Long-term Retrospective Study of Implants Placed after Sinus Floor Augmentation with Fresh-frozen homologous block.
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ABSTRACT:
SUBMITTER: Rocha LRS
PROVIDER: S-EPMC5551330 | biostudies-other | 2017 Apr-Jun
REPOSITORIES: biostudies-other
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Project description:Objectives:The objective of the present study is to present the current best evidence for enhancement of the vertical alveolar bone height and oral rehabilitation of the atrophic posterior maxilla with dental implants and propose some evidence-based treatment guidelines. Material and Methods:A comprehensive review of the English literature including MEDLINE (PubMed), Embase and Cochrane Library search was conducted assessing the final implant treatment outcome after oral rehabilitation of the atrophic posterior maxilla with dental implants. No year of publication restriction was applied. The clinical, radiological and histomorphometric outcome as well as complications are presented after maxillary sinus floor augmentation applying the lateral window technique with a graft material, maxillary sinus membrane elevation without a graft material and osteotome-mediated sinus floor elevation with or without the use of a graft material. Results:High implant survival rate and new bone formation was reported with the three treatment modalities. Perforation of the Schneiderian membrane was the most common complication, but the final implant treatment outcome was not influenced by a Schneiderian membrane perforation. Conclusions:The different surgical techniques for enhancement of the vertical alveolar bone height in the posterior part of the maxilla revealed high implant survival with a low incidence of complications. However, the indication for the various surgical techniques is not strictly equivalent and the treatment choice should be based on a careful evaluation of the individual case. Moreover, further high evidence-based and well reported long-term studies are needed before one treatment modality might be considered superior to another.
| S-EPMC5676313 | biostudies-literature
Project description:BackgroundThe purpose of the present study was to test the H0-hypothesis of no difference in the clinical and radiographical treatment outcome of single-crown restorations supported by short implants compared with standard length implants in conjunction with maxillary sinus floor augmentation (MSFA) after 1 year of functional implant loading. Forty patients with partial edentulism in the posterior part of the maxilla were randomly allocated to treatment involving single-crown restorations supported by short implants or standard length implants in conjunction with MSFA. Clinical and radiographical evaluation were used to assess survival of suprastructures and implants, peri-implant marginal bone loss (PIMBL), biological, and mechanical complications.ResultsBoth treatment modalities were characterized by 100% survival of suprastructures and implants after 1 year. Mean PIMBL was 0.60 mm with short implants compared with 0.51 mm with standard length implants after 1 year of functional loading. There were no statistically significant differences in survival of suprastructure and implants, PIMBL, and mechanical complications between the two treatment modalities. However, a higher incidence of biological complications was associated with standard length implants in conjunction with MSFA.ConclusionWithin the limitations of the present study, it can be concluded that single-crown restorations supported by short implants seems to be comparable with standard length implants in conjunction with MSFA. However, long-term studies are needed before final conclusions can be provided about the two treatment modalities.Trial registrationClinicaltrials.Gov ID: NCT04518020 . Date of registration: August 14, 2020, retrospectively registered.
| S-EPMC8282885 | biostudies-literature
Project description:Nowadays, short dental implants are being increasingly applied in extremely resorbed posterior regions. The recent studies have indicated that short implants present a similar success rate to conventional implants. It is assumed that short implants can avoid additional surgical morbidity and are less technically demanding. However, high-quality evidence (? Ib: evidence from at least one randomized controlled trial) on comparing the clinical outcome of short implants and longer implants combined with osteotome sinus floor elevation (OSFE) technique is limited.The proposed study is designed as a prospective single-center, three-arm parallel group, randomized controlled trial. We plan to enroll 150 patients in need of dental implant treatment in the posterior maxilla. The inclusion criteria include: age ? 18 years, partial edentulism in the posterior maxilla for at least 3 months from tooth loss, residual bone height ranging from 6 to 8 mm, sufficient bone width (? 6 mm) in the edentulous region. The patients will be divided into three groups according to a table of random numbers: group 1: short implants (6 mm) alone; group 2: short implants (8 mm) combined with osteotome sinus floor elevation (OSFE); group 3: standard implants (10 mm) combined with OSFE. The assignment will be concealed from the clinical operators until the beginning of implant surgery. The outcome examiners and patients will be kept blinded to the assignment. Implant survival rates, implant success rates, complications, resonance frequency analysis (RFA) measurements, marginal bone level, treatment time and patient-reported outcome (visual analogue scale for intraoperative discomfort and postoperative pain) will be recorded. Clinical re-evaluations will be performed at 12, 24, 36 and 60 months after crown placement.The results of the trial will support better decision-making for dental implant treatment in atrophic maxillary ridges. If favorable, the use of short implants may avoid adjunct procedures used for implant insertion, thus reducing operative time, complexity and postoperative discomfort.Clinicaltrials.gov identifier: NCT02350075 (registered on 17 February 2015).
| S-EPMC4518682 | biostudies-literature
Project description:BACKGROUND:After sinus floor augmentation, a thickening of the sinus mucosa has been described. The aim of the present study was to evaluate the involvement of the maxillary sinus ostium in the edematous processes after a sinus floor augmentation procedure. METHODS:Seventy-two cone-beam computerized tomographies (CBSTs) were taken before sinus floor augmentation and after 1?week and 9?months from surgery and analyses. Sinus mucosa thickness and area, ostium diameter and patency, and extension of the post-surgical transient mucosal thickening in relation to the ostium were evaluated on the CBCTs for all three periods. The term "virtual" when referring to sinus mucosa thickness and area was introduced because of the edema and bleeding that both contributed to a transient thickening and additional elevation of the sinus mucosa. RESULTS:The mean virtual thickness of the sinus mucosa was 2.7 ± 4.0?mm, 7.7 ± 7.1?mm, 1.7 ± 2.0?mm before surgery, and after 1?week and 9?months. The virtual mucosa area was 37.2 ± 52.5?mm2, 184.5 ± 153.8?mm2, and 34.0 ± 50.7?mm2. The ostium diameter at the three periods evaluated was 1.8 ± 0.5?mm, 1.1 ± 0.6?mm, 1.5 ± 0.8?mm, respectively. Three infundibula (4.2%) were found out of patency before surgery while this number increased to 14 (19.4%) after 1 week. Nine months after surgery, only one infundibulum (1.4%) was out of patency, however, without presenting signs of sinus pathologies. The extension of the mucosal edema on the palatal sinus was reduced after 9?months of healing. CONCLUSIONS:One week after sinus floor augmentation, the maxillary sinus mucosa increased in dimensions and in several cases involved the ostium, reducing its diameter and producing a transient loss of patency. After 9?months of healing, the initial conditions were recovered.
| S-EPMC7396408 | biostudies-literature
Project description: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).
| S-EPMC6830603 | biostudies-literature
Project description:BackgroundA prevalent modality to increase the amount of available bone prior to implantation is grafting of the maxillary sinus. Multiple factors such as the surgical technique, moment of implant placement as well as grafting materials and membranes are known to affect implant survival. However, the role of different factor combinations and associated reciprocal effects remain unclear. Conventional statistical methods do not consider inconsistency of study designs and do not take covariables into account. Hence, a systematic research and meta-analysis was conducted to investigate the influence of various treatment modalities on implant survival in the grafted maxillary sinus.Materials and methodsA meta-analysis was conducted according to the PRISMA guidelines. Articles published from 1980 through January 2013 were electronically and manually searched in MEDLINE (Ovid), the Cochrane Register of Controlled Trials, the Database of Abstracts of Effects, and the Cochrane Database of Systematic Reviews. Clinical reports on single intervention sinus augmentation with root-form implants, a minimum of 10 patients and 6 months of loading were eligible for inclusion if implant survival was stated or calculable. Results were calculated by non-parametric univariate Kaplan-Meier analysis and Bayesian multivariate interval-censored Cox regression.ResultsA total of 122 publications on 16268 endosseous implants placed in grafted maxillary sinus were included. The treatment parameters surgical approach, grafting material and implant type showed no selective preference. However, application of membranes showed a significantly reduced hazard-ratio, independent of other co-factors.ConclusionsThe use of membranes is the most significant factor to achieve long-term implant survival in sinus augmentation procedures. More data exceeding 3 years follow-up are needed to address prospective confounding and improve clinical evidence.
| S-EPMC3776785 | biostudies-literature
Project description:AIM:To study the influence of a collagen membrane placed subjacent to the sinus mucosa on the dimensional changes of augmented maxillary sinus floor. METHODS:Twenty patients were recruited in the study and randomly assigned to two groups. After the elevation of the maxillary sinus mucosa, a collagen membrane with standardized dimensions was placed at the test sites subjacent to the sinus mucosa and the elevated space was filled with a xenograft, both at test and control sites. A collagen membrane was then used to cover the antrostomy at both sites, and sutures were applied to close the wounds. Cone beam computed tomographies (CBCTs) were taken for all patients before surgery (T0), after 1?week from sinus floor augmentation (T1), and after 9?months of healing (T2). Dimensional changes over time of soft and hard tissues were evaluated on the CBCTs. RESULTS:After 1?week of healing, the sinus floor was elevated by 10.0?±?2.8?mm and 10.6?±?2.5?mm at the no-membrane and membrane groups, respectively. After 9?months of healing, a similar reduction of the height was observed in both groups, providing a total vertical augmentation of 8.6?±?2.8?mm at the no-membrane sites and 9.1?±?3.1?mm at the membrane sites. After 9?months of healing, the hard tissues subjacent to the sinus mucosa appeared to be partially corticalized in three patients in the no-membrane group and in six patients in the membrane group. CONCLUSIONS:The use of collagen membranes subjacent to the sinus mucosa did not influence the dimensional variations of the augmented regions and the clinical outcomes after 9?months of healing also in absence of perforations.
| S-EPMC6702501 | biostudies-literature
Project description:ObjectivesResonance frequency analysis (RFA) is used to monitor implant stability. Its output, the Implant Stability Quotient (ISQ), supposedly correlates with insertion torque, a common measurement of primary stability. However, the reliability of RFA in condensed bone remains unclear.Material and methodsIn this human cadaver study in edentulous jaws and fresh extraction sockets, implants were inserted using a split-mouth approach into condensed or untreated bone. Mean ISQ, peak insertion torque, and pre- and postoperative bone volume fractions (BV/TV) were assessed.ResultsIn edentulous jaws, insertion torque and ISQ correlated both in untreated (r = 0.63, p = 0.02) and in condensed (r = 0.82, p < 0.01) bone. In extraction sockets, insertion torque and ISQ only correlated in untreated (r = 0.78, p < 0.01), but not in condensed bone (r = 0.15, p = 0.58). In all edentulous jaws, preoperative BV/TV correlated with insertion torque (r = 0.90, p < 0.0001), ISQ (r = 0.64, p < 0.001), and changes in BV/TV (r = -0.71, p < 0.01). In all extraction sockets, preoperative BV/TV did not correlate with either insertion torque (r = 0.33, p = 0.15), ISQ (r = 0.38, p = 0.09), or changes in BV/TV (r = -0.41, p = 0.09). Joint analysis identified preoperative BV/TV as a predictor of postoperative BV/TV (p < 0.001), insertion torque (p < 0.001), and ISQ (p < 0.001).ConclusionsRFA is feasible for monitoring stability after late implant placement into condensed bone, but not after immediate placement into condensed fresh extraction sites.
| S-EPMC9292279 | biostudies-literature
Project description:Objectives:Test the hypothesis of no difference in implant treatment outcomes after maxillary sinus floor augmentation with or without barrier membrane coverage of the lateral window. Material and Methods:A MEDLINE (PubMed), Embase and Cochrane library search in combination with a hand-search of relevant journals was conducted. Human studies published in English until the 5th of July, 2019 were included. Randomised controlled trials and controlled trials with an observation period of minimum six months were included. Primary outcomes included survival of suprastructures and implants. Secondary outcomes included implant stability quotient, peri-implant marginal bone loss, bone regeneration, patient-reported outcome measures, biologic and mechanical complications. Results:The electronic search and hand-searching resulted in 1068 entries. Six randomised controlled trials characterised by low to high risk of bias and one controlled trial with high risk of bias fulfilled the inclusion criteria. High implant survival rate was reported with both treatment modalities. Meta-analyses disclosed a mean difference of newly formed bone of 6.4% (confidence interval = 0 to 12.9) and non-mineralised tissue of -1.1% (confidence interval = -2.7 to 0.5), indicating more newly formed bone and diminished non-mineralised with barrier membrane coverage. Conclusions:There seem to be no statistically significant differences in implant treatment outcomes after maxillary sinus floor augmentation with or without barrier membrane coverage of the lateral window. However, barrier membrane coverage increases percentage of newly formed bone and diminishes proliferation of non-mineralised tissue. Thus, barrier membrane coverage seems to be beneficial and also preventing displacement of the grafting material.
| S-EPMC7012617 | biostudies-literature
Project description:AimTo compare the effectiveness of two xenografts for maxillary sinus floor augmentation in terms of clinical, radiographical, histologic, and molecular outcomes.Materials and methodsA split-mouth randomized clinical trial was conducted at the University of Granada. Ten consecutive patients in need of bilateral two-staged maxillary sinus floor augmentation were included. Each patient received both biomaterials (porcine bone mineral and anorganic bovine bone), which were randomly assigned for bilateral sinus augmentation. The maxillary autogenous bone scraped from the sinus access window was mixed with each xenograft at a 20:80 ratio. After a healing period of 6 months, bone biopsies were collected with a trephine during the implant placement in the regenerated area. Histologic, histomorphometrical, immunohistochemical, and molecular outcomes were analyzed. Clinical and radiographical data throughout the treatment phases were also evaluated.ResultsThe resulting anatomic features were similar between both groups. After six months of graft consolidation, the graft resorption rates were similar between both biomaterials. The histologic, histomorphometrical, and immunohistochemical results showed no statistical differences between groups.ConclusionAnorganic bovine bone and porcine bone mineral combined with maxillary autogenous cortical bone show similar biologic and radiologic features in terms of biomaterial resorption, osteoconduction, and osteogenesis when used for maxillary sinus floor augmentation.
| S-EPMC9313845 | biostudies-literature