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A Simple and Safe Approach for Maxillary Sinus Augmentation with the Advanced Surgical Guide.

ABSTRACT: OBJECTIVE:The development of digital dentistry has contributed to the astonishing advancement of implant dentistry. Furthermore, digital technology is expected to be applied extensively to sinus augmentation, which is an advanced technique for implant surgery. This study introduces a simple method for a safer and more precise lateral window opening for sinus augmentation using a navigation program. METHODS:Five eligible patients with residual alveolar bone of 4 mm or less are presented, requiring lateral approach for sinus augmentation. Navigation system was opted for the sinus lift with simultaneous implant placement. Virtual planning started with establishing the adequate position of the lateral window based on the radiographic images and the scanned file of the dentition. The position of the window was indicated on the guide within the program. Afterwards, the virtually designed surgical guide was fabricated either with 3D printer or milling machine for the actual surgery. RESULTS:All the patients who underwent surgery with the surgical guide showed no sign of clinical complications including pain, swelling, nausea, epistaxis, or early loss of the implants. Results of radiographic evaluation also showed adequate placement of the implants in a pre-planned position, and the sinus window was also formed in the desired location. CONCLUSION:Lateral window opening combined with digital navigation system is believed to be a promising technique for a more precise as well as safer sinus augmentation.

SUBMITTER: Cho SW

PROVIDER: S-EPMC7313061 | biostudies-literature | 2020 May

REPOSITORIES: biostudies-literature

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A Simple and Safe Approach for Maxillary Sinus Augmentation with the Advanced Surgical Guide.

Cho Seoung-Won SW Yang Byoung-Eun BE Cheon Kyeong-Jun KJ Jang Won-Seok WS Kim Ju-Won JW Byun Soo-Hwan SH

International journal of environmental research and public health 20200527 11

<h4>Objective</h4>The development of digital dentistry has contributed to the astonishing advancement of implant dentistry. Furthermore, digital technology is expected to be applied extensively to sinus augmentation, which is an advanced technique for implant surgery. This study introduces a simple method for a safer and more precise lateral window opening for sinus augmentation using a navigation program.<h4>Methods</h4>Five eligible patients with residual alveolar bone of 4 mm or less are pres ...[more]

PMID: 32471026

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Project description:BACKGROUND:Sinus augmentation can be performed with or without grafting biomaterials, and to date, there is no quality evidence regarding the augmentation of the sinus floor using only platelet concentrates, which can improve the healing period and enhance bone regeneration by stimulating angiogenesis and bone formation. The main objective of this paper was to assess the effect of the sole use of platelet concentrates in sinus augmentation in terms of newly formed bone, augmented bone height, and clinical outcomes and to assess the additional beneficial effects of platelet-rich fibrin (PRF) in combination with other grafting biomaterials. METHODS:A systematic review was conducted following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Pooled analyses were performed with the Review Manager software. RESULTS:For sinus elevation only using platelet concentrates, 11 studies met the inclusion criteria and were included for qualitative synthesis. Only one study was a clinical trial, which reported improved outcomes for the allograft group compared to the titanium-PRF (T-PRF) group. A total of 12 studies where PRF was used in addition to grafting biomaterials met eligibility criteria and were included in the review. Results from meta-analyses provided no additional beneficial effects of PRF in sinus augmentation in terms of bone height and percentage of soft tissue area. There was a statistically significant lower percentage of residual bone substitute material in the PRF (+) group compared to the PRF (-) group. The percentage of newly formed bone was slightly higher in the PRF (+) group, but this was not statistically significant. CONCLUSION:There is no robust evidence to make firm conclusions regarding the beneficial effects of the sole use of platelet concentrates in sinus augmentation. However, studies have shown favorable outcomes regarding implant survival, bone gain, and bone height. The use of PRF with other grafting biomaterials appears to provide no additional beneficial effects in sinus lift procedures, but they may improve the healing period and bone formation. Well-conducted randomized clinical trials (RCTs) are necessary to confirm the available results to provide recommendations for the clinical practice.

Project description:BackgroundChronic rhinosinusitis is an inflammatory disorder in which the role of bacteria remains uncertain. While sinus outflow obstruction is often an initiating event, mucosal inflammation and dysbiosis may persist or develop in sinuses with widely patent surgical openings. Understanding of the relationship between dysbiosis and chronic sinus inflammation is obfuscated by inter-individual microbiota variability and likely intra-individual temporal variation that has yet to be defined. In this study, long-term microbiota stability is investigated within surgically-opened maxillary sinuses of individuals with and without sinus inflammatory disease.MethodsMaxillary sinus swabs were performed in 35 subjects with longstanding maxillary antrostomies. Subjects with and without active chronic maxillary sinusitis were included. Repeat swabs were obtained from the same sinuses after a prolonged interval (mean 719 ± 383 days). Patients were categorized based on the inflammatory status of the sinus mucosa at times of sample collection, as assessed by nasal endoscopy. Total DNA from swab eluents was extracted, and the microbiota characterized using 16S rRNA gene sequencing followed by taxonomic classification. Prevalence and abundance of genera were determined by analysis of 16S rRNA gene sequences. Taxa were identified that were stably present between two time points in individual subjects.ResultsThe overall proportion of stable taxa across time points was 24.5 ± 10.6%. This stability index was consistent across patient groups and not correlated with clinical parameters. Highly prevalent taxa, including Staphylococcus, Corynebacterium, Propionibacterium, and Pseudomonas, were often stably present, but varied in relative abundance. Janthinobacterium, Enterobacter, Lactobacillus, and Acinetobacter were prevalent and moderately abundant taxa in healthy sinuses, but not in inflamed sinuses. Moraxella and Haemophilus were present at low prevalence and proportional abundance in chronically or intermittently inflamed sinuses, but not in healthy sinuses.ConclusionsA relatively small component of the post-antrostomy maxillary sinus microbiota exhibits long-term stability in individual subjects. Stable bacteria include a limited number of highly prevalent and a larger number of lower prevalence taxa, which vary widely in proportional abundance. The concept of individual-specific core sinus microbiota, durable over time and medical therapy, but fluctuating in proportional abundance, has implications for understanding the role of bacteria in CRS pathogenesis.

Project description:BackgroundEvidence has been provided that a cell-based therapy combined with the use of bioactive materials may significantly improve bone regeneration prior to dental implant, although the identification of an ideal source of progenitor/stem cells remains to be determined.AimIn the present research, the bone regenerative property of an emerging source of progenitor cells, the amniotic epithelial cells (AEC), loaded on a calcium-phosphate synthetic bone substitute, made by direct rapid prototyping (rPT) technique, was evaluated in an animal study.Material and methodsTwo blocks of synthetic bone substitute (?0.14 cm(3)), alone or engineered with 1×10(6) ovine AEC (oAEC), were grafted bilaterally into maxillary sinuses of six adult sheep, an animal model chosen for its high translational value in dentistry. The sheep were then randomly divided into two groups and sacrificed at 45 and 90 days post implantation (p.i.). Tissue regeneration was evaluated in the sinus explants by micro-computer tomography (micro-CT), morphological, morphometric and biochemical analyses.Results and conclusionsThe obtained data suggest that scaffold integration and bone deposition are positively influenced by allotransplantated oAEC. Sinus explants derived from sheep grafted with oAEC engineered scaffolds displayed a reduced fibrotic reaction, a limited inflammatory response and an accelerated process of angiogenesis. In addition, the presence of oAEC significantly stimulated osteogenesis either by enhancing bone deposition or making more extent the foci of bone nucleation. Besides the modulatory role played by oAEC in the crucial events successfully guiding tissue regeneration (angiogenesis, vascular endothelial growth factor expression and inflammation), data provided herein show that oAEC were also able to directly participate in the process of bone deposition, as suggested by the presence of oAEC entrapped within the newly deposited osteoid matrix and by their ability to switch-on the expression of a specific bone-related protein (osteocalcin, OCN) when transplanted into host tissues.

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A Simple and Safe Approach for Maxillary Sinus Augmentation with the Advanced Surgical Guide.

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A Simple and Safe Approach for Maxillary Sinus Augmentation with the Advanced Surgical Guide.

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