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Sinus Floor Elevation (sinus + floor_elevation)

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Medical Sciences100%

Terms modified by Sinus Floor Elevation

  • sinus floor elevation surgery
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    Selected Abstracts

    A systematic review of the success of sinus floor elevation and survival of implants inserted in combination with sinus floor elevation

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 2008
    Part I: Lateral approach
    Abstract Objectives: The objectives of this systematic review were to assess the survival rate of grafts and implants placed with sinus floor elevation. Material and Methods: An electronic search was conducted to identify studies on sinus floor elevation, with a mean follow-up time of at least 1 year after functional loading. Results: The search provided 839 titles. Full-text analysis was performed for 175 articles resulting in 48 studies that met the inclusion criteria, reporting on 12,020 implants. Meta-analysis indicated an estimated annual failure rate of 3.48% [95% confidence interval (CI): 2.48%,4.88%] translating into a 3-year implant survival of 90.1% (95% CI: 86.4%,92.8%). However, when failure rates was analyzed on the subject level, the estimated annual failure was 6.04% (95% CI: 3.87%,9.43%) translating into 16.6% (95% CI: 10.9%,24.6%) of the subjects experiencing implant loss over 3 years. Conclusion: The insertion of dental implants in combination with maxillary sinus floor elevation is a predictable treatment method showing high implant survival rates and low incidences of surgical complications. The best results (98.3% implant survival after 3 years) were obtained using rough surface implants with membrane coverage of the lateral window. [source]

    A systematic review of the success of sinus floor elevation and survival of implants inserted in combination with sinus floor elevation Part II: Transalveolar technique

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 2008
    Wah Ching Tan
    Abstract Objectives: The objectives of this systematic review were to assess the survival rate of implants placed in sites with transalveolar sinus floor elevation. Material and Methods: An electronic search was conducted to identify prospective and retrospective cohort studies on transalveolar sinus floor elevation, with a mean follow-up time of at least 1 year after functional loading. Failure and complication rates were analyzed using random-effects Poisson regression models to obtain summary estimates/ year proportions. Results: The search provided 849 titles. Full-text analysis was performed for 176 articles, resulting in 19 studies that met the inclusion criteria. Meta-analysis of these studies indicated an estimated annual failure rate of 2.48% (95% confidence interval (95% CI): 1.37,4.49%) translating to an estimated survival rate of 92.8% (95% CI): 87.4,96.0%) for implants placed in transalveolarly augmented sinuses, after 3 years in function. Furthermore, subject-based analysis revealed an estimated annual failure of 3.71% (95% CI: 1.21,11.38%), translating to 10.5% (95% CI: 3.6,28.9%) of the subjects experiencing implant loss over 3 years. Conclusion: Survival rates of implants placed in transalveolar sinus floor augmentation sites are comparable to those in non-augmented sites. This technique is predictable with a low incidence of complications during and post-operatively. [source]

    Deproteinized cancellous bovine bone (Bio-Oss®) as bone substitute for sinus floor elevation

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 3 2003
    A retrospective, histomorphometrical study of five cases
    Abstract Objectives: To study in detail the performance of deproteinized cancellous bovine bone (DPBB, Bio-Osso®) granules as a bone substitute, a histomorphometric was performed on five patients treated with DPBB for reconstruction of the severely atrophic maxilla. Material and Methods: DPBB was used as mixture with autogenous bone particles, in concentrations that increased from 20% to 100% DPBB, with the time of healing increasing accordingly from 5 to 8 months. A total of 20 vertical biopsies was taken at the time of fixture installation and used for histomorphometry as undecalcified Goldner stained sections. Results: The results show that in all cases, the DPBB granules had been interconnected by bridges of vital newly formed bone. The volume of bone in the grafted area correlated inversely with the concentration of DPBB grafted, and varied between 37% and 23%. However, the total volume of mineralized material (bone plus DPI3B granules) remained within the same range in all five patients (between 53% and 59%). The high values for osteoid and resorption surface, and the presence of tartrate-resistant acid phosphatase-positive multinucleated osteoclasts in resorption lacunae, indicated that bone remodeling was very active in all grafts. Osteoclasts were also observed in shallow resorption pits on DPBB surfaces. The percentage DPBB surface in contact with bone remained stable at about 35% and could not be related to the proportion of DPBB grafted. Conclusion: Although the number of patients examined was limited, the data suggest that deproteinized cancellous bovine bone, preferably combined with autogenous bone particles, is a suitable material for sinus floor elevation in the severely atrophic human maxilla. Zusammenfassung Ent-Proteinisierter spöngiöser boviner Knochen (Bio-Oss) als Knochenersatz zur Sinusboden-Elevation. Eine retrospektive histomorphometrische Studie an 5 Fällen. Ziele:Um das Verhalten Ent-Proteinisierten spöngiösen bovinen Knochengranulats (DPBB, Bio,Oss) als Knochenersatzmaterial detailliert zu studieren, wurde an 5 Patienten, die mit DPBB zur Rekonstruktion der stark atrophischen Maxilla behandelt wurden, eine histomorphometrische Studie durchgeführt. Material und Methoden:DPBB wurde als Mischung mit autogenen Knochenpartikeln in einer Konzentration von 20 , 100% DPBB verwendet. Die Heilungsdauer wurde entsprechend von 5 auf 8 Monate erhöht. Zum Zeitpunkt der Implantatsetzung wurden insgesamt 20 vertikale Biopsien entnommen und für die Histomorphometrie als nicht-entkalkte, Goldner-gefärbte Schnitte verwendet. Ergebnisse: Die Ergebnisse zeigten in allen Fällen, dass die DPBB-Granula über Brücken von vitalem neu gebildetem Knochen miteinander verbunden waren. Das Volumen des Knochens in dem transplantiertem Gebiet korrelierte umgekehrt mit der Konzentration der transpantierten DPBB und variierte zwischen 37% und 23%. Jedoch lag das Gesamtvolumen des mineralisierten Materials (Knochen+DPBB-Granula)bei allen 5 Patienten im selben Bereich (zwischen 53% und 59%). Die hohen Werte für Ostoid und Resorptionsflächen sowie die Anwesenheit von TRAP-positiven multinukleären Osteoklasten in Resorptionslakunen, zeigte, dass das Knochenremodelling in allen Transplantaten sehr aktiv war. Auch in flachen Resorpionsgrübchen auf der DPBB-Oberfläche wurden Osteoklasten beobachtet. Der Prozentsatz der DPBB-Oberfläche welche im Knochenkontakt war blieb mit etwa 35% stabil und korrelierte nicht mit dem Anteil des transplantierten DPBBs. Schlussfolgerung:Obwohl die untersuchte Patientenzahl sehr gering ist, lassen die Daten vermuten, dass Ent-Proteinisierter spöngiöser boviner Knochen, vorzugsweise mit autogenen Knochenpartikeln kombiniert, ein geeignetes Material für die Sinusboden-Elevation bei stark atrophischer Maxilla ist. Résumé Os bovin spongieux déprotéiné comme substitut osseux dans l'épaississement sinusal. Une étude histomorphométrique rétrospective de cinq cas Le but de cette étude a été d'analyser en détail les performances de l'os bovin spongieux déprotéiné (DPBB, Bio-Oss®) en granules comme substitut osseux par une analyse histomorphométrique effectuée chez cinq patients traités pour une reconstruction au niveau d'un maxillaire sévèrement atrophié. DPBB a été utilisé en mélange avec des particules osseuses autogènes en concentrations augmentaient de 20 à 100% de DPBB, avec un temps de guérison augmentant paralèllement de cinq à huit mois. Vingt biopsies verticales ont ainsi été prélevées au moment du placement des implants et utilisées pour l'histomorphométrie sur coupes colorées Goldner non-décalcifiées. Les résultats ont indiqué que dans tous les cas les granules DPBB ont été interconnectées par des bridges d'os néoformé vivant. Le volume d'os dans l'aire greffée était en corrélation inverse avec les concentrations de DPBB greffées et variait entre 37 et 23 %. Cependant le volume total de matériel minéralisé (os+granules DPBB) restait dans les mêmes moyennes chez les cinq patients (entre 53 et 59 %). Les valeurs importantes pour la surface de résorption et ostéides, et la présence d'ostéoclastes multinucléaires positifs au TRAP dans les lacunes de résorption indiquaient que le remodelage osseux était très actif dans tous les greffons. Les ostéoclastes étaient également observés dans des petites crevasses de résorption étroites sur les surfaces DPBB. Le pourcentage DPBB en contact avec l'os demeurait stable à environ 35% et ne pouvait pas être mis en relation avec la proportion de DPBB greffé. Bien que le nombre de patients examinés aie été très limité, les données suggèrent que l'os bovin spongieux déprotéiné de préférence en combinaison avec des particules d'os autogène est un bon matériel pour l'épaississement du plancher sinusal en présence de maxillaire humain sévèrement atrophié. [source]

    Recombinant human bone morphogenetic protein-7 in maxillary sinus floor elevation surgery in 3 patients compared to autogenous bone grafts

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 9 2000
    A clinical pilot study
    Abstract Background/Aims: This pilot study was designed to determine the clinical bone formation ability of a human recombinant DNA bone morphogenetic protein-7, also referred to as Osteogenic Protein-1 [OP-1] combined with a collagen carrier, implanted in the maxillary sinus of 3 patients. The results were compared with a group of 3 patients treated with sinus floor elevation and autogenous bonegrafts. Methods: 6 consecutive patients, 4 female and 2 male, between 48 and 57 years of age were treated by means of sinus floor elevation for insufficient bone height in the posterior maxilla for implant surgery. 3 patients, 2 female and 1 male, were treated with OP-1 attached to a collagen device. In these patients, 4 maxillary sinus grafting procedures according to Tatum's method were carried out. 1 g of collagen carrier containing 2.5 mg rhOP-1 mixed with 3 ml of saline was placed between the bony floor and the elevated mucosal lining of the most caudal part of the maxillary sinus, in order to increase the vertical bone dimension to place dental implants of a sufficient length. The 3 other patients, also 2 female and 1 male, with a total of 5 sinus sites, were treated with sinus floor elevation and autogenous iliac crest bonegrafts. After 6 months, during dental implant preparation, bone cores were taken for histology. Thus, clinical, radiological and histological results of the 2 groups of 3 patients were compared. Results: 6 months after sinus grafting with OP-1, in 1 male, well-vascularized bonelike tissue of good quality was observed clinically. This could be confirmed by histology. In the second, female, patient no bone formation was observed at all. A cyst-like granular tissue mass, without purulent content, was removed. In the 3rd, female, patient, who received bilateral sinus grafts, some bonelike formation was seen, however it showed flexible tissue which led to the decision that at 6 months after the sinus grafting, the implant placement had to be postponed. In all 5 autogenous grafted sinuses a bone appearance similar to normal maxillary bone was observed clinically as well as histologically and dental implants could be placed six months after sinus floor elevation surgery. Conclusions: These findings indicate that the OP-1 device has the potential for initiating bone formation in the human maxillary sinus within 6 months after a sinus floor elevation operation. However, the various findings in these 3 patients indicate that the behaviour of the material is at this moment insufficiently predictable, in this indication area. Further investigation is indicated before OP-1 can be successfully used instead of the "gold standard" autogenous bone graft. [source]

    The use of autologous venous blood for maxillary sinus floor augmentation in conjunction with sinus membrane elevation: an experimental study

    CLINICAL ORAL IMPLANTS RESEARCH, Issue 3 2010
    Ha-Rang Kim
    Abstract Background: There have been reports of successful bone formation with sinus floor elevation induced by simply elevating the maxillary sinus membrane and filling the sinus cavity with a blood clot. Purpose: We investigated the feasibility of maxillary sinus floor augmentation using the patient's own venous blood in conjunction with a sinus membrane elevation procedure. Materials and methods: An implant that protruded 8 mm into the maxillary sinus after sinus membrane elevation was placed in the maxillary sinus of six adult female mongrel dogs. The resulting space between the membrane and the sinus floor was filled with autologous venous blood retrieved from each dog. The implants were left in place for 6 months. Results: During the experimental period, the created space collapsed and the sinus membrane fell down onto the implant. A small amount of new bone formation occurred in the space created by the collapsed membrane. The average height of newly formed bone around the implants in the sinus was 2.7±0.7 mm on the buccal side and 0.6±0.3 mm on the palatal side. Conclusion: The results of this pilot study indicate that blood clots do not have sufficient integrity to enable the sinus membrane to remain in an elevated position for therapeutically effective periods of time. Accordingly, it is recommended that this method be used only when a small aount of new bone formation is necessary around implants in the maxillary sinus cavity. To cite this article: Kim H-R, Choi B-H, Xuan F, Jeong S-M. The use of autologous venous blood for maxillary sinus floor augmentation in conjunction with sinus membrane elevation: an experimental study. Clin. Oral Impl. Res. 21, 2010; 346,349. doi: 10.1111/j.1600-0501.2009.01855.x [source]

    Maxillary sinus floor elevation using the (transalveolar) osteotome technique with or without grafting material.

    CLINICAL ORAL IMPLANTS RESEARCH, Issue 7 2009
    Part I: implant survival, patients' perception
    Abstract Objectives: To analyze the survival and success rates of implants installed utilizing the (transalveolar) osteotome technique, to compare peri-implant soft tissue parameters and marginal bone levels of osteotome-installed implants with implants placed using standard surgical procedures, and to evaluate patient-centered outcomes. Material and methods: During 2000 to 2005, 252 Straumann® dental implants were inserted in 181 patients. The surgical technique was a modification of the original osteotome technique presented by Summers. In addition to the clinical examination, the patients were asked to give their perception of the surgical procedure, utilizing a visual analogue scale. Results: The cumulative survival rate of the osteotome-installed implants after a mean follow-up time of 3.2 years, was 97.4% (95% confidence intervals: 94.4,98.8%). From the 252 implants inserted, three were lost before loading and another three were lost in the first and second year. According to residual bone height the survival was 91.3% for implant sites with ,4 mm residual bone height, and 90% for sites with 4 mm and 5 mm, when compared with that of 100% in sites with bone height of above 5 mm. According to implant length the survival rates were 100% for 12 mm, 98.7% for 10 mm, 98.7% for 8 mm and only 47.6% for 6 mm implants. Soft tissue parameters (pocket probing depth, probing attachment level, bleeding on probing and marginal bone levels) did not yield any differences between the osteotome-installed and the conventionally placed implants. More than 90% of the patients were satisfied with the implant therapy and would undergo similar therapy again if necessary. The cost associated with implant therapy was considered to be justified. Conclusion: In conclusion, the osteotome technique was a reliable method for implant insertion in the posterior maxilla, especially at sites with 5 mm or more of preoperative residual bone height and a relatively flat sinus floor. [source]

    Osteotomy and membrane elevation during the maxillary sinus augmentation procedure

    CLINICAL ORAL IMPLANTS RESEARCH, Issue 5 2008
    A comparative study: piezoelectric device vs. conventional rotative instruments
    Abstract Objectives: The aim of the present study was to investigate in a randomized-controlled clinical trial the performance of rotary instruments compared with a piezoelectric device during maxillary sinus floor elevation. Materials and methods: Thirteen patients who required a bilateral maxillary sinus augmentation for implant,prosthetic rehabilitation were included in this study. A within-patient control study was carried out. The osteotomy for sinus access was performed on one side of the maxilla using the piezosurgery (test sites) and on the other side using conventional rotary diamond burs (control sites). The parameters recorded were as follows: bony window length (L), bony window height (H), bone thickness (T) and osteotomy area (A) , calculated by multiplying L and H. In addition, the time necessary for the osteotomy and sinus membrane elevation as well as the number of surgical complications were calculated. Results: The mean length and height of the bone window were similar in both groups. The osteotomy area (A) obtained by multiplying L and H was wider in the control group (151.2 ± 20.4 mm2) compared with the test group (137 ± 24.2 mm2). The time necessary for the osteotomy and the sinus membrane elevation with conventional instruments was 10.2 ± 2.4 min, while with the piezoelectric device it was 11.5 ± 3.8 min. Moreover, membrane perforation occurred in 30% of the maxillary sinuses in the test group and in 23% of the control group. None of the differences observed between the two groups reached a level of significance. Conclusions: Within the limits of the present study, it may be concluded that piezosurgery and conventional instruments did not show any differences in the clinical parameters investigated for the maxillary sinus floor elevation. [source]

    Osteotome sinus floor elevation without grafting material: a 1-year prospective pilot study with ITI implants

    CLINICAL ORAL IMPLANTS RESEARCH, Issue 6 2006
    Rabah Nedir
    Abstract Objective: The aim of the present pilot study was to evaluate: (1) the predictability of an osteotome sinus floor elevation procedure with ITI-SLA implants without placing a bone grafting material, and (2) the possibility to gain bone height without filling the created space with a bone grafting material. Material and methods: Seventeen patients received 25 implants protruding in the sinus. Most implants (21/25) were 10 mm long, eight were inserted in type 2 bone, 12 in type 3 and five in type 4 bone. At implant placement, the mean residual bone height (RBH) under the maxillary sinus was 5.4±2.3 mm; it was 5.7±2.6 mm on the mesial side and 5.1±1.9 mm on the distal side. Nineteen implants had less than 6 mm of bone on at least one side and six implants had less than 6 mm on both sides. A healing period of 3,4 months was allowed before abutment tightening at 35 Ncm. The percentage of stable implants at abutment tightening and at the 1-year control was calculated. The endo-sinus bone gain and the crestal bone loss (CBL) at the mesial and distal sides were measured. Results: Abutments were tightened after 3.1±0.4 months. All implants but one (96%) resisted the applied 35 Ncm torque. At the 1-year control, all implants were clinically stable and supported the definitive prosthesis. All showed endo-sinus bone gain; the mean gain was 2.5±1.2 mm. The mean CBL was 1.2±0.7 mm. Endo-sinus bone gain and RBH showed a strong negative correlation (r=,0.78 on the mesial side and ,0.80 on the distal side). A good correlation (r=0.73) was found between implant penetration in the sinus and endo-sinus bone gain. Conclusion: Elevation of the sinus membrane alone without addition of bone grafting material can lead to bone formation beyond the original limits of the sinus floor. Despite a limited RBH at implant placement, a healing period of 3 months was sufficient to resist a torque of 35 N cm and to lead to a predictable implant function at the 1-year control. [source]

    Dental implants placement in conjunction with osteotome sinus floor elevation: a 12-year life-table analysis from a prospective study on 588 ITI®implants

    CLINICAL ORAL IMPLANTS RESEARCH, Issue 2 2006
    Nicola Ferrigno
    Abstract Objectives: The purpose of this prospective study was to evaluate the clinical success of placing ITI dental implants in the posterior maxilla using the osteotome technique. Material and methods: All implants were placed following a one-stage protocol (elevating the sinus floor and placing the implant at the same time). Five hundred and eighty-eight implants were placed in 323 consecutive patients with a residual vertical height of bone under the sinus ranging from 6 to 9 mm. The mean observation follow-up period was 59.7 months (with a range of 12,144 months). This prospective study not only calculated the 12-year cumulative survival and success rates for 588 implants by life-table analysis but also the cumulative success rates for implant subgroups divided per implant length and the percentage of sinus membrane perforation were evaluated. Results: The 12-year cumulative survival and success rates were 94.8% and 90.8%, respectively. The analysis of implant subgroups showed slightly more favourable cumulative success rates for 12 mm long implants (93.4%) compared with 10 and 8 mm long implants (90.5% and 88.9%, respectively). During the study period, only 13 perforations of the Schneiderian membrane were detected with a perforation rate of 2.2% (13 perforations/601 treated sites). Ten perforations out of 13 were caused during the first half of the study period and of these, seven were detected during the first 3 years of this prospective study. Conclusion: Based on the results and within the limits of the present study, it can be concluded that ITI implant placement in conjunction with osteotome sinus floor elevation represents a safe modality of treating the posterior maxilla in areas with reduced bone height subjacent to the sinus as survival and success rates were maintained above 90% for a mean observation period of ,60 months. Shorter implants (8 mm implants) did not significantly fail more than longer ones (10 and 12 mm implants): the differences were small compared with the number of events; hence, no statistical conclusion could be drawn. But, from the clinical point of view, the predictable use of short implants in conjunction with osteotome sinus floor elevation may reduce the indication for complex invasive procedures like sinus lift and bone grafting procedures. [source]

    High concentrations of bioactive glass material (BioGran®) vs. autogenous bone for sinus floor elevation

    CLINICAL ORAL IMPLANTS RESEARCH, Issue 4 2002
    Histomorphometrical observations on three split mouth clinical cases
    Abstract: In this study, high concentrations of bioactive glass (BG) particles were compared with autogenous bone in their capacity to augment maxillary bone when grafted in the human sinus floor using a split mouth design. Three female patients with severe maxillary atrophy underwent bilateral sinus floor elevation and bone grafting using 80,100% BG particles (300,355 ,m in size) mixed with 20% to 0% iliac crest bone particles at one (experimental) side, and 100% iliac crest derived bone particles at the other (control) side. A total of 22 bone biopsies was taken at the time of fixture installation; that is, at 4, 6 and 15 months after grafting, and processed for histology and histomorphometry. At the control (autogenous bone) sides, trabecular bone amounted to 39% of the biopsy volume in the graft (site) at 4 months, almost 41% at 6 months, and 42% at 15 months. This bone contained viable osteocytes and was mostly of mature, lamellar type. At the experimental (BG particles) sides, the graft consisted of 27% of mostly woven (and some lamellar) bone at 4 months, 36% (woven and lamellar) bone at 6 months, and 39% (mainly lamellar) bone at 15 months. The grafted BG particles started to excavate at 4 months and their centers gradually filled with bone tissue. As a consequence, the volume of BG particles in the biopsy decreased from 29% at 4 months to 15% at 6 months and 8% at 15 months. The BG particles appeared to resorb within 1,2 years by dissolution rather than by osteoclastic activity. Parameters for bone turnover (% osteoid surface, % resorption surface) indicated that bone remodeling was very active at both experimental and control sides, during more than 6 months. These results suggest that mixtures of mainly (80,90%) BG particles and some (10,20%) autogenous bone are effective for bone regeneration in the augmented sinus offer 6 months healing time, while about 12 months healing time is needed for 100% BG particles. [source]