven bone. The nonmineralized tissue seen in bone-forming areas consisted of a loose connective tissue, rich with vessels and cells. There were no signs of resorption of the BH particles. The lamellar bone appeared to have originated from the recipient site and was seldom in contact with the BH particles. After 3 years, the nonmineralized tissue area had decreased to 36.0 ± 19.0% (p > .05) and consisted mainly of bone marrow tissue. The surface area of lamellar bone had increased to 50.7 ± 22.8% (p > .05), and there was almost no immature bone. The mean specimen area occupied by BH particles, was 12.4 ± 8.7% and had not changed from 6 months (not significant). Moreover, the sizes of the particles were similar after 6 months and 3 years. The degree of BH particle,bone contact had increased from 28.8%± 19.9% after 6 months to 54.5 ± 28.8% after 3 years (p > .05). Conclusion: Histology of specimens from maxillary sinuses augmented with 80% BH particles, 20% autogenous bone, and fibrin glue showed a positive bone tissue response after 6 months and 3 years after augmentation of the maxillary sinus floor prior to implant placement in a group fo 20 patients. The bone surrounding and in contact with the BH particles after 6 months was mainly immature woven bone, which with time was replaced by mature lamellar bone filling the interparticle space as observed in the 3-year specimens. Moreover, bone-integrated BH particles seem to be resistant to resorption. The results indicate that the procedure may be considered when only small amounts of intraoral autogenous bone graft are available. [source]

    Does platelet-rich plasma promote remodeling of autologous bone grafts used for augmentation of the maxillary sinus floor?

    CLINICAL ORAL IMPLANTS RESEARCH, Issue 3 2005
    Gerry M. Raghoebar
    Abstract: The aim of this study was to evaluate the effect of platelet-rich plasma (PRP) on remodeling of autologous bone grafts used for augmentation of the floor of the maxillary sinus. In five edentulous patients suffering from insufficient retention of their upper denture related to a severely resorbed maxilla, the floor of both maxillary sinus was augmented with an autologous bone graft from the iliac crest. Randomly, PRP was added to the bone graft used to augment the floor of the left or right sinus (split-mouth design). Three months after the reconstruction, bone biopsies were taken with a trephine from the planned implant sites (N=30). Subsequently, three implants were placed in the left and right posterior maxilla. Microradiograms were made of all biopsies (N=30), whereafter the biopsies were processed for light microscopic examination. In addition, clinical parameters were scored. Wound healing was uneventful, clinically no difference was observed between the side treated with PRP or not. Also microradiographical and histomorphological examination of the biopsies revealed no statistical difference between the PRP- and non-PRP side. One implant placed in the PRP side of the graft was lost during the healing phase. Implant-retained overdentures were fabricated 6 months after implantation. All patients functioned well (follow-up 20.2±4.3 months). In this study, no beneficial effect of PRP on wound healing and bone remodeling was observed. It is posed that PRP has no additional value in promoting healing of grafted non-critical size defects. Résumé Le but de cette étude a été d'évaluer l'effet du plasma riche en plaquettes sur le remodelage de greffons osseux autogènes utilisés pour l'épaississement du plancher sinusal. Chez cinq patients édentés souffrant d'une rétention insuffisante de leur prothèse supérieure en relation avec un maxillaire sévèrement résorbé, les planchers sinusaux des deux maxillaires ont étéépaissis avec un greffon d'os autogène provenant de la crête iliaque. Au hasard, du plasma riche en plaquettes (PRP) a été ajouté au greffon osseux utilisé pour épaissir le plancher du sinus gauche ou droit (modèle de bouche divisée). Trois mois après la reconstruction, des biopsies osseuses ont été obtenues avec un trépan des sites planifiés pour placer des implants (N=30). Ensuite, trois implants ont été placés dans les parties maxillaires gauches et droites. Des microradiogrammes des 30 biopsies ont été effectuées, ces dernières ont ensuite été utilisées pour l'examen au microscope optique. De plus, des paramètres cliniques ont été enregistrés. La guérison a été parfaite, cliniquement aucune différence n'a été observée entre les sites traités avec PRP ou sans. L'examen microradiographique et histomorphologique des biopsies n'a révélé aucune différence significative entre les sites PRP et non-PRP. Un implant placé dans le site PRP du greffon a été perdu durant la phase de guérison. Des prothèses retenues sur implants ont été fabriquées six mois après l'insertion des implants. Tous les patients ont une mise en fonction excellente après un suivi de 20±4,3 mois. Dans cette étude, aucun effet bénéfique additionnel du PRP sur la guérison et le remodelage osseux n'a été observé. Le PRP n'aurait aucune valeur supplémentaire à promouvoir la guérison dans ce type d'opération. Zusammenfassung Das Ziel dieser Studie war, den Einfluss von plättchenreichem Plasma auf die Remodellierung von autologen Knochentransplantaten, welche für die Augmentation des Sinusbodens vom Sinus maxillaris verwendet wurden, auszuwerten. Bei 5 zahnlosen Patienten, welche aufgrund einer stark resorbierten Maxilla über einen ungenügenden Halt der Oberkieferprothese klagten, wurde der Sinus maxillaris mit autologem Knochen vom Beckenkamm augmentiert. Zufällig wurde dem Knochen, der zur Augmentation des rechten oder linken Sinusbodens verwendet wurde, plättchenreiches Plasma (PRP) hinzugefügt (unterschiedlich behandelte Seiten). Drei Monate nach der Augmentation wurden mittels Hohlfräsen Biopsien an den geplanten Implantatlokalisationen entnommen (N=30). Danach wurden je drei Implantate in die rechte und linke posteriore Maxilla eingesetzt. Von allen Biopsien wurde Mikroröntgenbilder angefertigt (N=30), danach wurden die Biopsien für die lichtmikroskopische Untersuchung aufgearbeitet. Zusätzlich wurden klinische Parameter aufgenommen. Die Wundheilung war unauffällig. Klinisch konnten keine Unterschiede zwischen den mit und ohne PRP behandelten Seiten beobachtet werden. Ebenso ergab die mikroradiographische und histomorphometrische Untersuchung der Biopsien keine statistisch signifikanten zwischen der PRP und nicht-PRP Seite. Ein Implantat, welches in eine PRP Seite eingesetzt worden war, ging während der Einheilphase verloren. Die implantatgetragenen Hybridprothesen wurden 6 Monate nach Implantation angefertigt. Alle Patienten funktionierten problemlos (Beobachtungszeit bis 20.2±4.3 Monate). In dieser Studie konnte kein positiver Einfluss des PRP auf die Wundheilung und die Knochenremodellierung beobachtet werden. Es wird vermutet, dass PRP keinen zusätzlichen Effekt bei der Förderung der Heilung von Transplantaten in Defekten mit nicht-kritischer Grösse hat. Resumen La intención de este estudio fue evaluar el efecto del plasma rico en plaquetas en el remodelado de injertos de hueso autólogo usado para aumento del suelo del seno maxilar. Se aumentó el suelo de ambos senos maxilares con injertos de hueso autólogo de la cresta iliaca en 5 pacientes edéntulos que padecían de insuficiente retención de su dentadura superior relacionada con un maxilar severamente reabsorbido. Aleatoriamente, se añadió plasma rico en plaquetas (PRP) al injerto óseo usado para aumentar el suelo del seno derecho o izquierdo (diseño de boca partida). Tres meses tras la reconstrucción, se tomaron biopsias de hueso con un trépano de los lugares de implantes planificados (N=30). Subsecuentemente se colocaron tres implantes en el maxilar posterior derecho e izquierdo. Se hicieron microrradiogramas de todas las biopsias (N=30), posteriormente las biopsias se procesaron para microscopía óptica. Además se tomaron parámetros clínicos. La cicatrización de la herida tuvo lugar sin incidentes. Clínicamente no se observó diferencia alguna entre el lado tratado con PRP o no. Tampoco el examen microrradiográfico e histomorfológico de las biopsias revelaron diferencias estadísticamente significativas entre los lados con o sin PRP. Un implante colocado en el lado del PRP se perdió durante la cicatrización. Las dentaduras implantorretenidas se fabricaron a los seis meses de la implantación. Todos los pacientes funcionaron bien (seguimiento de 20.2±4.3 meses). En este estudio no se observó ningún efecto beneficioso del PRP sobre la cicatrización y sobre el remodelado óseo. Se plantea que el PRP no tiene ningún valor adicional en promover la cicatrización de defectos no críticos injertados. [source]

    Histologic findings at augmented bone areas supplied with two different bone substitute materials combined with sinus floor lifting

    CLINICAL ORAL IMPLANTS RESEARCH, Issue 1 2004
    Report of one case
    Abstract: This case report is focused on the histologic findings of bone tissue supplied with two different hydroxyapatites (HAs) used for maxillary sinus floor grafting in the same patient after various healing intervals. An insufficient unilateral sinus floor grafting with Bio-Oss® biomaterial was followed by an additional grafting procedure with Algipore® biomaterial performed 4 years later. Bone samples obtained during second-stage dental implantation contained the interesting combination of Bio-Oss®, a bovine anorganic bone substitute, and Algipore®, a porous algae-derived HA, in close vicinity, yet after different healing periods. Light microscopy exhibited satisfactory osseointegration of both grafting materials. However, Bio-Oss® biomaterial showed no evidence of substantial remodeling after a healing period of 4.5 years. On the other hand, Algipore® particles demonstrated signs of remodeling by being locally resorbed and partially replaced with newly formed bone already within 6 months. Résumé Ce rapport d'un cas se concentre sur les découvertes histologiques du tissu osseux apporté par deux hydroxyapatites différents utilisés pour l'épaississement du plancher sinusal chez le même patient après différents intervalles de guérison. Un épaississement sinusal unilatéral insuffisant effectué avec le Bio-Oss® a été suivi d'un nouveau processus d'épaississement avec le Algipore® (un hydroxyapatite biologique dérivé d'algues marines calcifiées) quatre ans plus tard. Des échantillons osseux obtenus durant le placement des implants contenaient la combinaison intéressante du Bio-Oss®, un substitut osseux inorganique bovin, et du Algipore®, un hydroxyapatite d'algues, l'un à côté de l'autre, même si il y avait des périodes de guérison différentes. La microscopie optique a montré une ostéoïntégration satisfaisante des deux matériaux greffés. Cependant, le Bio-Oss® ne montrait aucune évidence d'un remodelage substantiel après une période de 4,5 années. Par contre les particules de Algipore® possèdaient des signes de remodelage tout en étant résorbées localement et partiellement remplacées par de l'os néoformé déjà après six mois. Zusammenfassung Diese Fallvorstellung präsentiert die Histologie eines Knochens, der bei einer in zwei Schritten und mit verschiedenen Hydroxylapatitprodukten durchgeführten Sinusbodenelevation entstanden ist. Die Einheilzeit der zwei Transplantate war verschieden lang. Eine einseitig durchgeführte und ungenügende Sinusbodenelevation mit dem Biomaterial Bio-Oss® wurde vier Jahre später mit einem zusätzlichen Augmentationseingriff unter Einsatz des Biomaterials Algipore® korrigiert. Bei der Implantation konnte man Knochenproben von interessanter Zusammensetzung entnehmen. Es handelte sich um einen Knochen, der während verschieden langer Zeit in engem Kontakt mit Bio-Oss®, einem anorganischen Rinderknochentransplantat, und Algipore®, einem porösen aus Algen gewonnenem Hydroxylapatit stand. Die Lichtmikroskopie zeigte eine zufriedenstellende Osseointegration beider Transplantatmaterialien. Bio-Oss® zeigte jedoch nach einer Einheilzeit von 4.5 Jahren noch keine Anzeichen einer substanziellen Remodellation. Bei den Algipore® Partikeln war dies bereits der Fall. Sie waren schon nach sechs Monaten an einigen Stellen anresorbiert, teilweise sogar mit neu gebildetem Knochen ersetzt. Resumen Este informe de un caso esta enfocado sobre los hallazgos histológicos de tejido óseo suministrado con dos diferentes hidroxiapatitas usadas para injerto del suelo del seno maxilar en el mismo paciente tras varios intervalos de cicatrización. Un insuficiente injerto del suelo del seno con biomaterial Bio-Oss® fue seguido por un procedimiento adicional de injerto con biomaterial Algipore® llevado a cabo 4 años mas tarde. Las muestras de hueso obtenidas durante la segunda fase de la implantación dental contenían una interesante combinación de Bio-Oss®, un sustituto óseo inorgánico bovino y Algipore®, una hidroxiapatita porosa derivada de algas, en próxima vecindad, aunque tras diferentes periodos de cicatrización. La microscopía óptica exhibió una osteointegración satisfactoria de ambos materiales de injerto. De todos modos, el biomaterial Bio-Oss® no mostró evidencia de un remodelado sustancial tras un periodo de cicatrización de 4.5 años. Por otro lado las partículas de Algipore® demostraron signos de remodelado al ser localmente reabsorbidas y reemplazadas parcialmente con hueso neoformado ya a los 6 meses. [source]