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Sinus Floor Augmentation Procedures (sinus + floor_augmentation_procedure)

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Medical Sciences100%

Selected Abstracts

Bone Reformation and Implant Integration following Maxillary Sinus Membrane Elevation: An Experimental Study in Primates

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 1 2006
Vinicius C Palma DDS
ABSTRACT Background:, Recent clinical studies have described maxillary sinus floor augmentation by simply elevating the maxillary sinus membrane without the use of adjunctive grafting materials. Purpose:, This experimental study aimed at comparing the histologic outcomes of sinus membrane elevation and simultaneous placement of implants with and without adjunctive autogenous bone grafts. The purpose was also to investigate the role played by the implant surface in osseointegration under such circumstances. Materials and Methods:, Four tufted capuchin primates had all upper premolars and the first molar extracted bilaterally. Four months later, the animals underwent maxillary sinus membrane elevation surgery using a replaceable bone window technique. The schneiderian membrane was kept elevated by insertion of two implants (turned and oxidized, Brånemark System®, Nobel Biocare AB, Göteborg, Sweden) in both sinuses. The right sinus was left with no additional treatment, whereas the left sinus was filled with autogenous bone graft. Implant stability was assessed through resonance frequency analysis (OsstellTM, Integration Diagnostics AB, Göteborg, Sweden) at installation and at sacrifice. The pattern of bone formation in the experimental sites and related to the different implant surfaces was investigated using fluorochromes. The animals were sacrificed 6 months after the maxillary sinus floor augmentation procedure for histology and histomorphometry (bone-implant contact, bone area in threads, and bone area in rectangle). Results:, The results showed no differences between membrane-elevated and grafted sites regarding implant stability, bone-implant contacts, and bone area within and outside implant threads. The oxidized implants exhibited improved integration compared with turned ones as higher values of bone-implant contact and bone area within threads were observed. Conclusions:, The amount of augmented bone tissue in the maxillary sinus after sinus membrane elevation with or without adjunctive autogenous bone grafts does not differ after 6 months of healing. New bone is frequently deposited in contact with the schneiderian membrane in coagulum-alone sites, indicating the osteoinductive potential of the membrane. Oxidized implants show a stronger bone tissue response than turned implants in sinus floor augmentation procedures. [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]

Bone Reformation and Implant Integration following Maxillary Sinus Membrane Elevation: An Experimental Study in Primates

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 1 2006
Vinicius C Palma DDS
ABSTRACT Background:, Recent clinical studies have described maxillary sinus floor augmentation by simply elevating the maxillary sinus membrane without the use of adjunctive grafting materials. Purpose:, This experimental study aimed at comparing the histologic outcomes of sinus membrane elevation and simultaneous placement of implants with and without adjunctive autogenous bone grafts. The purpose was also to investigate the role played by the implant surface in osseointegration under such circumstances. Materials and Methods:, Four tufted capuchin primates had all upper premolars and the first molar extracted bilaterally. Four months later, the animals underwent maxillary sinus membrane elevation surgery using a replaceable bone window technique. The schneiderian membrane was kept elevated by insertion of two implants (turned and oxidized, Brånemark System®, Nobel Biocare AB, Göteborg, Sweden) in both sinuses. The right sinus was left with no additional treatment, whereas the left sinus was filled with autogenous bone graft. Implant stability was assessed through resonance frequency analysis (OsstellTM, Integration Diagnostics AB, Göteborg, Sweden) at installation and at sacrifice. The pattern of bone formation in the experimental sites and related to the different implant surfaces was investigated using fluorochromes. The animals were sacrificed 6 months after the maxillary sinus floor augmentation procedure for histology and histomorphometry (bone-implant contact, bone area in threads, and bone area in rectangle). Results:, The results showed no differences between membrane-elevated and grafted sites regarding implant stability, bone-implant contacts, and bone area within and outside implant threads. The oxidized implants exhibited improved integration compared with turned ones as higher values of bone-implant contact and bone area within threads were observed. Conclusions:, The amount of augmented bone tissue in the maxillary sinus after sinus membrane elevation with or without adjunctive autogenous bone grafts does not differ after 6 months of healing. New bone is frequently deposited in contact with the schneiderian membrane in coagulum-alone sites, indicating the osteoinductive potential of the membrane. Oxidized implants show a stronger bone tissue response than turned implants in sinus floor augmentation procedures. [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]

Prevalence and management of Schneiderian membrane perforations during sinus-lift procedures

CLINICAL ORAL IMPLANTS RESEARCH, Issue 1 2008
Federico Hernández-Alfaro
Abstract: This clinical study was undertaken to evaluate the prevalence of surgical complications of the sinus graft procedure and to set a protocol to repair sinus membrane perforations intraoperatively using a variety of techniques and materials. From January 2000 to May 2005, 338 patients were studied, on whom 474 sinus floor augmentation procedures were performed, and a total of 1166 dental implants were simultaneously placed. A total of 104 perforations of the sinus membrane were observed (19 were bilateral). In group number 1, sinus membrane perforations of <5 mm were observed in 56 sinus augmentation procedures (53.85%), 44 were treated using a resorbable collagen membrane and 12 were sutured with a resorbable material. In group number 2, 28 sinus membranes had a perforation size between 5 and 10 mm (26.92%) and were treated using lamellar bone combined with a resorbable membrane. Group number 3 consisted of 20 sinus membrane perforations>10 mm (19.23%), 10 were covered with lamellar bone combined with a buccal fat pad flap, six were treated with a mandibular block graft and four perforations were treated with only a lamellar bone sheet. Two-hundred and seventy-eight implants were placed under repaired membrane perforations and 247 implants survived. Interestingly enough, all the 25 implants that failed to integrate were placed under perforated and reconstructed membranes during the sinus lift procedure. Based on the results of this study, the survival rates of implants placed under reconstructed membranes correlate inversely with the size of the perforations. [source]

Bovine-HA spongiosa blocks and immediate implant placement in sinus augmentation procedures

CLINICAL ORAL IMPLANTS RESEARCH, Issue 4 2002
Histopathological, histomorphometric observations on different histological stainings in 10 consecutive patients
Abstract: Bovine mineral spongiosa block (B-SB) was used as a bone substitute in sinus augmentation procedures in 10 consecutive patients. Implants were placed during the same session. The purpose of this study was to histopathologically examine the healing of the grafted site around the implants at 12 months. Radiographic follow-up showed apparent bone apposition in the augmented area around the implants. Clinically, all 36 implants were stable and integrated with the surrounding tissue. Histopathologically, new bone formation was evident in all specimen hard tissue cores. Hydroxyapatite particles were present in direct contact with the remodeled osseous tissue. Mallory trichrome staining showed different stages of mineralization and maturation of the newly formed bone around the grafted mineral particles. Morphometric evaluation of Picrosirius red stained slides under polarized light microscopy was performed at the peripheral/external and deep section slides of all specimens. The average bone area fraction was 34.2%, with a 1 : 5.4 mean lamellar/woven bone ratio at the peripheral side and 53.0%, with 1 : 2.5 mean ratio at the deep side. The differences of both parameters between the two sites were statistically significant. B-SB proved to be a suitable grafting material with simultaneously placed implants in sinus floor augmentation procedures. [source]