Minimally Invasive Management of Implant-Supported Rehabilitation in the Posterior Maxilla, Part I. Sinus Floor Elevation: Biologic Principles and Materials

2020 ◽  
Vol 40 (3) ◽  
pp. e85-e93 ◽  
Author(s):  
Claudio Stacchi ◽  
Sergio Spinato ◽  
Teresa Lombardi ◽  
Fabio Bernardello ◽  
Carlo Bertoldi ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Sinus Floor Elevation ◽  
Posterior Maxilla ◽  
Sinus Floor ◽  
Invasive Management

Axial Triangle of the Maxillary Sinus, and its Surgical Implication With the Position of Maxillary Sinus Septa During Sinus Floor Elevation: A CBCT Analysis

2020 ◽  
Vol 46 (4) ◽  
pp. 415-422
Author(s):  
Junho Jung ◽  
Jung Soo Park ◽  
Seoung-Jin Hong ◽  
Gyu-Tae Kim ◽  
Yong-Dae Kwon
Keyword(s):  
Maxillary Sinus ◽  
Surgical Techniques ◽  
Lateral Sinus ◽  
Sinus Floor Elevation ◽  
Second Molar ◽  
Sinus Wall ◽  
Posterior Maxilla ◽  
Significant Difference ◽  
Sinus Floor ◽  
Molar Region

The aim of this study was to measure the convexity of the lateral wall of the maxillary (Mx) sinus and identify the locational distribution of antral septa in relation to the zygomaticomaxillary buttress (ZMB), in order to suggest another anatomical consideration and surgical modification of sinus floor elevation procedures. This study was designed as a cross-sectional study, and a total of 134 patients and 161 sinuses containing edentulous alveolar ridges were analyzed. The angle between the anterior and lateral walls of the Mx sinus (lateral sinus angle [LSA]), and the angle between the midpalatal line and the anterior sinus wall (anterior sinus angle [ASA]) were measured. Mean LSAs and ASAs were 105.9° ± 9.86° and 58.4° ± 6.43°, respectively. No significant difference between left and right sides was found (LSA, P = .420; right = 105.5° ± 9.27°; left = 105.5° ± 9.27° and ASA, P = .564; right = 57.9° ± 6.80°; left = 58.8° ± 6.02°). The prevalence of septa was 37.3%, and it was most frequently noted in the second molar region (32.8%), followed by the first molar (20.9%), retromolar (16.4%), and second premolar regions (14.9%). Septa were most frequently located posterior to the ZMB (49.2%), while ZMB was mostly located in the first molar region (66.4%). Narrow LSAs may complicate the surgical approach to the posterior maxilla, especially when sinus elevation should be used in the second molar region. Considering the occasional presence of antral septa, membrane elevation may be complicated when a septum is encountered during the procedure. These results suggest that 3-dimensional examination of the convexity of the Mx sinus should be performed preoperatively to choose proper surgical techniques and minimize surgical complications.

Minimally invasive transcrestal sinus floor elevation with graft biomaterials. A randomized clinical trial

2011 ◽  
Vol 23 (4) ◽  
pp. 424-432 ◽  
Author(s):  
Leonardo Trombelli ◽  
Giovanni Franceschetti ◽  
Alessandro Rizzi ◽  
Pasquale Minenna ◽  
Luigi Minenna ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Minimally Invasive ◽  
Randomized Clinical Trial ◽  
Sinus Floor Elevation ◽  
Sinus Floor

scholarly journals The Human Amniotic Mesenchymal Stem Cells (hAMSCs) Improve the Implant Osseointegration and Bone Regeneration in Maxillary Sinus Floor Elevation in Rabbits

2019 ◽  
Vol 2019 ◽  
pp. 1-10
Author(s):  
Lu Yin ◽  
Zhi-xuan Zhou ◽  
Ming Shen ◽  
Ning Chen ◽  
Fei Jiang ◽  
...  
Keyword(s):  
Bone Regeneration ◽  
Maxillary Sinus ◽  
Bone Volume ◽  
Control Group ◽  
Sinus Floor Elevation ◽  
Dental Implantation ◽  
Posterior Maxilla ◽  
Maxillary Sinus Floor ◽  
Sinus Floor ◽  
Maxillary Sinus Floor Elevation

Insufficient bone height in the posterior maxilla is a challenging problem in dental implantation. Bio-Oss, though routinely used in maxillary sinus floor elevation (MSFE), is not osteoinductive. Human amniotic mesenchymal cells (hAMSCs) isolated from placental tissues have potential for multidifferentiation and immunomodulatory properties and can be easily obtained without the need for invasive procedures and without ethical concerns. This is the first study to use hAMSCs to improve implant osseointegration and bone regeneration after MSFE. Human AMSCs were loaded into a fibrin gel and injected into rabbit MSFE models. The rabbits were assigned to four groups (n=3 per group), i.e., the control group, the hAMSC group, the Bio-Oss group, and the hAMSC/Bio-Oss group. The animals were sacrificed at postsurgery for four and twelve weeks and evaluated by histology and immunohistochemistry. Bone volume, bone volume/tissue volume, bone-to-implant contact ratio, and vessel-like structures in the hAMSC/Bio-Oss group were significantly better than those in other groups in the peri-implant and augmented areas. Immunofluorescence staining showed that alkaline phosphatase (ALP) activities of two hAMSC groups were higher than those of the other two groups. Sequential fluorescent labeling was performed in all of the 12-week groups. Observations showed that hAMSCs accelerated mineralized deposition rates on implant surfaces and in bone-augmented areas. These data demonstrated that hAMSCs could enhance implant osseointegration and bone regeneration after MSFE and might be used to optimize dental implantation in the future.

scholarly journals Schneider Membrane Elevation in Presence of Sinus Septa: Anatomic Features and Surgical Management

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Mario Beretta ◽  
Marco Cicciù ◽  
Ennio Bramanti ◽  
Carlo Maiorana
Keyword(s):  
Maxillary Sinus ◽  
Lateral Approach ◽  
Sinus Lift ◽  
Sinus Floor Elevation ◽  
Posterior Maxilla ◽  
Maxillary Sinus Floor ◽  
Sinus Floor ◽  
The Right ◽  
Maxillary Sinus Floor Elevation ◽  
Gothic Arch

Maxillary sinus floor elevation via a lateral approach is a predictable technique to increase bone volume of the edentulous posterior maxilla and consequently for dental implants placement. The sinus floor is elevated and it can be augmented with either autologous or xenogeneic bone grafts following an opening bone window created on the facial buccal wall. Maxillary septa are walls of cortical bone within the maxillary sinus. The septa shape has been described as an inverted gothic arch arising from the inferior or lateral walls of the sinus and may even divide the sinus into two or more cavities. Some authors have reported a higher prevalence of septa in atrophic edentulous areas than in nonatrophic ones. Radiographic identification of these structures is important in order to perform the right design of the lateral window during sinus lift. Aim of this investigation is to highlight the correct steps for doing sinus lift surgery in presence of those anatomic variations. Clinicians should always perform clinical and radiographic diagnosis in order to avoid complications related to the sinus lift surgery.

scholarly journals Different Techniques For Sinus Floor Elevation: A Review Part II – Indirect Techniques

2021 ◽  
Vol 9 (1) ◽  
pp. 1-4
Author(s):  
Nitin Kothari ◽  
Vivek Jadhav ◽  
Snigdha Patil
Keyword(s):  
Minimally Invasive ◽  
Maxillary Sinus ◽  
Alveolar Bone ◽  
Effective Solution ◽  
Sinus Floor Elevation ◽  
Less Invasive ◽  
Implant Placement ◽  
Sinus Floor ◽  
Bone Height

The bone available for implant placement may be limited by the presence of the maxillary sinus togetherwith loss of alveolar bone height and it may be increased by augmentation. Minimally invasive sinusaugmentation is an effective solution for this problem. This review explains indirect sinus augmentationprocedures which are less invasive and highly successful if done using prescribed technique.

scholarly journals Minimally Invasive Lateral Approach through Circular Window with a Diameter of 5 to 6 mm for Maxillary Sinus Floor Elevation with Simultaneous Implant Placement: Retrospective Study

2021 ◽  
Vol 11 (17) ◽  
pp. 8244
Author(s):  
Sang-Woon Lee ◽  
Young-Wook Park
Keyword(s):  
Minimally Invasive ◽  
Maxillary Sinus ◽  
Treated Patient ◽  
Lateral Approach ◽  
Sinus Floor Elevation ◽  
Circular Window ◽  
Implant Placement ◽  
Maxillary Sinus Floor ◽  
Sinus Floor ◽  
Maxillary Sinus Floor Elevation

The aims of this study were to propose a minimally invasive lateral approach technique for maxillary sinus floor elevation (MSFE) with simultaneous implant placement and to evaluate the surgical outcome and complications of this technique. This study reviewed 49 surgeries of MSFE with simultaneous implant placement (n = 83) using a minimally invasive lateral approach. A circular shape window with a diameter of 5 to 6 mm and an area of 20–30 mm2 was made on the lateral wall of the maxillary sinus. After elevation of the Schneiderian membrane, the xenograft was used for bone grafting. The MSFE was possible with a minimum-sized window in 47 of 49 cases. For the remaining 2 cases, MSFE with a minimum-sized window was failed. In one case, it was expanded to be more than 30 mm2 to repair the membrane perforation. In another case, MSFE was performed by forming two minimum-sized windows. Post-operative bleeding after MSFE occurred in one anticoagulant-treated patient. There was no failed implant during the follow-up period (mean 22 months). A minimally invasive lateral approach through a small circular window with a diameter of 5 to 6 mm is a feasible and safe technique for MSFE with simultaneous implant placement.

scholarly journals Short implants (≤6 mm) versus longer implants with sinus floor elevation in atrophic posterior maxilla: a systematic review and meta-analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e029826 ◽  
Author(s):  
Qi Yan ◽  
Xinyu Wu ◽  
Meiying Su ◽  
Fang Hua ◽  
Bin Shi
Keyword(s):  
Systematic Review ◽  
Survival Rate ◽  
Meta Analysis ◽  
Sinus Floor Elevation ◽  
Moderate Quality ◽  
Short Implants ◽  
Posterior Maxilla ◽  
Sinus Floor ◽  
Quality Evidence

ObjectivesTo compare the use of short implants (≤6 mm) in atrophic posterior maxilla versus longer implants (≥10 mm) with sinus floor elevation.DesignA systematic review and meta-analysis based on randomised controlled trials (RCTs).Data sourcesElectronic searches were conducted in PubMed, Embase and the Cochrane CENTRAL. Retrospective and prospective hand searches were also performed.Eligibility criteriaRCTs comparing short implants (≤6 mm) and longer implants (≥10 mm) with sinus floor elevation were included. Outcome measures included implant survival (primary outcome), marginal bone loss (MBL), complications and patient satisfaction.Data extraction and synthesisRisks of bias in and across studies were evaluated. Meta-analysis, subgroup analysis and sensitivity analysis were undertaken. Quality of evidence was assessed according to Grading of Recommendations Assessment, Development and Evaluation.ResultsA total of seven RCTs involving 310 participants were included. No significant difference in survival rate was found for 1–3 years follow-up (RR 1.01, 95% CI 0.97 to 1.04, p=0.74, I²=0%, moderate-quality evidence) or for 3 years or longer follow-up (RR 1.00, 95% CI 0.97 to 1.04, p=0.79, I²=0%, moderate-quality evidence). However, short implants (≤6 mm) showed significantly less MBL in 1–3 years follow-up (MD=−0.13 mm, 95% CI −0.21 to 0.05; p=0.001, I²=87%, low-quality evidence) and in 3 years or longer follow-up (MD=−0.25 mm, 95% CI −0.40 to 0.10; p=0.001, I²=0%, moderate-quality evidence). In addition, short implant (≤6 mm) resulted in fewer postsurgery reaction (RR 0.11, 95% CI 0.14 to 0.31, p<0.001, I²=40%, moderate-quality evidence) and sinus perforation or infection (RR 0.11, 95% CI 0.02 to 0.63, p=0.01, I²=0%, moderate-quality evidence).ConclusionsFor atrophic posterior maxilla, short implants (≤6 mm) are a promising alternative to sinus floor elevation, with comparable survival rate, less MBL and postsurgery reactions. Additional high-quality studies are needed to evaluate the long-term effectiveness of short implants (≤6 mm).Trial registeration numberThe protocol has been registered at PROSPERO (CRD42018103531).

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