Elevation Bone Research Articles

Research Progress of Maxillary Sinus Cyst and Maxillary Posterior Dental Region Implantation

The loss of single or multiple teeth in the maxillary posterior region usually leads to alveolar bone resorption, atrophy, and maxillary sinus cavity gasification, resulting in insufficient vertical bone height of the maxillary posterior alveolar bone, which brings great difficulties to tooth implantation. Maxillary sinus floor lifting is an important method to solve the posterior maxillary bone mass deficiency, which can be divided into internal lifting and external lifting. In order to avoid the occurrence of complications such as maxillary sinus mucosa perforation and facilitate the selection of surgical methods, it is particularly important to accurately understand the anatomical characteristics of maxillary sinus before surgery. Maxillary sinus cyst is the most common benign disease of maxillary sinus. It has always been considered as an absolute contraindication for maxillary sinus floor elevation bone grafting, which seriously restricts the possibility of maxillary sinus bone increment. This article reviews the research progress of maxillary sinus cyst and maxillary posterior dental implantation at home and abroad.

Bone regeneration for dental implant placement: A 5-year retrospective ​study of 358 cases

Introduction: Bone regeneration techniques are essential prior to dental implant placement in cases of mandibular or maxillary bone deficit. Depending on the area and the extent of bone loss, as well as the type of prosthetic rehabilitation to be applied, different bone regeneration techniques can be used. Aim: The scope of this study is to analyze a series of patients that underwent mandibular or maxillary bone regeneration, in effort to highlight the most widely used techniques and their outcome. Materials and Methods: 358 cases that underwent max- illary or mandibular bone regeneration in an oral and maxillofacial private clinic within the last 5 years are thoroughly analyzed retrospectively in terms of various parameters from their demographic and medical re- cords, the type of bone regeneration technique that was applied and the final bone augmentation and implant osseointegration outcome. Results: The most widely used technique for bone re- generation was GBR (n=184, 51.3%), followed by sinus floor elevation (n=162, 45.3%) and autologous onlay bone block grafts (n=12, 3.4%). In 1 case of GBR with a non-resorbable membrane, membrane exposure was noted. In 5 cases of sinus lift, inflammation occurred. In one case with bone block grafts from the iliac crest, inflammation presented a few weeks after surgery and one of the bone blocks was partially resorbed. Conclusions: GBR with a resorbable membrane barrier and sinus lift appears to have the most predictable outcomes in terms of mandibular or maxillary bone augmentation.

An 8-year follow-up of autotransplantation into artificial socket with sinus elevation and autogenous bone grafting

An 8-year follow-up of autotransplantation into artificial socket with sinus elevation and autogenous bone grafting

BONE REGENERATION FOR DENTAL IMPLANT PLACEMENT: A 5-YEAR RETROSPECTIVE STUDY OF 358 CASES

Introduction: Bone regeneration techniques are essential prior to dental implant placement in cases of mandibular or maxillary bone deficit. Depending on the area and the extent of bone loss, as well as the type of prosthetic rehabilitation to be applied, different bone regeneration techniques can be used. Aim: The scope of this study is to analyze a series of patients that underwent mandibular or maxillary bone regeneration, in effort to highlight the most widely used techniques and their outcome. Materials and Methods: 358 cases that underwent maxillary or mandibular bone regeneration in an oral and maxillofacial private clinic within the last 5 years are thoroughly analyzed retrospectively in terms of various parameters from their demographic and medical records, the type of bone regeneration technique that was applied and the final bone augmentation and implant osseointegration outcome. Results: The most widely used technique for bone regeneration was GBR (n=184, 51.3%), followed by sinus floor elevation (n=162, 45.3%) and autologous bone block grafts (n=12, 3.4%). In 1 case of GBR with a non-resorbable membrane, membrane exposure was noted. In 5 cases of sinus lift, inflammation occurred. In one case with bone block grafts from the iliac crest, inflammation was presented a few weeks after surgery and one of the bone blocks was partially resorbed. Conclusions: GBR with a resorbable membrane barrier and sinus lift appeared to have the most predictable outcomes in terms of mandibular or maxillary bone augmentation.

The effect of transcrestal sinus-floor elevation without graft on the long-term prognosis of maxillary implants.

To evaluate the effects of (a) transcrestal sinus-floor elevation (TSFE) and (b) residual bone height on long-term implant survival. Chi-squared and t tests were used for descriptive comparison of the groups. Kaplan-Meier survival curves and corresponding log-rank tests were used to investigate implant survival over time. Multivariable Cox regressions were performed for the total population and experimental group. A total of 634 patients received 648 implants with TSFE, while 674 implants without TSFE served as controls. Thirty implant failures occurred in the experimental group and 28 in the control group. Ten-year Kaplan-Meier survival curves for the 157 implants (24.3%) still under observation showed a probability of survival of 93.7% for the implants with TSFE and 92.9% for the 72 implants without TSFE (p=.678). The probability of 10-year survival of all implants in the experimental group decreased to 77.4% for implants placed in residual bone heights of 1-3mm, compared with 95.7% for implant sites with bone heights of 4-6mm and 97.6% for bone heights of >6mm. Transcrestal sinus-floor elevation has no negative effect on the long-term implant survival. Membrane perforation or negligible bone height, however, reduces the probability of 10-year survival.

Two-stage closed sinus lift for severe bone deficiency in the posterior maxilla imrpoves long-term clinical outcomes

To evaluate the long-term clinical outcomes of two-stage closed sinus lift for the maxillary sinus with residual bone height (RBH) of 1-3 mm in the posterior maxillary. Seventy-eight patients with maxillary posterior tooth loss (1 mm≤RBH≤3 mm and alveolar ridge width ≥5 mm) were treated with two-stage closed sinus lift at the Dental Implantation Center of our hospital between March, 2012 and December, 2014. Coral hydroxyapatite powder and 148 implants were implanted. The superstructure was fixed within 6 months after the operation and the patients were followed up for 1-5 years for assessing the patients' satisfaction, postoperative response, stability and survival rates of the implant, soft tissue condition, bone height of maxillary sinus floor elevation and the marginal bone loss. Perforation of the maxillary sinus floor occurred in 3 (3.85%) of the cases. Twenty-three (30.67%) patients complained of mild pain, and 52 (69.33%) did not experience headache or fever or reported obvious pain or swelling after the operation. The overall response to the operation was favorable. The ISQ value was 58.39±1.39 immediately after the operation, and increased significantly to 81.88±1.22 at 6 months (P < 0.05). During the healing period and the follow-up, none of the implants fell off, and the implant survival rate was 100%. The peri-implant probing depth and modified sulcus bleeding index at 1 year after sinus lifting were similar to those at 5 years after the operation (P > 0.05), but the sinus floor elevation and marginal bone resorption at the two time points differed significantly (P < 0.05). Compared with lateral wall lifting, two-stage close lifting of the maxillary sinus floor is associated with less trauma and less discomfort, and effectively solves the problem of severe alveolar bone height deficiency in the maxillary posterior region to achieve favorable long-term clinical outcomes.

Excessive anterior cervical muscle tone affects hyoid bone kinetics during swallowing in healthy individuals

PurposeThis study aimed to determine whether excessive neck muscle tone affects hyoid bone kinetics during swallowing using videofluorography (VF) in an unnatural posture in healthy individuals.Subjects and methodsSubjects were 28 healthy adults (12 men, 16 women; mean age, 39.75±9.50 years) without any history or present complaints of swallowing disorders. We first established the participant’s posture a reclining wheelchair that was adjusted to a 30-degree angle with the headrest (without excessive neck muscle tone) or without headrest (with excessive neck muscle tone), used an electromyogram above the mylohyoid muscle to represent the suprahyoid muscles and above the sternohyoid muscle to represent the infrahyoid muscles to confirm neck muscle tone, and then conducted VF of swallowing measurements. Videofluorographic images were obtained when 5 mL of 50% (w/v) barium sulfate was being swallowed, and hyoid bone coordinate (the resting position and the elevated position), extent of horizontal and vertical hyoid bone elevation, as well as duration and velocity of hyoid bone elevation were evaluated (x-axis and y-axis coordinates for the resting position of hyoid bone are referred to as Xr and Yr, respectively; those for the elevated hyoid bone position induced during swallowing are referred to as Xs and Ys, respectively).ResultsIn the resting position of the hyoid bone, the Yr coordinates in those with excessive neck muscle tone were significantly lower than in those without excessive neck muscle tone. Vertical hyoid bone elevation and hyoid bone elevation velocity were significantly higher with excessive neck muscle tone than without excessive neck muscle tone, whereas horizontal elevation showed no significant differences.ConclusionOur findings suggest that the generation of neck muscle tone due to inappropriate posture may encourage hyoid depression and increase the extent of hyoid bone elevation, thereby increasing the risk of aspiration.

Clinical and Histological analysis of sinus floor elevation and alveolar bone augmentation using an interconnected superporous hydroxyapatite with beta-tricalcium phosphates: Preliminary results

The placement of dental implants in highly atrophic alveolar bone continues to be a major challenge in implant dentistry. Sinus floor elevation and guided bone regeneration (GBR) involves augmenting the bone with grafting materials to provide adequate support for implants. From the various materials available for the bone augmentation, autogenous bone is considered the gold standard because of its high osteoconductive, osteoinductive, and osteogenic potential. However, the collection of autogenous bone requires an extra surgical site for bone harvesting, which increases the risks of morbidity and discomfort.

Assessment of the autogenous bone graft for sinus elevation

ObjectivesThe posterior maxillary region often provides a limited bone volume for dental implants. Maxillary sinus elevation via inserting a bone graft through a window opened in the lateral sinus wall has become the most common surgical procedure for increasing the alveolar bone height in place of dental implants in the posterior maxillary region. The purpose of this article is to assess the change of bone volume and the clinical effects of dental implant placement in sites with maxillary sinus floor elevation and autogenous bone graft through the lateral window approach.Materials and MethodsIn this article, the analysis data were collected from 64 dental implants that were placed in 24 patients with 29 lacks of the bone volume posterior maxillary region from June 2004 to April 2011, at the Department of Oral and Maxillofacial Surgery, Inha University Hospital. Panoramic views were taken before the surgery, after the surgery, 6 months after the surgery, and at the time of the final follow-up. The influence of the factors on the grafted bone material resorption rate was evaluated according to the patient characteristics (age and gender), graft material, implant installation stage, implant size, implant placement region, local infection, surgical complication, and residual alveolar bone height.ResultsThe bone graft resorption rate of male patients at the final follow-up was significantly higher than the rate of female patients. The single autogenous bone-grafted site was significantly more resorbed than the autogenous bone combined with the Bio-Oss grafted site. The implant installation stage and residual alveolar height showed a significant correlation with the resorption rate of maxillary sinus bone graft material. The success rate and survival rate of the implant were 92.2% and 100%, respectively.ConclusionMaxillary sinus elevation procedure with autogenous bone graft or autogenous bone in combination with Bio-Oss is a predictable treatment method for implant rehabilitation.

Particulate Inlay Nasal Graft With Immediate Dental Implant Placement in a Patient With Repaired Alveolar Cleft: Case Report

Primary bone grafts in congenital cleft alveolus do not always provide sufficient bulk or height of bone for ideal placement of endosseous implants. Thus, maxillary sinus or nasal floor elevation and inlay bone grafts in previously grafted areas are not exceptions in the daily routine. This case report stresses the need of a detailed treatment plan and careful surgical management of nasal floor elevation with particulate autogenous bone graft to successfully provide the patient with osseointegrated prostheses.

Reconstruction of the severely resorbed maxilla with a combination of sinus augmentation, onlay bone grafting, and implants

Purpose: A new method of reconstruction of the atrophic maxilla by combining a bilateral sinus floor elevation and cancellous bone graft with buccal and labial onlay graft using L-shaped corticocancellous blocks from the posterior iliac crest is presented. Patients and Methods: Seventeen patients were treated with this procedure. One hundred one IMZ implants were placed in 14 patients, and 22 Brånemark implants were placed in three patients. Patients were observed for 6 months after prosthetic rehabilitation. Results: All patients were fully rehabilitated with fixed bridges except one, who prefered an overdenture. Only two implants were lost at the time of the abutment connection. Some bone resorption was seen around six implants. The success rate with this procedure was 92.7% 6 months after prosthetic rehabilitation if implants with bone resorption were considered failures. Conclusions: These preliminary results indicate that this surgical procedure is suitable for reconstruction of most atrophic maxillas.

Sickle cell dactylitis: histopathologic observations.

The histopathologic features of sickle cell dactylitis observed at autopsy in a 9-month-old Negro infant with sickle cell disease (homozygous S) are described. The changes observed included extensive infarction of the marrow, medullary trabeculae, and inner layers of the cortical bone. This was associated with circumferential periosteal elevation and subperiosteal new bone formation. In addition, there was significant alteration in the morphology of the growth zone at the osteochondral junction. These features are similar to those observed in experimental models in which the medullary blood supply is completely interrupted with sparing of the periosteal vascular bed.