Lift Procedure Research Articles

Biomechanical Analysis of Truncated Cone Implants for Maxillary Sinus Lift: An In Vitro Study on Polyurethane Laminas.

This study aimed to evaluate the biomechanical performance of two truncated cone implant designs in maxillary sinus lift (MSL) procedures using polyurethane laminas. A total of 128 implants were used. Polyurethane laminas were divided into two groups based on thickness (1 and 3 mm) and two subgroups based on density (20 and 30 pounds per cubic foot, PCF). Each subgroup tested two implants (Sinus-plant and Sinus Lift Concept: SLC), resulting in 8 experimental conditions and 16 implants per condition. The insertion torque (IT), removal torque (RT), and implant stability quotient (ISQ) were measured. SLC implants achieved significantly higher IT and RT across all tested conditions (p < 0.0001), reporting the highest values at the 30 PCF/3 mm lamina (IT: 34.09 ± 0.32 Ncm; RT: 32.15 ± 0.29 Ncm) and the lowest at the 20 PCF/1 mm lamina (IT: 11.86 ± 0.22 Ncm; RT: 10.28 ± 0.22 Ncm). Additionally, SLC implants achieved significantly higher ISQ values, ranging from around 61 to 48 ISQ. Notably, this difference was not significant at the 20 PCF/3 mm lamina, highlighting that bone density may play a more critical role than thickness for SLC implants. This study simulated the clinical condition of achieving primary stability even with extreme maxillary bone thickness. The findings indicate that while both implant designs can be utilized in MSL procedures, the SLC is particularly effective in scenarios with limited bone thickness and density, potentially allowing for simultaneous MSL, implant placement, and healing screw application.

Long-Term Comparative Outcomes of Short Implants Versus Maxillary Sinus Elevation in Posterior Maxilla Rehabilitation.

Background: Vertical atrophy of the maxilla has traditionally been treated with sinus lift procedures and implant placement, performed in one or two surgical stages. Subsequently, the transcrestal sinus lift technique was introduced, offering distinct advantages in terms of indications and reduced morbidity. Most recently, short implants have emerged as a valid alternative to these procedures, even in cases of severe horizontal resorption, allowing for direct placement in many cases. This study was designed to assess the clinical outcomes of short implant placement in alveolar ridges with severe bone atrophy, compared with conventional-length implants placed in areas undergoing conventional sinus elevation. Methods: A retrospective split-mouth study was conducted to compare conventional sinus elevation with standard-length implants versus short implants for addressing vertical bone atrophy in the posterior maxilla. The primary variable was the variation in the marginal bone level. The secondary variables were implant survival and complications. The evaluation of the statistical significance of the difference in categorical variables was accomplished by Chi-squared test or Fisher's exact test. The comparison between the study groups in continuous variables was performed using Wilcoxon test. The statistical significance was set at p-value < 0.05. Results: The study sample consisted of 24 patients and a total of 73 dental implants. The lateral sinus elevation group (LSEG) included 39 implants, while the short implants group (SIG) included 32 implants. All prostheses were screw-retained. Changes in marginal bone levels indicated a marginal bone loss of less than 0.5 mm in both groups, with no statistically significant difference. In the LSEG, two cases of mucositis were identified, attributed to improper use of an interdental brush. Additionally, two cases of prosthetic screw fracture were reported in the LSEG as technical complications. Conclusions: Long-term outcome data have provided evidence that the use of short implants is comparable to a state-of-the-art procedure (sinus grafting and placement of implants) regarding implant survival, marginal bone remodeling, and complication rates.

Automated Segmentation of Graft Material in 1-Stage Sinus Lift Based on Artificial Intelligence: A Retrospective Study.

Accurate assessment of postoperative bone graft material changes after the 1-stage sinus lift is crucial for evaluating long-term implant survival. However, traditional manual labeling and segmentation of cone-beam computed tomography (CBCT) images are often inaccurate and inefficient. This study aims to utilize artificial intelligence for automated segmentation of graft material in 1-stage sinus lift procedures to enhance accuracy and efficiency. Swin-UPerNet along with mainstream medical segmentation models, such as FCN, U-Net, DeepLabV3, SegFormer, and UPerNet, were trained using a dataset of 120 CBCT scans. The models were tested on 30 CBCT scans to evaluate model performance based on metrics including the 95% Hausdorff distance, Intersection over Union (IoU), and Dice similarity coefficient. Additionally, processing times were also compared between automated segmentation and manual methods. Swin-UPerNet outperformed other models in accuracy, achieving an accuracy rate of 0.84 and mean precision and IoU values of 0.8574 and 0.7373, respectively (p < 0.05). The time required for uploading and visualizing segmentation results with Swin-UPerNet significantly decreased to 19.28 s from the average manual segmentation times of 1390 s (p < 0.001). Swin-UPerNet exhibited high accuracy and efficiency in identifying and segmenting the three-dimensional volume of bone graft material, indicating significant potential for evaluating the stability of bone graft material.

Application of dynamic navigation technology in oral and maxillofacial surgery.

Dynamic navigation (DN) technology has ushered in a paradigm shift in dentistry, revolutionizing the precision of diverse procedures in oral and craniofacial surgery. This comprehensive review aims to review the manifold applications of DN, including implantology, endodontics, oral and dental surgeries, and other dental disciplines. A thorough search of the online databases PubMed and Google Scholar was conducted up to March 2024. Publications associated with DN in the field of oral and maxillofacial surgery were sourced. Narrative literature review. DN harnesses cone beam computerized tomography imaging, virtual design software, and motion tracking technology to construct a virtual model of the patient's oral cavity, affording real-time instrument tracking during procedures. Notably, in implantology, DN facilitates implant placement, enhances safety measures, and augments procedural efficiency. The application of DN in sinus lift procedures contributes to improved surgical outcomes and reduced complications. Within endodontics, DN guides root canal treatment (RCT), retreatment of failed RCT, and endodontic microsurgery, ensuring conservative access cavities and precise canal location. Beyond these, the versatility of DN extends to encompass maxillomandibular and orthognathic surgeries, tooth extraction, removal of foreign bodies, and facial reconstruction. However, it is crucial to acknowledge potential disadvantages and error-prone scenarios as DN technologies advance. DN technology empowers dentists with high accuracy, heightened safety protocols, and increased procedural efficiency, culminating in enhanced patient outcomes across various dental procedures. As DN technology further expands, its pivotal role will advance in the future of oral and maxillofacial surgery.

Aggresive Mass Excision Through Nasolabial Fold Areain the Treatment of Facial Neurofibromatosis : Case Report

Neurofibromatosis type 1 is a rare disease which can manifest itself by the development of plexiform neurofibromatosis, with craniofacial deformities. In this paper, we propose special consideration in excision nasolabial fold mass to help lifting procedures in neurofibromatosis patients. We are reporting two case, both presented with von Recklinghausen’s disease, a 21 years old male patient with neurofibromatosis in his right hemifacial for which he had been operated on five times previously at other center, and a 24 years old male with neurofibromatosis in his left hemifacial. After several stages of reconstruction which started with nasolabial fold mass excision, the result was satisfactory, by using the multiple stage repair, it was done until the end result is similar to anatomical form. The mass debulking procedures for these patients, which started with Nasolabial Fold mass excisison are continued with durable lifting procedures. This method gives results a satisfactory lifting procedure.

Long Terms Results of Temporal Facelift: 6 Years of Experience in 250 Cases.

Temporal facelift (TFL) is an innovative technique for lifting the upper and mid-face. It is characterized by a unique dissection plane above the subgaleal fascia, which seamlessly transitions into the sub-superficial muscular aponeurotic system (SMAS) layer in the mid-face. This approach enables comprehensive mid-face elevation, robust canthopexy, and a significant brow lift in various vectors. The authors present their experience with 250 TFL procedures over a period of 6 years. This retrospective study analyzed 250 of 441 patients who underwent TFL surgery. The surgical procedures, conducted under general anesthesia by a senior surgeon following the TFL method, involved a vertical-vector deep-plane mid-face lift, canthopexy, and brow-lift triad. Close monitoring of complications and detailed photographic documentation of the outcomes were performed. Postoperative care included taping the operation area to reduce swelling, with subsequent follow-up examinations and interventions such as lymphatic massage and botulinum toxin injections for asymmetric brow movements or steroid injections for excessive mid-face swelling. Among 250 patients (248 female, 2 male; mean age, 37y), unilateral neuropraxia of the frontal branch of the facial nerve occurred in 5.6% and resolved spontaneously within 2.8 months. Persistent dimples (2.8%) resolved by the fifth postoperative month. Six patients (2.4%) underwent revision surgery with no observed complications like hematoma, necrosis, infection, or seroma. The TFL technique represents a significant advancement in upper and mid-face lifting procedures and offers several advantages over the traditional methods.

Minimal invasive sinus elevation (MISE), a different approach for maxillary sinus lift surgery

Aim: The maxillary sinus lift is a crucial surgical procedure performed to increase the vertical height of the remaining bone, often required before implant placement. Several techniques are used to approach the maxillary sinus, with varying results. Among them, it is possible to mention the minimal invasive sinus elevation (MISE) technique. Methods: This paper provides a comprehensive review of the MISE technique, its materials, and surgical methods. It analyzes the outcomes compared to conventional methods and discusses its applicability in different clinical scenarios. Results: The MISE technique has proven effective in increasing bone height with a lower risk of membrane perforation compared to traditional methods. It offers high implant success rates and minimal post-operative complications, with strong patient outcomes regarding bone regeneration and implant stability. This section will analyze these results with both quantitative and qualitative evaluations. Conclusions: The MISE technique notably improves sinus lift procedures, providing a minimally invasive method with reliable clinical results. Its predictability and lower risk of membrane perforation make it well-suited for implant surgeries involving sinus elevation. Future studies should explore long-term results and refine the technique for broader clinical use.

Biomechanical Basis for Bone Healing and Osseointegration of Implants in Sinus Grafts.

A thorough comprehension of the mechanisms controlling new bone formation and implant osseointegration after maxillary sinus floor elevation is crucial for aligning our treatment choices with biological principles and enhancing clinical outcomes. The goal of bone regeneration in sinus lift procedures is to provide a sufficient amount of newly-formed tissue to support implant osseointegration. However, it is still unclear whether there is a minimum quantity of vital bone within the newly-formed tissue required for effective support, though it is generally assumed that vital bone is essential for this process. The source and integration of new bone in maxillary sinus floor elevation procedures remain debated. Most clinical studies suggest a paramount role for sinus floor and bony walls, with a centripetal pattern of new bone formation, while conflicting reports exist regarding the osteogenic role of the Schneiderian membrane. The influence of mechanical input on peri-implant bone formation, mineralization, and maturation is significant, with bone remodeling regulated by mechanical strains generated during loading. Defining optimal loading for implants, particularly in sinus lift procedures, is challenging, as early loading may damage interfacial tissue, interfering with osteogenesis. Differences in osseointegration dynamics between native and augmented bone may arise from biological and mechanical factors, but also from patient-specific factors which should be evaluated in treatment planning. Factors to consider include sinus anatomy, patient and site-specific regenerative potential, and the selection of graft material that matches the osteogenic and mechanical requirements. Tailored approaches integrating patient-specific considerations and refined implant strategies will enhance predictability and longevity of treatment.

Survival Rates and Risk Factors of Resorbable Blast Media Surface Dental Implants: A Retrospective Cohort Study with an Average 60-Month Follow-Up.

This retrospective cohort study aimed to evaluate the survival rates and risk factors associated with Resorbable Blast Media (RBM) surface dental implants. The study involved 1,130 implants placed in 260 patients, with a follow-up ranging from a minimum of 26 months to a maximum of 120 months, for an average of 60 months. 1,130 RBM surface implants with hybrid macro-geometry were placed in 260 patients. Implant survival and failure rates were analyzed over an average 60-month follow-up. Failure rates were examined based on implant length, patient gender, and sinus lift procedures. Additional factors, including patient age, implant placement timing (immediate vs. delayed), guided bone regeneration (GBR), implant diameter, and implant location, were assessed to determine their impact on long-term implant success. The overall survival rate for the implants was 94.4%, with most failures occurring within the first 12 months postplacement. Male patients experienced significantly higher failure rates (7.36%) than female patients (4.0%). Short implants (8 mm) were particularly vulnerable to failure, with an 8.65% failure rate. Sinus augmentation procedures also presented an increased risk, with 10% failure for lateral sinus augmentation and 9.78% for crestal sinus elevation. In contrast, factors such as patient age, timing of implant placement, GBR, implant diameter, and implant location did not significantly influence failure rates. Notably, narrow-diameter implants (3.3 and 3.7 mm; n=97) in the molar region did not increase the risk of failure, with only 5 experiencing failure. Failures post-prosthetic loading were most common after about 3 years. This study confirms the long-term viability of RBM surface implants, with high survival rates when early failures are mitigated. Short implants and sinus lift procedures pose greater risks of failure, particularly in the early stages. However, simultaneous GBR and sinus procedures did not significantly impact long-term outcomes, affirming the safety and efficacy of these complex interventions.

Does alveolar ridge preservation reduce the need for sinus floor elevation: A comparative study to spontaneous healing.

In cases of atrophy in the maxillary posterior region, characterized by reduced vertical bone volume, implant placement becomes challenging. Augmentation procedures like sinus lifts are often needed to address insufficient bone volume. This study aims to explore if alveolar ridge preservation, using a bovine bone substitute and a porcine collagen membrane, significantly decreases the need for sinus lifts compared to natural wound healing after tooth extraction. In this comparative clinical study, 40 patients requiring a total of 53 extractions were assigned to one of the following groups: a test group with bovine bone substitute material (Straumann® XenoFlex) and a porcine collagen membrane (Jason® membrane), or a control group with spontaneous socket healing. After 6 months, digital volume tomography was performed for implant planning. For seven patients from the control group (n = 22 extracted sites) sinus lift augmentations were performed while only four sinus lift procedures were performed in the test group (n = 31 extracted sites), indicating a higher need for sinus augmentation procedures in the control group, however not statistically different on a p value of 0.05 (p = 0.168). In the control group, the mean value of the radiographically measured bone height (mesial and distal) was 11.13 ± 2.12 mm preoperatively before tooth extraction, while it was 11.3 ± 2.17 mm postoperatively after implant placement. In contrast, the mean value in the test group was 11.78 ± 3.09 mm preoperatively and 11.92 ± 2.79 mm postoperatively. Statistical analysis revealed no significant difference between the two groups (odds ratio 0.32; 95% CI: 0.08, 1.26; p = 0.951). The implant survival rate in the control group was 100%, compared to 96.77% in the test group. Within the limits of this study, the use of bovine bone substitute and a porcine resorbable membrane after tooth extraction in the posterior maxilla seems to reduce the need for sinus augmentation in comparison to spontaneous healing although the difference was not statistically significant. Additionally, the Alveolar Ridge Preservation in the test group made external sinus floor elevation unnecessary compared to the control group. The change in radiographically measured bone height pre- and postoperatively showed no significant difference between the two groups.

Sequential Bone Repair in Rabbit Sinus Lifts Using Bio-Oss and Hyaluronic Acid-Polynucleotide Gel (Regenfast).

A comprehensive investigation to associate the use of polynucleotides and hyaluronic acid with bovine bone in maxillary sinus lift procedures in rabbits has not been performed yet. The aim was to evaluate the influence of this novel association on the processes of bone regeneration in maxillary sinus augmentation. In this prospective, randomized, within-animal model, maxillary sinus augmentation was performed bilaterally in 12 rabbits. Deproteinized bovine bone material (DBBM) was used as filler material. A hyaluronic acid-polynucleotide gel was aggregated at the test site. Histological evaluations were performed after 2 and 10 weeks of healing. After 2 weeks of healing, similar amounts of new bone were observed at both the control (7.7 ± 4.3%) and test sites (8.1 ± 3.8%; p = 0.697). Bone formation was observed predominantly along the osteotomy margins and adjacent sinus walls. After 10 weeks of healing, the total new bone fraction reached 28.0 ± 10.1% at the control sites and 27.3 ± 10.5% at the test sites (p = 0.563). Multiple perforations of the sinus mucosa were observed in both groups when in contact with the biomaterial granules. The present study failed to demonstrate a positive effect on bone formation when incorporating hyaluronic acid-polynucleotide gel (Regenfast) into a xenograft for maxillary sinus augmentation. Additionally, the use of this gel did not mitigate the occurrence of thinned mucosa or reduce the risk of subsequent sinus mucosa perforation.

Aesthetic and Functional Outcomes of Simultaneous Rhinoplasty and Lip Lift Surgery: A Systematic Review.

Rhinoplasty and lip lift surgeries are pivotal procedures in facial aesthetics, addressing nose and lip enhancements, respectively. The concurrent execution of these surgeries has gained popularity for achieving improved facial balance and harmony. However, data on the outcomes of combined rhinoplasty and lip lift procedures remain limited. This study aims to evaluate the aesthetic outcomes, complications, and patient satisfaction of simultaneous rhinoplasty and lip lift surgeries. This systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive literature search across PubMed, Scopus, Medline, Science Direct, and Web of Science was performed, focusing on studies reporting simultaneous rhinoplasty and lip lift surgeries. The Newcastle-Ottawa Scale (NOS) was used to assess the risk of bias in the included studies. Data on aesthetic outcomes, complications, and patient satisfaction were extracted and synthesized. A total of six studies, encompassing 361 patients, were included. Results demonstrated high patient satisfaction, with favorable aesthetic outcomes such as improved nasolabial and frontonasal angles and shortened lip length. Minimal complications were reported, with mild scarring and temporary paraesthesia being the most common, both resolving within a few months. Functional outcomes were positive, with no long-term impairments in nasal airflow or lip function. Simultaneous rhinoplasty and lip lift surgeries yield high patient satisfaction and excellent aesthetic outcomes with minimal complications. The findings suggest this combined approach is safe and effective, particularly for patients seeking enhanced facial harmony. Future studies should focus on long-term outcomes and the optimization of surgical techniques.

Utilization of Text-to-Image Artificial Intelligence Model in Preoperative Counseling for Lip Lift Procedures

Summary: Text-to-image models powered by artificial intelligence (AI) offer a promising tool for enhancing patients' comprehension of cosmetic surgery outcomes and providing personalized visual forecasts of their appearance after the procedure. This study explores the efficacy of text-to-image AI models, specifically DALL·E2, in improving preoperative counseling for patients undergoing lip lift procedures. Preoperative photographs of four patients, who had given their consent, were processed using DALL·E2, which allows users to modify specific areas of an image and input text descriptions to visualize anticipated changes. We successfully demonstrated the ability of DALL·E2 to generate accurate visual predictions within a short timeframe of two minutes. Selected images provided realistic expectations of the postoperative appearance, aiding in better patient understanding and expectation management.

Evaluation of the Efficacy of the HaeNaem Zero Bone Loss Kit in Indirect Sinus Lift Using Osseodensification.

Aim The purpose of this study was to evaluate alveolar height at the antral floor following dental implant placement after an indirect sinus lift using osseodensification (OD) with the HaeNaem bur system. Materials and methods A total of 12 patients seeking implant rehabilitation in the maxillary posterior region were selected for the study. Preoperative cone beam CT (CBCT) was performed to measure the residual crestal bone height (RCBH). Patients with an RCBH of 6-8 mm were included in the study. The HaeNaem Zero Bone Loss bur kit was utilized to create an osteotomy site through OD, accompanied by a simultaneous indirect sinus lift. Postoperative CBCT was obtained after four months to assess the difference in bone height and implant stability following implant placement. Results In our study, we performed a comparison of the alveolar ridge height before and after the procedure among the study participants using a paired t-test. This analysis revealed statistically significant differences (p-value <0.01) between the measurements taken before and after the procedure, indicating that the intervention yields effective results. Conclusions Based on the results of this study, it can be inferred that the indirect sinus lift procedure utilizing the OD technique with the HaeNaem Zero Bone Loss bur kit presents an effective treatment alternative for cases with insufficient bone height in the posterior maxilla. This approach is particularly advantageous when considering the increased financial feasibility of treatment options or in situations where advanced and/or time-consuming complex surgeries are contraindicated.

The influence of suturing and or gluing of perforated Schneiderian membrane during sinuslift procedure on the outcome: a retrospective study

The sinus lift procedure has become the most common method for maxillary bone augmentation. The most frequently observed intraoperative complication is the perforation of the Schneiderian membrane. Various treatment options have been proposed for managing these perforations, including the use of resorbable membranes, centrifugated blood products as PRF, or PRGF, suturing, and fibrin glue application. While long-term studies exist for the use of resorbable membranes to close perforations, there is limited data on the long-term outcomes of suturing or gluing the perforated sinus membrane. The aim of this retrospective study is to evaluate the long-term outcomes of suturing and/or applying fibrin glue to repair perforated sinus mucosa during sinus floor elevation procedures. Between 2005 and 2009, a total of 692 patients underwent 923 sinus lift surgeries, and Schneiderian membrane perforation occurred in 202 sinus floor elevations (21.98%) across 168 patients. The main documented causes of perforations, which ranged from 2 to 10 mm in diameter, were the presence of septa, followed by thin and adherent membranes. Of the perforations, 100 (49.5%) were treated with microsurgical suturing combined with fibrin glue, 78 (38.6%) were treated with fibrin glue alone, and 24 (11.9%) were treated exclusively with suturing. Sinus grafting was performed using autogenous bone in combination with a biomaterial, following the layering technique. All surgeries resulted in primary healing without complications, enabling all patients to undergo restoration as planned. The long term clinical and radiological evaluations of 44 randomly selected patients who followed the recall program up to 10 years post operative confirmed the effectiveness of this treatment approach.

Neck Lift to Treat Platysma Bands and Defining Cervical Angle: A Systematic Review and Pooled Analysis.

Many surgical techniques have been proposed to address the submental-cervical angle in neck lift. Despite the several advances, obstacles persist when dealing with platysma bands and redefinition of the obtuse cervical angle. The aim of this study was to quantify platysma bands recurrence, any neurovascular damage, and other complications following neck lift procedures involving platysma muscle. After the approval and registration on the International Prospective Register of Systematic Reviews (PROSPERO), the systematic review was performed in accordance with the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A series of specific keywords and predefined MeSH terms were utilized in different search engines (Medline, PubMed, Google Scholar, and the Cochrane library databases). Primary outcome was the recurrence of platysma bands; secondary outcomes included any postoperative complications, including any nerve damage. Pooled analysis was performed using a random effects model. Twelve articles, encompassing 2,106 patients, were relevant to this issue and included data on neck lift surgery with any platysma transection outcomes. Twenty-six patients had a recurrence of platysma bands during the follow-up, with a pooled rate of 1.4%. The pooled overall nerve damage rate was 0.9%. At the reported follow-up, the pooled hematoma percentage was 1.8%, and the pooled sialoma rate was 0.3%. Even less common complications were long-lasting edema, dehiscence of the submental suspension, and skin necrosis. Cervicomental angle redefinition remains a controversial and complicated procedure, which can be approached with different maneuvers. However, more long-term outcome reports as well as standardized complication outcomes are warranted in order to compare different and new techniques. LEVEL OF EVIDENCE: III.

Evolving Techniques and Trends in Maxillary Sinus Lift Procedures in Implant Dentistry: A Review of Contemporary Advances.

The most challenging aspects of planning implant rehabilitation for the posterior maxillary region are the pneumatization of the maxillary sinus and the resorption of the residual alveolar ridge. To address the first aspect, there are two primary modalities for sinus augmentation: the direct or lateral window technique and the indirect or crestal technique. Clinicians must possess comprehensive knowledge of the maxillary sinus anatomy and be able to diagnose pathognomonic abnormalities through presurgical imaging and investigations. This skill is essential for performing technique-sensitive augmentation of the maxillary sinus with or without using biomaterials such as bone grafts, membranes, and platelet concentrates. These materials help create a suitable bone bed for either simultaneous or delayed implant placement through various traditional and evolving modified sinus augmentation techniques. It is also critical to effectively elevate the Schneiderian membrane during sinus floor elevation surgery, as complications in this process can adversely affect implant survival and potentially lead to implant failure. This review explores various aspects of maxillary sinus augmentation, ranging from traditional methods to evolving contemporary techniques, and draws on existing literature to examine their advantages, limitations, indications, and contraindications.

Analysis of bone quality formation in sinus lifts with immediate implants

Sinus lift surgeries are part of the daily practice of dentists. This study evaluates the long-term structure of the bone placed in sinus lifts through the fractal dimension. We conducted a retrospective study on a sample of 35 patients with 51 sinus lifts performed using a lateral window approach and filling material placement. We radiologically analyzed the graft bone to observe its evolution up to one and a half years after the surgical procedure. The obtained results were the average area of the sinuses analyzed was 1401.96 mm2, with a mean area occupied by the filling material of 297.75 mm2. Significant differences are observed when comparing the fractal dimension values obtained on the initial day and one year after prosthesis loading. Similarly, when comparing the values of the area occupied by the biomaterial at the start day and one year after prosthesis loading, significant differences are also obtained (p-value < 0.001). In conclusion, the filling material used in the lateral window sinus lift procedure undergoes significant resorption and shows changes in the fractal dimension.

Anatomical Considerations for Thread Lifting Procedure.

Thread lifting is a minimally invasive procedure that enhances facial aesthetics by repositioning sagging tissues with absorbable threads. It requires a comprehensive understanding of facial anatomy for safe and effective results. This study aims to highlight the critical anatomical considerations in thread lifting, including the navigation of facial vascular structures, the protection of facial nerves, manipulation of fat compartments, and engagement of retaining ligaments. These factors are essential for minimizing complications and achieving optimal outcomes. A review was conducted focusing on the anatomical elements critical to thread lifting. The study analyzed clinical outcomes related to vascular structures, nerve pathways, fat compartments, and ligaments in patients undergoing the procedure. The review revealed that careful navigation of facial blood vessels is crucial to avoid complications such as bleeding and bruising. Knowledge of facial nerve pathways is essential to prevent nerve damage, which could result in facial weakness or paralysis. Proper manipulation of facial fat compartments helps address aging-related changes, and engaging retaining ligaments is vital for a sustainable lift without tissue distortion. Thread lifting demands not only technical skill but also a deep understanding of facial anatomy to ensure patient safety and desired aesthetic results. Expertise in these anatomical considerations is essential for minimizing complications and preserving the natural function of facial structures.

On The Use of a Sticky Bone Substitute in the Presence of a Ruptured Schneider Membrane During Sinus Lift Procedures - An Experimental Within-Rabbit Study.

To assess the efficacy and safety of a sticky dual-phase porcine-derived bone substitute, compared to a similar non-adhesive graft, in addressing induced perforations of the Schneider membrane during sinus lift using a within-subject design rabbit model. Bilateral sinus floor elevations were performed in 12 rabbits. The sinus mucosa was intentionally perforated using a blade on both sides and randomly filled with either a cortico-cancellous bone embedded in a 20% thermosensitive gel (GTO sticky bone test) or a cortical cancellous bone and 10% collagen (mp3 control). Healing progress was evaluated after 2 and 10 weeks in 6 animals at each time-point, with cone-beam computed tomography (CBCT), micro-computed tomography (microCT) and histological assessments. One animal of the 2-week group died but was substituted. No other complications were observed. At 2-week, on CBCTs, biomaterials particles were observed in the vicinity of the Schneider membrane in two out of six sinuses of each group, but never dispersed into the sinus. MicroCT and histology consistently revealed few granules beyond the elevated region. Histologically, five sinuses in the mp3 group and two sinuses in the GTO group exhibited granules outside the elevated region but in the vicinity of the perforations. In the 10-week groups, the number of affected sinuses decreased to one in the mp3 group and two in the GTO group. Throughout all observations, the graft granules consistently resided proximate to the elevated region. Micro-CT demonstrated a reduction in the volume of the elevated region by approximately 12% after 2 weeks and 50-54% after 10 weeks. The use of both sticky and non-sticky bone substitutes seems to prevent a substantial amount of particles from extruding through an induced perforation of the Schneiderian membrane. This suggests that it could be possible to use a sticky bone as an alternative to a barrier membrane to avoid the extrusion of bone granules in the presence of accidental perforation of the sinus membrane in clinical practice. After 10 weeks of healing, the volume of the elevated region decreased by approximately 50%, possibly due to biomaterial resorption and loss through the surgically created perforation.