Residual Alveolar Ridge Height Research Articles

Anatomical Factors Affecting the Complexity of Maxillary Sinus Augmentation in Saudi Patients: A Cone Beam Computed Tomography (CBCT) Study.

This study aims to evaluate the anatomical variations of the maxillary sinus and determine the difficulty score of maxillary sinus augmentation (MSA) in Saudi patients seeking dental implant rehabilitation of the posterior maxilla using cone beam computed tomography (CBCT). CBCT records of dental patients seeking treatment at a University Dental Teaching Hospital between 2019 and 2023 were retrospectively analyzed. Measurements were obtained from CBCT images, including membrane thickness, sinus width, buccal bone thickness, presence of maxillary sinus septa, residual alveolar ridge height, angle of the buccolingual sinus wall, and the presence of the alveolar antral artery (AAA). The difficulty score for MSA was determined based on these anatomical factors. A total of 107 maxillary sinuses in 86 subjects were evaluated. The average membrane thickness was 2.23 mm, with males showing significantly higher thickness than females. Sinus septa were found in 54 (50.5%) sinuses, with 18 (17%) of sinuses having interfering septa. Twenty-three (21.5%) sinuses had a residual alveolar ridge height of less than 4 mm. The average angle of the buccolingual sinus wall was 79.39°, indicating a high prevalence of wide-shaped sinuses. The average sinus width was 14.09 mm, with 55 sinuses (51.4%) less than 15 mm. The average buccal bone thickness was 1.07 mm, in29 (27%) sinuses, the thickness was more than 2 mm. AAA was visualized in 60 (56%) of sinuses, with 45 (42%) of sinuses having AAA interfering with the MSA window. In this study, most sinuses were classified as simple or moderate difficulty, with higher membrane thickness, presence of septa, and AAA being the significant risk factors for complications. These findings provide valuable insights for implant surgeons in Saudi patients seeking dental implant rehabilitation of the posterior maxilla, enabling them to anticipate and minimize potential complications during MSA procedures.

The impact of antiplatelet and anticoagulant medications on early implant failure following sinus floor augmentation: A retrospective cohort analysis.

The effect of antiplatelet and anticoagulant medications on the outcomes of sinus floor augmentation remains unclear. This retrospective cohort study analyzed data from electronic medical records of consecutive patients undergoing sinus floor augmentation at a single medical center. Patients were categorized into three categories: patients under antiplatelet medications, patients under anticoagulation medications, and healthy individuals. Data collected included tobacco smoking, residual alveolar bone height, timing of implant placement, materials used, vertical bone gain, early implant failure (EIF), and complications such as Schneiderian membrane perforation and postoperative bleeding. Multivariable analysis was performed to assess risk factors for EIF. Statistical significance was considered below 5%. Among 110 patients with 305 implants, EIF occurred in 10% of patients and 4.65% of implants. No significant difference in postoperative bleeding or EIF was found between study groups. Univariate and multivariable analyses highlighted tobacco smoking (odds ratio [OR] = 7.92), lower residual alveolar ridge height (OR = 0.81), and staged implant placement (OR = 4.64) as significant EIF risk factors in this cohort. Anticoagulant and antiplatelet therapies do not significantly elevate the risk of EIF or postoperative bleeding following sinus floor augmentation. Tobacco smoking, residual alveolar ridge height and staged sinus floor augmentation were risk factors for EIF in patients using antiplatelet or anticoagulation medications undergoing sinus floor augmentation.

Comparison between Platelet-rich Fibrin and Saline Filling after Sinus Elevation without Adjunctive Bone Graft in Dental Implants Insertion Using CBCT.

The goal of this research was to compare radiographically the outcomes of hydraulic transcrestal sinus lifting with platelet-rich fibrin (PRF) or normal saline filling on implant survival rates, negative outcomes, and variations in the height of residual alveolar ridge (HARB). There were 80 study participants included and 90 dental implants were placed. The study participants were divided into two categories: Category A and Category B. Each category consists of 40 study participants. Category A: Normal saline was placed in the maxillary sinus. Category B: PRF was placed in the maxillary sinus. Implant survival, complications, and HARB alterations were the outcome metrics. Radiographic images through Cone-beam computed tomography (CBCT) were retrieved and compared prior to surgery (T0), immediately following surgery (T1), three months later (T2), 6 months later (T3), and 12 months later (T4). There are 90 implants having an average length of 10.5 ± 0.7 mm were inserted into the posterior portion of the maxilla of 80 patients with an average HARB of 6.9 ± 1.2 mm. At T1, elevation in HARB peaked, and the sinus membrane continued to droop but steadied while observed at T3. The steady increment of areas of radiopacities was noticed below the elevated membrane of the maxillary antrum. A radiographic intrasinus bone increase of 2.9 ± 1.4 mm was caused by the PRF filling, compared to 1.8 ± 1.1 mm by the saline filling at T4 (p < 0.05). Over the course of the one-year follow-up period, all of the implants were operating normally with no major issues. Platelet-rich fibrin when used as a filling medium alone without bone graft can cause significant ascend in height of the residual alveolar bone (HRAB). The degradation of the alveolar bone under the maxillary sinus following tooth loss frequently restricts the placement of the implant in the edentulous region of posterior maxilla. Numerous sinus-lifting surgery procedures and tools have been developed to address these problems. It has been a topic of debate regarding the benefits of bone grafts placed at the apical region of the implant. The sharp protrusions of the granules of bone graft may also provide a danger of membrane puncture. Recently, it was shown that regular bone gain might occur inside the maxillary antrum without the use of any bone transplant material. Additionally, if there were substances that filled the gap between the floor of the sinus and the raised sinus membrane, then the membrane of the maxillary sinus could be raised greater and for a longer period of time during the phase of formation of new bone formation.

Clinical evaluations of alveolar ridge preservation in compromised extraction sockets with cortical-lamina anchoring technique: Case series study.

The objective of this study is to retrospectively evaluate the clinical outcomes of alveolar ridge preservation (ARP) in the compromised extraction sockets using autogenous cortical-lamina anchoring technique (CAT). Twenty patients were treated with ARP in the compromised extraction sockets by applying CAT. Then implant placement and crown delivery was performed. A planned follow-up was performed by analyzing various outcome measures to evaluate the clinical outcomes, including primary outcome measures [radiographic assessment of residual alveolar ridge height (RARH) and residual alveolar ridge width (RARW)] and secondary outcome measures [clinical assessment of the healing of the soft and hard tissue, survival rates of implants, marginal bone loss (MBL) evaluation of implants, buccal bone thickness (BBT), and esthetic treatment outcomes]. Among the 20 patients, 17 were consecutively treated and 3 dropped out after implant crown delivery because of loss to follow-up. After the ARP, the initial RARH (12.37 mm) significantly increased to 19.29 mm (P < .05). No significant difference was detected in the RARW before (7.92 ± 1.18 mm) and after (7.92 ± 1.18 mm) the ARP, but reduce to 6.99 ± 1.18 mm at the implant placement and 6.64 ± 0.77 mm at the 3-year follow-up (P < .05). The MBL at the implant crown delivery (0.13 ± 0.12 mm) significantly increased to 0.31 ± 0.14 mm at 1-year follow-up and 0.56 ± 0.23 mm at 3-year follow-up, respectively. The bone loss was limited (<1 mm) but statistically significant (P < .05). The BBT at the implant placement (2.53 ± 0.56 mm) significantly reduced to 2.23 ± 0.44 mm at implant crown delivery and 2.14 ± 0.40 mm at 3-year follow-up, respectively. The bone loss was also limited (<0.5 mm) but statistically significant (P < .05). Each implant site showed acceptable aesthetic outcome and the average score was 16.4. The incisions healed uneventful in all patients and the implant survival rate was 100% during the 3-year follow-up. Autogenous CAT was successfully applied to preserve the height and width of alveolar ridge in the compromised extraction sockets.

Outcomes Following Hydraulic Pressure Indirect Sinus Lift in Cases of Simultaneous Implant Placement With Platelet-Rich Fibrin.

BackgroundTo achieve a better long-term prognosis in the posterior maxilla with poor quality of bone, the sinus lift must ensure bone regeneration till the apex of the dental implant for osseointegration. An indirect sinus lift is a minimally invasive procedure where simultaneous bone condensation is achieved. During the sinus lift procedures, different graft materials are used to gain the height of the bone in the sinus. The present study aimed to evaluate the outcomes of indirect sinus lift with hydraulic pressure and the simultaneous placement of implant using platelet-rich fibrin (PRF).MethodologyIn total, 24 subjects aged 18-74 years with missing maxillary premolars and first and second molars who opted for dental implants placed with indirect sinus lift with hydraulic pressure and had low sinus with less residual ridge height, bone density, and bone height were assessed at one day, one week, one month, three months, and six months.ResultsThe average mean height preoperatively was 5.573 ± 0.66 mm which showed a significant increase postoperatively to 9.603 ± 0.78 mm (p < 0.001). Mean sinus membrane lift was 4.8 ± 2.2 mm at six months. The implant stability quotient increased significantly at six months postoperatively from 69.07 ± 3.39 at the immediate postoperative time to 72.92 ± 2.714 at six months postoperatively (p < 0.001).ConclusionsThe current study suggests that minimally invasive indirect sinus lift with bone augmentation utilizing PRF increased residual alveolar ridge height and implant stability with fewer problems than previous sinus lift procedures in the posterior maxillary area.

Relationship of Maxillary Sinus Mucosal Thickening and Residual Alveolar Ridge Height: A CBCT Analysis

Objectives: Maxillary sinus pathological conditions, like thickening of the Schneiderian membrane, can influence the outcomes of augmentation procedures and implant treatment. The present study aimed to evaluate the relationship between the residual ridge height and maxillary sinus membrane thickening. Materials and Methods: A total of 240 cone-beam computed tomography (CBCT) images of the maxillary sinus of 141 patients (62.1% males and 37.9% females, bilateral in 99 patients and unilateral in 42 patients) who were candidates for implant placement were evaluated. The CBCT scans were subsequently assessed for the following variables: residual ridge height, sinus membrane thickening at future implant(s) site(s), the ostium patency, and presence of periapical lesion adjacent to the edentulous area. Results: The total prevalence of sinus membrane thickening (66.2%) was sub-classified as follows: flat in 53.7%, polypoid in 12.1%, and complete opacification in 0.4%. The prevalence of sinus membrane thickening was higher in male participants. It was revealed that age had no significant relationship with presence of a periapical lesion or sinus membrane thickening (P>0.05). Membrane thickening was detected in all sinuses with obstructed ostium. Reduced residual ridge height was significantly associated with higher sinus membrane thickening at the second premolar and first molar sites (P<0.05). Conclusion: Maxillary sinus membrane thickening (mostly with flat appearance) is frequently observed on CBCT scans taken prior to augmentation and implant placement. This, in return, may trigger a reduction in ridge height.

Direct Sinus Augmentation Procedure for Rehabilitation of Severely Atrophic Posterior Maxilla with Sticky Bone – A Case Report

Aim: Rehabilitation of atrophic maxilla using sticky bone and simultaneous implant placement.&#x0D; Presentation of Cases: Sinus augmentation along with simultaneous implant placement prevents the additional surgery. This often benefits both the patient and the dentist. This case report highlights the sinus augmentation procedure for rehabilitation of a severely atrophic posterior maxilla using Sticky bone, a combination of Xenograft and Platelet rich fibrin with simultaneous dental implant placement.&#x0D; Discussion: Pneumatization of posterior maxilla often complicates dental implant surgery. Various sinus lift surgical procedures have been developed over the years, to increase residual alveolar ridge height. Implant placement is made easier by enhancing the posterior maxilla by various sinus augmentation procedure&#x0D; Conclusion: Direct sinus augmentation procedure using sticky bone for rehabilitation of severely atrophic posterior maxilla with simultaneous implant placement provides a reliable and predictable outcome.

Impacto de la tomografía computarizada de haz cónico en el diagnóstico y plan de tratamiento preimplantologico de senos maxilares

Objective: To determine the impact of CBCT on diagnostic evaluation and treatment plan for the maxillary sinus in dental implant planning. Material and Methods: Diagnostic evaluation and treatment plan for the maxillary sinus were evaluated by eight specialists experienced in dental implant placement. Eight panoramic radiographs (PAN) and CBCT examinations were obtained from five adult patients with a specific clinical need for dental implants. Evaluation was performed first on PAN then, at least 2 weeks later, on CBCT. Residual alveolar ridge height, mucosal thickening, radiographic findings and treatment plan were recorded. The confidence level was evaluated for both diagnostic evaluation and treatment plan. The kappa statistic for intra-observer reproducibility and McNemar test were performed. Results: In the diagnostic evaluation, CBCT showed significant impact on the diagnosis of radiographic findings. Availability of CBCT significantly changed the treatment plan, for less invasive treatment, or no treatment need. Observers had significantly greater confidence when using CBCT than PAN, when indicating presence of mucosal thickening and radiographic findings in the maxillary sinus. In addition, CBCT increased confidence in the treatment plan. Conclusion: The present study suggests that CBCT has an impact on the diagnostic evaluation of radiographic findings in the maxillary sinus and on the decision to place implants, owing to misdiagnosis of pathology and planning of more invasive treatments when using PAN. Availability of CBCT also improves clinician confidence. Further studies at higher levels of diagnostic efficacy should be performed, to justify the use of CBCT, by evaluating the actual treatment performed and its outcome.

The Effect of Nano-hybrid Composite Resin Denture Teeth on Mandibular Residual Ridge

Introduction:Progressive ridge resorption is one of the main causes of loss of stability and retention of mandibular complete dentures with subsequent loss of masticatory efficiency and patient discomfort. Aim: This study was conducted to evaluate radiographically the effect of nano-hybrid composite resin teeth on mandibular residual ridge using cone beam computerized tomography (CBCT). A comparative study. Materials and Methods: Twelve completely edentulous male patients were randomly divided into two groups according to the artificial tooth material used in complete denture construction. One group received complete dentures with nano-hybrid composite resin teeth and the other group received complete dentures with cross-linked acrylic resin teeth. CBCT was taken at the delivery, 6 months and 12 months follow -up appointments. The evaluation was done for height and width changes of the mandibular residual alveolar ridge at different anatomical sites either in the anterior or posterior part of the mandible. Results: Analysis was done by using two-tailed t-test revealed that increase in amount of bone loss in both groups which is in favor to patients wearing dentures with nano-hybrid composite resin teeth, with no statistically significant difference between the two groups. Conclusion: Despite of introduction of new denture tooth material as nano-hybrid composite resin teeth, the cross-linked acrylic resin teeth still considered the gold standard denture teeth regarding the degree of occlusal force transmission and preservation of residual alveolar ridge.

Long-term crestal bone changes in implants placed in augmented sinuses with minimal or moderate remaining alveolar bone: A 10-year retrospective case-series study.

To evaluate long-term clinical and radiographic outcomes of dental implants placed after lateral window sinus augmentation utilizing the sagittal sandwich technique. Patients treated with sinus augmentation were included in this retrospective case-series study. The surgical procedure was performed with particulate autogenous bone- and anorganic bovine bone-derived mineral (3:7 ratio). Implants were grouped based on baseline residual alveolar ridge height: group S (residual alveolar ridge height of 0.1-3.5mm), group M (height of 3.5-7mm), and group C (native bone). Radiographs were taken at baseline (abutment installation) and annually throughout the 10-year follow-up. A total of 86 patients (92 sinus lifts) and 209 implants were included. Ten sinus membrane perforations were recorded (11% incidence), and graft infections occurred in 3 cases (3.2% incidence). During the 10-year follow-up, 3 implants (1.4%) failed. No significant differences in the mean implant marginal bone loss (MBL) between the three groups were found after 1-, 2-, and 5-year follow-up (p>.05). At 10years, group C exhibited more MBL than group M with a mean difference of -0.53mm (p=.01). After 10years, MK III implants displayed significantly more bone loss in native bone than those in augmented bone with a mean difference of 0.48mm (p=.02). Five patients and 7 implants developed peri-implantitis with no significant differences between the groups (p=.570). Implant placement after two-stage sinus grafting utilizing the sagittal sandwich technique is a relatively safe and predictable procedure with minimal complications and MBL after 10-year follow-up.

Evaluation of bone regeneration for augmentation of alveolar bone using 3D computer guided ceramic Sheets.

Background: This study was designed to evaluate bone augmentation of posterior alveolar mandibular ridge using 3D computer guided ceramic Sheets as a membrane in GBR . Methods: Seven patients were included in the present study. Preoperative clinical evaluation, and CBCT scan for ridge evaluation and planning, all patient clinically suffering from severed resorbed posterior alveolar ridge of the mandible. Measuring height and width of right and left residual alveolar ridge was performed in CBCT software viewer base on this digital model 3D zirconia sheet was designed and plan on patient CBCT then milled on CAD/ CAM 5 axis machine to the desired macroscopic shape. After surgery, clinical evaluations were done at intervals of 2 weeks, first month, 3rd and 6th month and directed toward the observation of the healing process, sings of inflammation, infection soft tissue dehiscence, Zr exposure or any complications of wound. 2nd surgical intervention to remove the screws and Zr sheet and CBCT evaluation to measuring alveolar ridge on both sides. Results: Results of the current showing that customized Zr sheet can use successfully to obtain vertical and horizontal bone augmentation well compatible with soft tissue without exposure. Conclusion: Customized Zr sheet act as a perfect barrier and space maintaining in GBR procedures with precise fit. Good soft tissue acceptance to Zirconia. Customized Zr sheet reduce chairing time and amount of graft. More predictable results can obtained by using xenograft under Zr sheet.

Histomorphometrical Assessment of Sinus Augmentation Using Allograft (Particles or Block) and Simultaneous Implant Placement

The aim of the present study was to compare the clinical, radiological and histomorphometrical outcome of simultaneous implant placement following augmentation of atrophic maxillary sinuses using allograft (block or particles). Consecutive patients with maxillary residual alveolar ridge height ≤3 mm, scheduled for sinus floor augmentation with simultaneous implant placement, were randomly included. Allograft bone-block or bone-particles served as grafting material. Simultaneously, dental implants were inserted. Biopsies were taken at second stage surgery (after 9 months) for histomorphometric evaluation. Initially 38 sinus augmentations (29 individuals) were allocated for the study. In 4 out of 21(19%) sinuses using particles it was impossible to stabilize the implants and a second stage insertion was preferred, leaving 34 sinuses for histomorphometric evaluation. The difference in the ability to perform simultaneous implant placement was statistically significant (p < 0.05). Ninety implants were inserted simultaneously. All implants osseointegrated. None of the implants was lost up to the end of follow-up time (Range 50–120 months, Mean 74.5 ± 13.5 months). Bone gain radiographically 12.3 ± 1 mm vs. 11.2 ± 1 mm (block vs. particles respectively) and new bone formation histomorphometrically 27.7 ± 15% vs. 32.1 ± 19% (block vs. particles respectively) showed no statistically significant differences between the two groups. Sinus augmentation using allograft (particles or block) and simultaneous implant placement is predictable. All outcome parameters are similar when sinus bone-blocks augmentation is compared to bone-particles augmentation (radiological new bone gain, implant survival, hisomorphometricly new bone formation) despite the ability to stabilize implants, when placed simultaneously with sinus augmentation. Blocks may be advisable when simultaneous implant placement is imperative in cases with residual alveolar bone height ≤3 mm.

Sinus Augmentation with Simultaneous, Non-Submerged, Implant Placement Using a Minimally Invasive Hydraulic Technique.

Background and objectives: To evaluate whether sinus augmentation, using a minimally invasive implant device, via a non-submerged surgical approach, might negatively influence the outcome. Materials and Methods: A retrospective cohort study was conducted by evaluating patients’ files, classifying them into two groups. Fifty patients (22 men 28 women) were included in the study, 25 in each group. The use of an implant device based on residual alveolar ridge height for sinus augmentation, radiographic evaluation, insertion torque, membrane perforation, post-operative healing, and a minimum of 12 months follow-up were evaluated. Results: The mean residual alveolar ridge height was 5.4 mm for the non-submerged group and 4.2 mm for the submerged group. There were no intraoperative or postoperative complications (including membrane perforations). The mean insertion torque was 45 N/cm for the study group and 20 N/cm for the control group. Complete soft tissue healing was observed within three weeks. Mean bone gain height was 8 mm for the study and 9.3 mm for the control group. All implants osseointegrated after 6–9 months of healing time. Mean follow-up was 17.5 months, range 12–36 months. Marginal bone loss at last follow-up was not statistically significantly different: 1 mm in the non-submerged vs. 1.2 mm in the submerged group. Conclusions: Submerged and non-submerged healing following maxillary sinus augmentation was comparable provided residual alveolar ridge height >5 mm and insertion torque >25 N/cm.

Sinus lift procedures in dental implants: A literature review on techniques, recommendations, and complications

Posterior atrophic maxilla with pneumatized sinus often challenges dental implant surgery. Sinus lift in order to augment the residual alveolar ridge height resulted in various sinus lift surgical techniques. Sinus augmentation in atrophic maxilla transforms the atrophic posterior maxilla to a favorable place for implant placement. Additional surgery of sinus lift during implant placement becomes a difficult decision for both dentist and patient. This literature search focuses on many valuable articles that support evidence on the treatment options and predictable increase in bone height after sinus lift procedure. This literature review explains on the classification of posterior atropic maxilla and its treatment options, sinus lift techniques, recommendations, complications, and a precise discussion that supports this procedure.

The Feasibility of Flapless Approach to Sinus Augmentation Using an Implant Device Designed According to Residual Alveolar Ridge Height.

Hydraulic sinus lift and augmentation may be successfully performed using a dedicated implant device designed according to residual bone height (RBH). The aim of this study was to evaluate whether a flapless surgical approach might negatively influence the outcome. A total of 40 consecutive patients (16 men and 24 women) were included in the study, 20 in each group (minimal flap/control versus flapless/study). Inclusion criteria were ≥ 3 mm RBH, ≥ 6 mm width of the residual alveolar ridge according to preoperative cone beam computerized tomography, and ≥ 8 mm buccopalatal keratinized gingiva for the flapless group. Primary outcome parameters included intraoperative membrane perforation. Secondary outcome parameters included postoperative infection, soft tissue healing, bone gain, and short-term dental implant survival. Mean RBH was 4.6 mm. No intraoperative membrane perforations and no postoperative infections were observed. Mean bone gain height was similar for both groups, at 11 mm. Soft tissue healing was observed within 2 months. In all cases, second-stage surgery allowed generation of at least 2 mm of keratinized gingiva buccally. All implants were osseointegrated at second-stage surgery. The use of a flapless approach to maxillary sinus augmentation using an implant device based on RBH yields predictable results.

Morphometric analysis of sinus depth in the posterior maxilla and proposal of a novel classification

The aim of this study was to analyse the posterior maxillary sinus based on its extension into the alveolar process and to provide a simple clinical classification. A retrospective cohort study was conducted in CT scans of 200 dentate and 200 edentulous patients (100 women and 100 men, respectively). After manual placement of 12 reference points morphometric analysis was performed and sinus depth, residual alveolar ridge height (RH) and the sinus opening angle were calculated. Sinuses were classified according to the quartiles of sinus depth: class I (above the hard palate), class II (0–6 mm below the hard palate) and class III (>6 mm below the hard palate). Sinus depth was found to be a reliable anatomical landmark and did not vary significantly between gender (p = 0.8940) or dentition groups (p = 0.9723). Alveolar height varied significantly between sinus classes (p < 2 × 10−16) and dentition groups (p < 2 × 10−16) but not between genders (p = 0.5178). The sinus opening angle was significantly different between sinus classes (p < 2.2 × 10−16) but not between gender or dentition groups. We propose a novel classification built upon the quartiles of sinus depth, dividing the sinuses into three classes. Our classification is the first one that represents the anatomy of the patient independent of gender and dentition.

Minimally Invasive Sinus Augmentation Procedure Using a Dedicated Hydraulic Sinus Lift Implant Device: A Prospective Case Series Study on Clinical, Radiologic, and Patient-Centered Outcomes.

The aim of this study was to evaluate clinical and radiologic outcomes of a novel device that allows simultaneous hydraulic sinus membrane elevation, bone grafting, and implant placement. A sample of 18 consecutive participants with severe atrophy of the posterior maxilla underwent transcrestal elevation of the sinus membrane and implant placement. At the 6-month follow-up, the following parameters were assessed: implant success, any complications, marginal bone loss (MBL), three-dimensional (3D) graft measurements, implant stability quotient (ISQ), and graft density. No implants failed during follow-up (10.8 ± 2.8 months; range: 7-14 months). No membrane tears or other adverse events were observed. Mean residual alveolar ridge height was 4.78 ± 0.88 mm. Six months after the procedure, the mean MBL was 0.18 mm. The mean sinus membrane elevation was 12.78 ± 2.18 mm (range: 10.7-14.23). Along the basic 3D reference planes, the dimensions of grafted bone measured around implants were as follows: axial area = 239.7 ± 57.68 mm2; sagittal area = 257.0 ± 60.83 mm2; coronal area = 143.3 ± 29.46 mm2. The mean volume of the graft was 2.38 ± 0.26 mL at baseline and 2.05 ± 0.24 mL 6 months after graft maturation (difference: 0.33 ± 0.29 mL, P = .0090). Graft density (in Hounsfield units [HU]), improved during healing from 322.0 ± 100.42 HU to 1,062.0 ± 293.7 HU; difference 740.0 ± 295.35 HU (P = .0001). The mean ISQ value was 65.5 at implant placement, and it increased to 74.1 at the 6-month examination (P = .0014). Of 18 patients, 12 experienced no pain (66.6%) and 10 experienced no swelling (55.5%). No severe pain or swelling was reported in any of the cases. The mean number of analgesic tablets consumed was 0.78 ± 0.67. Mean surgical time was 24.0 ± 4.07 minutes. The iRaise Sinus Lift System may provide a new option for minimally invasive transcrestal sinus surgery with minimal patient discomfort. A physiologic contraction of 13.9% of its original volume was experienced during healing. Long-term clinical studies are needed to confirm these preliminary results.

A novel implant system dedicate to hydraulic Schneiderian membrane elevation and simultaneously bone graft augmentation: An up-to 45months retrospective clinical study.

To evaluate clinical and radiographic performance of a novel implant system that allows for hydraulic Schneiderian membrane elevation and simultaneously bone graft augmentation. Sixty-two consecutive patients with a mean age of 53.1 years and a severe atrophy of the posterior maxilla (3.0to 7.0mm) underwent 64 transcrestal sinus floor elevations and submerged implant placement. The following clinical and radiographic parameters were assessed: implant failure, any complications and bone gain measured using cone beam computed tomography. No patient dropped out. No implants failed and all the prostheses were uneventful at the last follow-up examination (mean 23.0 months; range 12-45). All the procedures were completed successfully, with elevation of the sinus membrane and insertion of bone graft and the dental implant at the planned site. No intraoperative or postoperative adverse events were observed, such as membrane tears or facial hematoma. The mean residual alveolar ridge height was 5.2±1mm (range 3.3-7.0mm). Mean bone gain was 10.9±2.43mm (range 5.3-16.5) after an average healing period of 8 months. Hydraulic elevation of the Schneiderian membrane using the iRaise sinus-lift system (Maxillent Ltd) can be considered a valuable treatment option for the rehabilitation of atrophic edentulous posterior maxillae.

Minimally Invasive Sinus Lift Implant Device: A Multicenter Safety and Efficacy Trial Preliminary Results

In cases of advanced maxillary sinus atrophy of the bone (pneumatization), the sinus floor has to be augmented in order to obtain acceptable bone volume for implantation. The objective of the present study is to evaluate a new procedure and device, designed as a closed sinus lift using a dedicated dental implant that allows for Schneiderian membrane elevation and the placement of a flowable bone replacement graft. Eighteen patients (8 males, 10 females) underwent 23 procedures. All procedures were completed successfully, with elevation of the sinus membrane and insertion of bone graft and the dental implant at the planned site. No membrane tears were noted. No intraoperative or postoperative adverse events were observed in any of the cases. There were no postprocedural emergency or distress calls. The patients' average age was 52 (range 38-72). The mean residual alveolar ridge height was 5.5 mm (range 4.0-7.0). The average bone gain was 11.2 mm (range 9-13) after an average healing period of 8.7 months (range 6.7-13.1). All implants achieved clinical stability and prosthetic rehabilitation was uneventful. A closed sinus floor elevation procedure can be accomplished using a dedicated dental implant that allows for hydraulic elevation of the Schneiderian membrane and placement of a flowable bone replacement graft and dental implant placement all at the same time with minimal patient discomfort.

Radiographic evaluation of alveolar ridge heights of dentate and edentulous patients

To evaluate the reduction of residual alveolar ridge height on panoramic radiographs and the differences between denture wearers and non-denture wearers. The study consisted of 147 individuals (74 men and 73 women) [50 were denture wearers and 50 non-denture wearers (examination groups) and 47 of them were dentate (control group)]. Individuals having diseases impacting on bone were excluded. Vertical measurements were made at 15 sites (central incisors, first premolars and molars at the left and right of both jaws and the distance between the zygoma/orbit). MANOVA (multi-variate analysis of variation) was used for the statistical analysis of the results. There were significant differences between the alveolar ridge heights of dentate and edentulous groups (p < 0.001). Between the denture wearer and the non-denture wearer groups, there was significant difference in the lower jaw (p < 0.001), but no significant difference in the upper jaw (p = 0.635). There were also differences between men and women (p < 0.005) and upper and lower jaws at every measurement sites (p < 0.01). Reduction in residual alveolar ridge height was in close relation with gender, denture usage and edentulousness.