Sinus Augmentation Research Articles

Residual Bone Height and New Bone Formation after Maxillary Sinus Augmentation Procedure Using Biomaterials: A Network Meta-Analysis of Clinical Trials.

Different factors may affect new bone formation following maxillary sinus floor augmentation for the rehabilitation of posterior edentulous maxilla. The purpose of this study was to determine the influence of residual bone height (RBH) on new bone formation after lateral sinus augmentation utilizing different biomaterials, through a network meta-analysis (NMA). PUBMED, Scopus, and Web of Science electronic databases were searched until 31 December 2022 to obtain relevant articles. A hand search was also conducted. Randomised controlled studies on maxillary sinus augmentation comparing different grafting materials in patients with atrophic posterior maxilla, in need of prosthetic rehabilitation, were included. The risk of bias was assessed following the guidelines of the Cochrane Collaboration. The primary outcome was new bone formation (NBF), assessed histomorphometrically. The statistical analysis was performed by splitting the data according to RBH (<4 mm and ≥4 mm). A total of 67 studies were eligible for conducting NMA. Overall, in the included studies, 1955 patients were treated and 2405 sinus augmentation procedures were performed. The biomaterials used were grouped into: autogenous bone (Auto), xenografts (XG), allografts (AG), alloplasts (AP), bioactive agents (Bio), hyaluronic acid (HA), and combinations of these. An inconsistency factor (IF) seen in the entire loop of the XG, AP, and Bio+AP was found to be statistically significant. The highest-ranked biomaterials for the <4 mm RBH outcome were XG+AG, XG+AP, and Auto. Similarly, the surface under the cumulative ranking curve (SUCRA) of biomaterials for ≥4 mm RBH was Auto, Bio+XG, and XG+Auto. There is no grafting biomaterial that is consistently performing better than others. The performance of the materials in terms of NBF may depend on the RBH. While choosing a biomaterial, practitioners should consider both patient-specific aspects and sinus clinical characteristics.

Clinical and Radiological Evaluation of a Self-Condensing Bone Implant in One-Stage Sinus Augmentation: A 3-Year Follow-Up Retrospective Study.

Stabilization of dental implants in the sinus region with a bone height below 4 mm gen-erally requires a two-stage sinus floor elevation surgery. To improve this aspect, the aim of this retrospective study was to demonstrate the feasibility of performing a one-stage maxillary sinus augmentation using an innovative self-condensing implant design, even in case of a bone height close to 2 mm. Clinical and radiological outcomes from 54 patients (26 females; 28 males; 69 total implants positioned) were analyzed 3 years post-surgery. The three-dimensional grafts change was evaluated by Cone-Beam Computed Tomography (CBCT) before surgery (T0), immediately after surgery (T1), and 1-year post-surgery (T2). The sinus floor levels measured at the medial (M-W), middle (MD-W), and lateral (L-W) walls reported: M-W of 1.9 ± 2.4 mm (T1) and 1.7 ± 2.6 mm (T2); MD-W of -0.1 ± 2.7 mm (T1) and 0.7 ± 2.4 mm (T2); L-W of 3.1 ± 3.0 mm (T1) and 3.1 ± 3.0 mm (T2); besides a bone crest height (C-F) of 4.6 ± 2.0 mm (T1) and 12.1 ± 1.4 mm (T2). Moreover, after 3 years only 1 implant was lost, and so an implant survival rate of 98.55% was recorded. In conclusion, these results suggest the efficacy of using this implant design for a one-stage sinus lift approach, not only in terms of increased implant survival rate and decreased marginal bone loss, but also for its potential applicability in case of reduced bone height.

A Randomized Clinical Trial Comparing Implants Placed in Two Different Biomaterials Used for Maxillary Sinus Augmentation.

The objective of this study was to compare marginal bone loss, surgical and clinical complications, and dental implant survival rate in bilateral maxillary sinus augmented by autologous or porcine xenograft. A randomized controlled clinical trial using split-mouth design enrolled 12 consent adult patients (59.7 ± 8.7 years), who received bilateral maxillary sinus floor augmentation for oral rehabilitation with implant-supported prosthesis. Each patient received both the autologous bone from the mandible (control) or porcine xenograft (test) during the random bilateral sinus lift surgery. A total of 39 dental implants were placed in the posterior maxilla of the 12 patients after 6 months, being rehabilitated after the respective osseointegration period. Both graft materials demonstrated a high implant survival rate at 12 months: 95% for the xenograft side, only 1 implant without osseointegration, and 100% for the autologous side. Radiographic bone loss was low and similar for both groups: control group with a mean of 0.063 ± 0.126, and test group with a mean of 0.092 ± 0.163. No major surgical-related complications have occurred. Only one patient had several prosthetic complications due to fractures of prosthetic components. The maxillary sinus augmentation procedure, both with autologous bone and porcine xenograft materials, is an excellent clinical option procedure for the prosthetic rehabilitation of atrophic maxillae, with low marginal bone loss after one year follow-up, few clinical complications, and a high implant survival rate.

P-36722453-339 - Success rate with dental implants in 628 maxillary sinus lift with biomaterial in severe maxillary atrophy. Our experience.

P-36722453-339 - Success rate with dental implants in 628 maxillary sinus lift with biomaterial in severe maxillary atrophy. Our experience.

Comparison of Implant Success Rate Between Direct And Indirect Sinus Lift Procedure

Objective: The objective of the study is to compare gain in bone height and post-operative complications e with direct and indirect sinus lift procedure. Methods: This prospective clinical study was conducted at the department of Science of Dental Materials, University Medical and Dental college Faisalabad, in a period of one year from November 2021 to November 2022. For patients in the 20-50 years age range either gender with maxillary posterior edentulous regions but with a low sinus and deficient alveolar ridge, implant retained prostheses would be a viable option. Results: Results showed that pain and gingival inflammation resolved at 1st week postoperatively. These two parameters frequency was higher in patients with indirect method as compared to patients who were treated with direct method. Swelling was also settled in both treatment groups after 1st week postoperatively. However, frequency of swelling was higher in indirect method as that of direct method but the difference was not statistically significant. There is significant change in bone height postoperatively in both treatment groups. But gain in mean bone height was significantly higher in patients treated with direct approach. Conclusion: This study did not find a significant difference between direct versus indirect sinus lift procedures in terms of swelling, inflammation, and pain following surgery. Indirect sinus lifts, however, result in a significantly lower bone height gain than direct sinus lifts. Â Key Words: Edentulism, Sinus lift procedures, Direct, Indirect, Bone height, Sinus surgery.

New Perspectives about Maxillary Sinus Lifting: a Literature Review

Maxillary sinus lifting is a procedure for bone height gain in atrophic jaws. New safe and less complex manners have been evalueted, which use modifications of conventional techniques, through technologies such as devices and equipment that make them less traumatic. This study aims to conduct a literature review of articles found in the PubMed database between the years 2015 and 2020 that addresses advances in Maxillary sinus lifting techniques. We noticed that there is a development in the techniques that promotes the reduction of operative time, perforations and consequently a better postoperative for the patient, reducing the unpleasant perception of the surgery. The use of surgical ultrasound reduces the trauma to the soft tissues and the number of membrane perforations. A great step in the development of the sinus membrane lifting technique was the perception that bone formation is possible with the detachment of the membrane, not requiring the placement of a graft. There is no technique that replaces Maxillary Sinus Lifting yet. Only to improve it.

Dental tourism and the risk of barotrauma and barodontalgia.

Background and aim Dental tourism, which reflects the provision of health care services abroad, also includes a travelling component. Air travel after dental intervention may cause barotrauma and barodontalgia. This paper aimed to provide guiding principles regarding the minimal time interval between dental procedures and air travel to prevent these adverse effects.Methods A literature search was performed to reveal information with regards to complications related to flights following dental treatments. There is little research in this area and most of it has been conducted on the military aircrew population, which has different characteristics of flight and personnel than civilian commercial flights.Results The recommended time of flying is one week after most dental intervention and six weeks after a sinus lift procedure. The minimal time required between a procedure and flight is 24 hours after restorative treatment, 24-48 hours after simple extraction, 72 hours after nonsurgical endodontic procedure, surgical extraction, and implant placement, and at least two weeks after sinus lift procedure.Conclusions The provided guidelines may serve as a starting point for the clinician's decision-making. The tailoring of an individual treatment plan to the patient should take into consideration the patient's condition, dental procedure, complications and flight characteristics. Further research based on commercial flights is needed to formulate more accurate guidelines for the civilian population.

Two-Step Progressive Transcrestal Sinus Augmentation Using a 4.5 mm Unloaded Implant as a "Temporary Implant" in Highly Atrophic Ridge: Case Report.

Severe atrophic posterior maxillary ridge (residual bone height < 3 mm) could be a challenging situation to place dental implants. Several treatment options have been proposed, but some of them may require advanced surgical skills to achieve best results. In this article, we present a novel and easier technique to allow implant placing in localized areas of severe atrophy. In a first step, a 4.5-length extra-short (unloaded) implant is placed after a transcrestal maxillary sinus floor augmentation (MSFA). After the gained apical bone consolidation, this "temporary implant" is atraumatically removed and a longer and wider definitive implant is placed to support the definitive single restoration. The case of a 45-year-old female treated with this approach is also presented. The patient suffered a severe resorption in the upper right molar area after a tooth extraction. Four months after the "temporary implant" placement and MSFA grafting with plasma rich in growth factors and autologous bone, 3 mm of dense apical bone gain could be observed. In a second surgical time, the 4.5 mm-length "temporary implant" was removed, and a 5.5 mm-length "definitive implant" was placed. This second implant was placed in a denser type 1 (1,000 Hounsfield Unit) new formed apical bone. Four months later, the implant was loaded with a screw-retained crown over a transepithelial (intermediate abutment). After 1-year follow-up, the implant was in health and no mechanical or biological complications were noticed. The satisfactory results of this case encourage the realization of new studies to elucidate its reproducibility.

Retraction notice to "Study on osteogenesis and angiogenesis of Pluronic F-127 composite gel loaded with transforming growth factor β3 and bone marrow mesenchymal stem cells in rabbit maxillary sinus lift"

Retraction notice to "Study on osteogenesis and angiogenesis of Pluronic F-127 composite gel loaded with transforming growth factor β3 and bone marrow mesenchymal stem cells in rabbit maxillary sinus lift"

Trans-sinus Implant using TTPHIL-ALL-TILT ®Technique as Alternative to Sinus Lifts: A Technical Description and Case Series

Background: Severe atrophy of maxillary ridge and extended maxillary sinus pneumatisation limits the treatment options available for rehabilitating patients with teeth missing in posterior maxilla. Sinus lifts followed by bone grafting has become the norm for rehabilitating such patients. But, sinus lift procedures can be cumbersome, time-consuming and uneconomical, especially if patients are in need of immediate function. Objective: This case series describes a unique combination of placing trans- sinus implants using TTPHIL-ALL-TILT ® technique for treating patients with atrophied posterior maxilla. Methods: Three different clinical situations have been described where trans-sinus placement of implants using TTPHIL-ALL-TILT ® technique was done for managing atrophied posterior maxilla. first case was that of a single tooth missing in the posterior maxilla, the second of multiple posterior tooth missing (distal extension, partially edentulous condition) and the third being that of a completely edentulous maxilla. The implants were placed in a flapless tilted manner along with double bi-cortical engagement through the maxillary sinus. Results and Discussion: Following prosthetic rehabilitation, clinical reviews were performed after 6 months. In all cases, implant stability was manually checked and no pathological symptoms or signs were recovered at any follow-up visit. Conclusion: Trans-sinus implant using TTPHIL-ALL-TILT ® technique prove to be good choice to rehabilitate these three clinical scenarios. All three patients were extremely satisfied with the treatment outcome. This could very well become a convenient treat alternative to sinus lift procedures.

Can Our Blood Help Ensure Antimicrobial and Anti-Inflammatory Properties in Oral and Maxillofacial Surgery?

In recent decades, the potential of PRF has been extensively studied. The number of studies about PRF has increased three times since the year 2012, but the full spectrum of its fundamental properties, such as antimicrobial and anti-inflammatory activity, is not clearly described. In oral and maxillofacial surgery, PRF is described in alveolar ridge preservation, orthognathic surgery, cleft lip and palate surgery, maxillary sinus augmentation, and dental implant placement as demonstrating favorable results and its clinical advantages. The structural complexity, inhomogeneous nature, and clotting ability of PRF make its antimicrobial effect evaluation complicated. Nevertheless, most of the used antimicrobial testing methods are based on antibacterial agent diffusion ability in culture media. Because the oral and maxillofacial region is the most frequent area of PRF application, its antimicrobial activity evaluation also prevails in the oral microbiome. PRF's biological potential is highly dependent on the specific preparation protocol and methodology used; it should be carefully prepared and kept under proper conditions to keep cellular content alive. PRF's influence on living cells demonstrates a stimulating effect on bone regeneration, and an angiogenetic effect, and it provides anti-inflammatory activity. According to analyzed studies, PRF demonstrated success in oral and maxillofacial surgery in various methods of application. Antibacterial and anti-inflammatory properties were proven by antibacterial activity against different bacterial species, sustained growth factor, sustained release, and cell activity on the material application. Accurately and correctly prepared PRF can ensure antibacterial and anti-inflammatory properties, and it can be a beneficial clinical tool in oral and maxillofacial surgery.

Sinonasal Complications Following the Sinus Lift Procedure.

Background: Although the incidence of postoperative acute and chronic rhinosinusitis in patients undergoing a sinus lift procedure is relatively high, a paucity of rhinology literature examines the management of and outcomes for this patient population. The objective of this study was to review the management and postoperative care of sinonasal complications and identify possible risk factors that should be considered prior to and following sinus augmentation. Methods: We identified sequential patients who had undergone a sinus lift procedure and were referred to the senior author (AK) at a tertiary rhinology practice for intractable sinonasal complications and reviewed their charts for demographic data, history of illness including prereferral treatment, examination findings, imaging results, treatment modalities, and culture results. Results: Nine patients were initially treated medically without improvement and subsequently underwent endoscopic sinus surgery. The sinus lift graft material remained intact in 7 patients. Two patients had extrusion of the graft material into the facial soft tissues, resulting in facial cellulitis requiring graft removal and debridement. Seven of the 9 patients had predisposing factors that could have prompted referral to an otolaryngologist for optimization prior to sinus lifting. The mean follow-up was 10 months, and all patients had full resolution of symptoms. Conclusion: Acute and chronic rhinosinusitis is a complication of the sinus lift procedure and is more commonly seen in patients with preexisting sinus disease, anatomic sinonasal obstruction, and Schneiderian membrane perforation. Preoperative evaluation by an otolaryngologist may improve outcomes in patients at risk of sinonasal complications from sinus lift surgery.

Lateral Window Maxillary Sinus Augmentation – Complications and Management

Introduction: The sinus lift procedure is the most predictable surgical intervention for enhancing bone quality and quantity in the posterior maxilla prior to the placement of endosseous dental implants. However, despite careful planning and precise surgical technique, several complications can arise. These include - haemorrhage, membrane perforation, infection, wound dehiscence, post operative pain, implant failure/ loss, graft loss, hematoma, barrier membrane exposure, oroantral fistula and sinusitis. Aim: The purpose of this report was to address the most common complications associated with the sinus lift procedure and discuss how to avoid and manage them when they occur. Methodology: A total of 140 articles from peer reviewed journals published in English from January 1986 to January 2023 were collected from a search performed using MEDLINE and PubMed. The keywords utilized were “dental implant”, “sinus augmentation”, “sinus complication”, “membrane perforation”, “bleeding – sinus augmentation”. Twenty-nine of the 140 articles satisfied the inclusion criteria and were utilized in this article. Results: Sinus membrane perforation is the most prevalent complication of maxillary sinus augmentation procedures, ranging from 11-60%. An incidence of 28% perforation rate is found. Bleeding was reported with an incidence of 2% of the sinus procedures performed. The use of piezoelectric devices as well as other measures play an important role in ensuring the stopping of bleeding. Conclusion: Proper planning and management of these complications will minimize the negative effects on therapy and allow for a successful implant result when placed in augmented maxillary sinuses.

Does the use of platelet-rich plasma in sinus augmentation improve the survival of dental implants? A systematic review and meta-analysis.

Platelet-rich plasma is considered an effective modality to promote bone regeneration, improve hard and soft tissue healing in surgical procedures including sinus augmentation. However, the survival of dental implants in sinus augmented sites with platelet-rich plasma has shown equivocal results in recent studies. In this systematic review, data on dental implants' survival in sinus augmentation sites with platelet-rich plasma were examined. Randomized controlled trials on the topic with a minimum mean follow-up of 6 months with no language restriction were considered. Other study designs on the topic were excluded. Accordingly, relevant articles were searched in Clinicaltrials.gov, Cochrane databases, PubMed/Medline, and Scopus up to April 2021. Using the Cochrane risk of bias assessment tool, the listed studies' risk of bias was evaluated. From the included studies, the pertinent information was taken and pooled for qualitative and quantitative analysis using R software 4.1.1. Six randomized controlled trials involving 188 patients who underwent sinus augmentation with and without platelet-rich plasma, and 781 implants were included for qualitative and quantitative analysis. Four hundred and eleven implants were placed in the intervention group (with platelet-rich plasma) and 370 implants were placed in the control group (without platelet-rich plasma). The pooled estimate (OR 0.84, 95% CI 0.37 to 1.91; I2=0%) indicated that there was no statistically significant difference observed between the groups. The test for subgroup differences showed no statistically significant differences between the subgroups (p=0.45) with no heterogeneity (I2=0%). The bias associated with selective reporting of outcome data was considered as some concern for bias. This systematic review revealed that the effect of platelet-rich plasma is uncertain on the survival of dental implants.

Evaluation of the effect of direct sinus lift surgery on maxillary sinus volume by Mimics software.

Sinus lift surgery allows sufficient volume of bone to be created in the posterior part of the maxilla. The aim of this study was to investigate the changes in maxillary sinus volume after a sinus lift and the rate of increase in ridge height at the site of the graft. Eleven patients were chosen for sinus lift from among those who were referred to the radiology department for implant placement in the posterior region of the maxilla and whose bone height at the posterior of the maxilla was less than 4 mm on the cone-beam computed tomography (CBCT) image. The sinus volume was measured after importing the CBCT file in DICOM format into Mimics software. After determining the sinus volume, the patients underwent sinus lift surgery, and the amount of material used during the surgery was measured. After the time required to repair the area, the CBCT image was taken again. Then, the changes in the volume of the maxillary sinus and the increase in the height of the maxillary ridge at the surgical site were calculated. Then, the second stage of the surgery was performed to place the implant at the implant site. For an average of 1.40 cm3 of material, the rate of increase in ridge height was 10.52 mm, and the average change in sinus volume was 1.19 cm3. CBCT images and Mimics software have many applications in examining and predicting parameters before and after sinus lift surgery.

15-Year Retrospective Study on the Success Rate of Maxillary Sinus Augmentation and Implants: Influence of Bone Substitute Type, Presurgical Bone Height, and Membrane Perforation during Sinus Lift.

To evaluate the success rate of bone grafts and implants carried out at the Latin American Institute for Research and Dental Education (ILAPEO), considering the following: (i) the different pure bone substitutes (autogenous, xenogeneic, and alloplastic), (ii) the presurgical bone height, and (iii) how the treatment is compromised when membrane perforation occurs during sinus lift in maxillary sinus surgeries. Material and Methods. The initial sample comprised 1040 records of maxillary sinus lifting surgeries. After evaluation, the final sample retained 472 grafts performed using the lateral window technique with a total of 757 implants. The grafts were divided into 3 groups: (i) autogenous bone (n = 197), (ii) xenogenous bovine bone (n = 182), and (iii) alloplastic material (n = 93). One calibrated examiner classified the sample into two groups based on the residual bone height (<4 mm and ≥4 mm) of the area of interest measured on parasagittal sections of tomographic images. Data on membrane perforation occurrences in each group were collected; qualitative variables were described using frequency, expressed as percentages. The Chi-square test was used to analyze the success of the graft types and the survival rate of the implants as a function of the grafted material and the residual bone height. The Kaplan-Meier survival analysis was used to calculate the survival rate of bone grafts and implants according to the classifications adopted in this retrospective study. The success rate of grafts and implants was 98.3% and 97.2%, respectively. There was no statistically significant difference in the success rate among the different bone substitutes (p = 0.140). Only 8 grafts (1.7%) and 21 implants (2.8%) failed. There was a greater success rate for both grafts (96.5%) and implants (97.4%) when the bone height was ≥4 mm. The success rate in the 49 sinuses in which the membrane was perforated was 97.96% for the grafts and 96.2% for the implants. The follow-up periods after rehabilitation ranged from 3 months to 13 years. Within the limitations of the data analyzed in this retrospective study, maxillary sinus lift was a viable surgical technique that enabled implant placement with a predictable long-term success rate, regardless of the type of material used. The presence of membrane perforation did not interfere with the success rate obtained for grafts and implants.

Treatment tactics for patients with retention cysts, odontogenic cysts, mucocele and other pathologies of the maxillary sinuses as preparation for a sinus lift

The aim the studi. Differential diagnosis of retention cysts of the maxillary sinus with odontogenic cysts, acute and chronic sinusitis, aspergillosis, and mucocele in preparation for sinus-lifting surgery. The analysis of the case histories of 265 patients aged 18-65 years of both sexes who were treated at the dental clinic «Rudenta Family» from 2016 to 2021 was carried out. On the basis of clinical symptoms and data of cone-beam computed tomography (CBCT), a description of the pathologies of HPV is given for the purpose of differential diagnosis and correct interdisciplinary interaction with ENT doctors for the purpose of dental implantation in the lateral parts of the upper jaw. In 90 (out of 265) patients (34%), a change in the condition of the maxillary sinus mucosa was detected. 18 patients (7%) for preoperative preparation were sent to the ENT department of the FSBI «CCB with polyclinic» of the UDP of the Russian Federation with diagnoses: chronic maxillary sinusitis of various etiologies and mucocele. In this group of patients, sinus lifting followed by dental implantation was performed 6 months after endoscopic maxillofacial surgery under the control of CBCT. Retention cyst Retention cysts of the maxillary sinus were of different sizes in 62 (23.4%) patients and, depending on the size and localization of the sinus-lifting was performed with simultaneous removal of the cyst, or without removal of the cyst. Retention cysts do not need to be removed as a preoperative preparation for sinus lifting. In the case of large sizes and difficulty in peeling the Schneider membrane, retention cysts are removed by a dental surgeon during antral augmentation as one of the stages of the operation. In such pathologies as odontogenic cyst, acute and chronic sinusitis, aspergillosis, mucocele, interdisciplinary interaction of ENT doctor and dentist is necessary. Differential diagnosis of maxillary snus pathology is carried out on the basis of clinical data and a picture of cone-beam computed tomography.

Combination of autologous bone, xenograft with hyaluronate and Plasma Rich in Growth Factors in horizontal bone augmentation and sinus lift

Combination of autologous bone, xenograft with hyaluronate and Plasma Rich in Growth Factors in horizontal bone augmentation and sinus lift

Socket preservation, sinus lift and lateral augmentation by using natural bovine bone substitute with hyaluronate

Socket preservation, sinus lift and lateral augmentation by using natural bovine bone substitute with hyaluronate

Dental implant failure and bone augmentation: A retrospective study.

To retrospectively assess the failure rate of implants placed in augmented and non-augmented sites and to investigate whether the time of implant and bone placement are associated with the risk of implant failure in a university setting. In this retrospective study, data were retrieved from the electronic patient database of the University of Minnesota School of Dentistry, USA to identify patients older than 18 years of age who received dental implant treatment. Patient characteristics and the adequacy of available bone were retrieved from the patients' dental records and analyzed. Performing sinus lift and/or alveolar ridge augmentation in stages or simultaneously with implant placement and the need for multiple bone regeneration procedures were recorded. Kaplan-Meier plots and Cox regression models were created to analyze the data. Data from 553 implants were analyzed in the study. More than half of the implants were placed in the maxilla (56.8%) and posterior regions (74.3%). The overall survival rate was 96.9%. Sinus augmentation was performed in 19.5% of the cases, while in 12.1% of the included treatments an implant was placed simultaneously. Staged and simultaneous ridge augmentation occurred in 45.2% and 18.8% of the cases, respectively. Implants placed in an area following (p=0.018) or simultaneously (p=0.025) with sinus augmentation showed a significantly reduced survival. Cox regression analysis showed that smoking and simultaneous ridge augmentation and implant placement increased failure rates. Within the limitations of this study, implants placed in tobacco users as well as in augmented maxillary sinuses, simultaneously or in stages, and in augmented ridges lead to higher implant failure rates. Key words:Bone grafting, dental implant, osseointegration, risk factor, survival rate, treatment outcome.