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Introduction: Maxillary sinus augmentation is a common and predictable procedure utilized to gain vertical alveolar bone height to allow for successful placement of dental implants in the deficient posterior maxilla. The surgical techniques, however, may be associated with intraoperative complications, the most common of which is Schneiderian membrane perforation and, less commonly, bleeding and the loss of an implant into the sinus cavity. Case Presentation: In the current report, we present two cases with unique complications. A large perforation which was discovered after the graft material had been placed was successfully managed by carefully removing the graft material from both sides of the perforation and sealing the perforation with a resorbable membrane and a tack fixation. The second case involved a patient who presented with an implant that had migrated into the sinus during an unsuccessful transcrestal sinus lift. The case was successfully treated by locating and removing the implant through an intentional membrane perforation, repairing the perforation, and placing a new implant with simultaneous grafting. Conclusion: Management and repair of maxillary sinus membrane perforations that are either intentionally or iatrogenically created can be predictable procedures with favorable outcomes if thoughtful evaluation and treatment are provided. Managing such complications at the time of occurrence avoids unnecessary additional surgical procedures that might prove to be even more complicated. [ABSTRACT FROM AUTHOR]

Introduction: The Modified Osseodensification Visco‐Elastic (MOVE) protocol combines two established techniques for sinus lifting: osseodensification drills to elevate the Schneiderian membrane, and the use of a viscoelastic putty to distribute forces on the membrane, a combination first described by Neiva et al. (2019). This case series elucidates the technique for combining these materials, and its possible benefits, which include reduced procedure time, less traumatic sinus elevation, and more versatility for unusual sinus anatomy, such as sloped sinus floors and immediate implant sites. Case Series: The three cases, illustrating a single implant, adjacent implants, and an immediate implant, demonstrate various indications for using the MOVE protocol, documented with two‐ and three‐dimensional radiography. The MOVE protocol is explained in detail with supplemental photos of the steps. Conclusion: Applying the MOVE protocol has the potential to allow for same‐day implant placement in sites that previously required preoperative bone augmentation or lateral wall sinus access, thereby reducing the extent of surgical invasiveness associated with implant placement in the posterior maxilla. [ABSTRACT FROM AUTHOR]

Introduction: The traditional techniques of maxillary sinus floor elevation via a direct or indirect approach are suitable for the majority of cases. However, in cases of unfavorable anatomy and/or a thick lateral bony wall, we propose here a new approach for sinus floor elevation. Case Presentation: Forty‐two‐year‐old female presents for sinus floor elevation after a failed attempt due to anatomical limitations and intraoperative complications. During the second surgical procedure, the access to the sinus membrane was performed from the palatal side due to thickness of the buccal wall ranging from 6 to 9 mm and the presence of septa. The sinus augmentation was successful, allowing for future implant placement. Conclusion: In selected cases, when the anatomy of the maxillary sinus poses limitations and the lateral wall thickness requires significant bone removal, the palatal approach is a valid alternative to the traditional sinus augmentation techniques. [ABSTRACT FROM AUTHOR]

Down Syndrome or trisomy 21 (T21) is a genetic condition caused by the presence of an extra chromosome in pair 21 and is related to a high prevalence of agenesis of permanent teeth and periodontal alterations that may be associated to the loss of permanent teeth at early ages. With the increase in life expectancy of people with T21 in the last decades, it is necessary to expand the knowledge to offer possibilities of treatment with dental implants, aiming to serve this aging population. Aims: The aim of this article is to report a surgical procedure of sinus lift to enable the installation of dental implants in the posterior region of the maxilla. Methods and results: A 50 year‐old patient with T21 was rehabilitated with implants, simultaneously with sinus lift surgery, by the lateral window technique, using xenogenous bone graft and fibrin‐rich plasma. After 1 year, the patient was rehabilitated with prosthetics on implants. Conclusion: The feasibility of this technique in patients with Down syndrome could be observed, after 3 years of follow up, with favorable clinical results. [ABSTRACT FROM AUTHOR]

Purpose: The bone-implant interface plays a crucial role in obtaining sufficient primary stability for dental implants in weak bone supports. The aim of this human cadaver study was to evaluate the primary stability of new thin-threaded implants when placed in type IV bone right after maxillary sinus floor elevation., Materials and Methods: The study followed the CACTUS (ChAracteristics of Cadaver Training and sUrgical Studies) guidelines. Twenty-four edentulous maxillary posterior zones with type IV bone and a residual bone height of 4 mm were selected using computed tomography scans. First, an osteotome sinus floor elevation was performed (C.M.C Tech, IBS IMPLANT, Daejeon, South Korea). Implants with thin threads (MagiCore, IBS IMPLANT, Daejeon, South Korea) were placed simultaneously. Samples were divided into two groups: Group 1 (G1): 11 mm-long implants with an elevation of 8 mm; Group 2 (G2): 7 mm-long implants with an elevation of 4 mm. Primary stability was assessed using resonance frequency analysis (RFA)., Results: The average primary stability values in the mesiodistal (MD) direction were 45.67 ± 3.09 Implant Stability Quotient (ISQ) for G1 and 38.76 ± 16.94 ISQ for G2, and in the buccolingual direction were 43.33 ± 13.23 ISQ for G1 and 38.47 ± 16.14 ISQ for G2., Conclusions: The primary stability of the thin-threaded implants was compatible with clinical osseointegration in sinus sites with limited bone contact area in both experimental situations. Clinical studies are needed to confirm these encouraging results., (© 2024 The Author(s). Journal of Prosthodontics published by Wiley Periodicals LLC on behalf of American College of Prosthodontists.)

Abstract Background Autogenous bone graft is considered as the preferred grafting material for maxillary sinus floor augmentation (MSFA). However, harvesting of extraoral or intraoral autogenous bone graft is associated with risk of donor site morbidity and supplementary surgery. From a clinical and patient perspective, it would therefore be an advantage, if postoperative discomfort could be minimized by diminishing the need for autogenous bone graft harvesting. The objective of the present study was to test the hypothesis of no difference in patient’s perception of recovery after MSFA with autogenous bone graft from the zygomatic buttress (control) compared with 1:1 mixture of autogenous bone graft and deproteinized porcine bone mineral (DPBM) (Test I) or biphasic bone graft material (BBGM) (Test II). Sixty healthy patients were randomly allocated to either control or test groups. Oral Health-related Quality of Life (OHRQoL) was evaluated by Oral Health Impact Profile-14 (OHIP-14) at enrollment. Recovery was estimated by self-administrated questionnaires and visual analog scale assessing pain, social and working isolation, physical appearance, eating and speaking ability, diet variations, sleep impairment and discomfort after 1 week and 1 month. Descriptive statistics was expressed as mean with standard deviation (SD). Correlation between OHRQoL at enrollment and recovery were assessed by linear regression. p-value below 0.05 was considered significant. Results Treatment satisfaction and willingness to undergo similar surgery were high in all groups. Average numbers of days with pain and sick leave were 3.5 (SD 3.9) and 0.5 (SD 1.2), respectively, with no significant difference between groups. Moreover, no significant difference in eating and speaking ability, physical appearance, work performance and sleep impairment were seen between groups. Mean OHIP-14 score at enrollment was 9.30 (SD 9.25) (control), 9.95 (SD 7.96) (Test I) and 8.15 (SD 9.37) (Test II), with no significant differences between groups. Impaired OHRQoL, gender or age seems not to predispose for delayed recovery or increased postoperative discomfort. Conclusions MSFA with diminutive autogenous bone graft harvesting is associated with high patient satisfaction, limited postoperative discomfort and willingness to undergo similar surgery. Presurgical OHRQoL, gender or age seems not to be associated with impaired patient’s perception of recovery.

Abstract Purpose The success rate of dental implants after graftless sinus augmentation versus conventional sinus augmentation surgery in atrophic maxillae in edentulous patients was investigated. Methods This randomized study was performed in ten edentulous patients with marked maxillary atrophy. On the graftless side, the sinus membrane was lifted by a resorbable membrane. The control side was augmented with a mixture of autografts and xenografts. Implant placement followed 6 months postoperatively. Outcomes were implant survival, success of prosthetic rehabilitation and stability of vertical bone gain. Results Ten patients were included. Postoperative radiology showed sufficient bone gain on both maxillary sides. Follow-up varied from 57 to 88 months. The conventional side showed significant (p = 0.041) more bone gain than the experimental side (respectively, 9.69 mm and 6.20 mm). A total of 59 implants were placed: 30 after conventional, 29 after graftless augmentation. One implant was lost on the conventional side and four on the experimental side. The implant survival was significantly higher on the conventional side (96.7% vs. 86.2%, p

ABSTRACT The loss in height of the alveolar bone crest after tooth extraction makes rehabilitation of the posterior maxilla challenging due to low bone density and atrophy, in addition to pneumatization of the maxillary sinus. Maxillary sinus lift surgery prior to implant placement makes implant-supported rehabilitation feasible. This study aimed to describe a case report of maxillary sinus surgery using the side window technique prior to rehabilitation with a prosthesis supported by dental implants, highlighting the importance of planning to minimize intraoperative complications. This is a clinical case report of a 59-year-old male patient who was assisted at a private higher education institution complaining of edentulous spaces and the desire for rehabilitation with implants. He underwent rehabilitation planning, including the surgical treatment of maxillary sinus lifting using the side window technique. Bone gain was confirmed using cone beam computed tomography six months after the surgical approach to the maxillary sinus. The planning of rehabilitation of the posterior maxilla and careful sinus lift surgery using the side window technique is a predictable therapeutic option for clinical cases with bone gain in height of the posterior region of the maxilla prior to the installation of dental implants. The clinical case presented demonstrated success in the gain of bone volume in the posterior region of the maxilla, without postoperative complications, and the patient was still satisfied with the proposed treatment, awaiting complete implant-supported rehabilitation.

Objective: This systematic review aimed at assessing the effect of the repositioned bone lid on bone augmentation in lateral sinus lift in pre-clinical in vivo and clinical studies. Secondary aims were to report on the healing of the bone window and to assess the implant survival rate. Material and methods: Animal and human studies comparing lateral maxillary sinus floor elevation in combination or not with the repositioned bone lid were retrieved from MEDLINE (PubMed), Web of Science and Cochrane online library. Studies published in English up to April 2022 and reporting on histological and/or radiographic outcomes were considered. Case reports, case series and reviews were excluded. A hand search was also conducted. Risk of bias was assessed and meta-analysis performed to investigate the effect of the bone lid on new bone formation. Results: After screening, 5 animal studies (4 in rabbits, 1 in sheep) and 2 clinical studies (1 RCT, 1 case–control) were included. Meta-analysis confirmed a higher new bone formation in rabbits at 2 and 8 weeks using the bone lid. The two clinical studies investigated lateral sinus lift with concomitant implant placement and reported similar results and high short-term implant success rate in both test and control groups. Conclusions: The meta-analysis provided moderate evidence that the repositioned bone lid favored the formation of new bone to a higher extent as compared to resorbable membranes in animal studies. Implant success seems not to be influenced by the technique in the short term. [ABSTRACT FROM AUTHOR]

Objectives: To retrospectively evaluate whether repositioning the bone window leads to a better outcome of three‐dimensional sinus augmentation in lateral sinus floor elevation (LSFE) with simultaneous implant placement. Methods: 34 patients with a total of 40 implants (14: test group, 26: control group) receiving LSFE with simultaneous implant placement were included in this retrospective research. CBCT images were taken before surgery, immediately and 6 months after surgery. The two‐dimensional augmentation parameters, including apical bone height (ABH), endo‐sinus bone gain (ESBG), and palatal/buccal bone height (PBH/BBH), and three‐dimensional parameters, including augmentation volume (AV) and palatal/buccal augmentation volume (PAV/BAV), were measured. The lateral defect length (LDL) and lateral window length (LWL) were also measured to evaluate the lateral antrostomy recovery. Results: At the 6‐month follow‐up, the reduction rates at ABH, ESBG, and BBH of the test group (ABH: 10.41% ± 30.30%, ESBG: 2.55% ± 8.91%, BBH: 2.50% ± 8.65%) were significantly lower than those of the control group (ABH: 25.10% ± 22.02%, ESBG: 11.47% ± 9.79%, BBH: 7.10% ± 5.37%; p <.05). In addition, the test group showed better three‐dimensional augmentation stability on the buccal side (BAV reduction: 15.51% ± 10.86% vs. 27.15% ± 12.61%; p <.05). Moreover, the LDL/LWL ratio of the test group was significantly lower than that of the control group (p <.05). Conclusion: Within the limitations of this study, repositioning of the bone window in LSFE with simultaneous implant placement could contribute to endo‐sinus augmentation stability on the buccal side at the 6‐month follow‐up. Moreover, it would also facilitate recovery of the lateral antrostomy defect. [ABSTRACT FROM AUTHOR]

Background: Implant placement in maxillary molar sites with severe height deficiency often requires multiple surgeries, which was time‐consuming, invasive, and subject to serious postoperative complications. Purpose: To introduce and assess a three‐in‐one technique (extraction, alveolar ridge preservation [ARP], and sinus elevation) for augmenting deficiency maxillary molar alveolar ridges. Material and Methods: Fourteen patients with severe posterior maxillary ridge height deficiency underwent extraction, sinus elevation via an intrasocket window and ARP using sticky bone and then covered with acellular dermal matrix (ADM). Primary closure was intentionally not obtained. Cone‐beam computed tomography and periapical radiography were used to measure dimensional ridge changes over time. Bone biopsies were taken at implant placement 7–21 months after surgery, which proceeded without additional grafting. Peri‐implant soft tissue was assessed after 8–12 months of functional loading. Results: Maxillary molar sites (13 first molars, 1 second molar) with a mean sinus floor height of 1.73 ± 0.86 mm and mean buccal plate thickness of 1.62 ± 1.15 mm were elevated and grafted. Immediately after surgery, the mean sinus floor height was 14.03 ± 1.97 mm and the alveolar thickness at virtual implant platform level was 12.99 ± 1.88 mm. After 5–9 months healing, those measurements decreased by 2.45 ± 1.73 mm (p = 0.000) and 3.88 ± 3.95 mm (p = 0.006), respectively. Healed ridges were composed of 18.74% ± 4.34% mean vital bone and 19.08% ± 9.10% mean residual graft. After 8–12 months of functional loading, the peri‐implant tissue appeared healthy, and there was a mean marginal bone loss of 0.12 ± 0.11 mm. Conclusions: For maxillary first molar sites with severe sinus floor height deficiency, this minimally invasive three‐in‐one treatment allows for uncomplicated implant placement and short‐term functional stability. [ABSTRACT FROM AUTHOR]

The aim of this study was to compare the clinical effects of osteotome sinus floor elevation (OSFE) combined with concentrated growth factor (CGF) and simultaneous implant placement with or without bone grafting in the maxillary posterior region, where the residual bone height (RBH) was 4–6 mm. A total of 44 patients who underwent OSFE combined with CGF and the simultaneous placement of 60 implants (group A, 31 implants with bone grafting; group B, 29 implants without bone grafting) were included in this retrospective study. The clinical indicators of implants were observed for 24 months. Sinus floor lift height was 6.02 ± 0.99 mm in group A and 5.81 ± 0.72 mm in group B (P = 0.360) after surgery. There was no significant difference in the vertical bone resorption between the two groups at 24 months (P = 0.097). Postoperative pain at 14 days (visual analogue scale) was significantly greater in patients with bone grafting when compared to those without bone grafting (P < 0.001). There was no significant difference in marginal bone loss (MBL) between the two groups (P = 0.707 for MBL during the first 12 months, P = 0.922 for MBL during months 12–24). The implant success rate was 100% with or without bone grafting. The technique of OSFE with CGF, either with or without bone grafting, is safe and reliable in patients with RBH 4–6 mm. [ABSTRACT FROM AUTHOR]

Copyright of Turkiye Klinikleri Journal of Dental Sciences is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This prospective single-arm clinical study aimed to radiographically and histomorphometrically evaluate the efficacy of the lateral approach for sinus floor elevation (LSFE) using biomimetic octacalcium phosphate (OCP) synthetic bone graft (Bontree®). LSFE using Bontree® was performed on 10 patients (15 implant placement sites) willing to undergo implant surgery, followed by implant placements after 6 months of the healing period. The vertical bone height (VBH) and Hounsfield unit (HU) values at each implant placement site were evaluated radiographically using cone-beam computed tomography at baseline immediately after surgery (T1) and 6 months after surgery (T2). A histomorphometric evaluation of the bone core biopsy specimen was also performed. The mean VBH and HU changes at all sites included a decrease by 0.91 mm and a statistically significant increase by 431.86, respectively, from T1 to T2. The mean ratio of the newly formed bone (23.34% ± 10.63%) was greater than that of the residual bone graft (19.09% ± 8.74%), indicating that Bontree® is effective for new bone formation. This pilot study suggests that Bontree® is a promising bone substitute for LSFE. [ABSTRACT FROM AUTHOR]

Objective: The effect of different deproteinized bovine bone mineral (DBBM) particle sizes on bone healing in maxillary sinus floor augmentation remains unclear. This study compared the newly formed tissue and angiogenesis‐related bone healing after sinus floor augmentation using large or small DBBM particles. Materials and Methods: Overall 32 patients were randomly divided into two groups using either large (1–2 mm) or small (0.25–1 mm) DBBM particles for sinus floor augmentation. After 6 months, the mineralized tissue volume was calculated using micro‐computed tomography (micro‐CT) analysis. The newly formed tissue composition was histomorphometrically analyzed. Angiogenesis was also examined by means of vascular endothelial growth factor (VEGF) expression. Implant failure and marginal bone loss were measured at a 1‐year follow‐up. Statistical analysis was performed using independent samples t‐test. Results: Micro‐CT analysis demonstrated that grafting with large particles resulted in higher bone volume (6.99 ± 2.72 mm3, p = 0.002) and Bone Volume/Tissue Volume (0.25 ± 0.1, p = 0.03) compared with small particles (3.76 ± 1.83 mm3 and 0.14 ± 0.13, respectively). Small particles showed higher non‐mineralized tissue volume (26.31 mm3) compared with large particle group (17.4 ± 5.34 mm3) with p = 0.001. The histological data revealed significantly higher area of newly formed bone (32.15% ± 14.04% for the large particle and 15.99% ± 14.12% for the small particle groups, p = 0.004). Likewise, non‐mineralized tissue was significantly greater in the small particle group (66.48% ± 20.97%) compared with the large particle group (44.36%, p = 0.016). Moreover, use of large particles resulted in a significantly higher VEGF staining intensity score and VEFG positive cells. No implant failure was recorded in both groups, while no difference was found in terms of marginal bone loss at the 1‐year follow‐up. Conclusions: Sinus floor augmentation using large DBBM particles resulted in more angiogenesis expression, higher bone volume, and new bone formation at 6 months after sinus augmentation. However, clinical outcomes with regards to implant placement were similar in both groups. [ABSTRACT FROM AUTHOR]

Copyright of Acta Stomatologica Croatica is the property of Acta Stomatologica Croatica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The aim of this systematic review and meta-analysis was to determine the prevalence and characteristics of maxillary sinus septa using cone beam computed tomography and computed tomography data. Publications were searched until October 5, 2020 in three electronic databases. Additionally, article bibliographies were searched, and authors were contacted if required. This review has been registered in PROSPERO (CRD42019124933). Two independent evaluators assessed methodological quality using the Joanna Briggs Institute levels of evidence; inter-rater reliability tests were performed (Cohen's κ). The prevalence of maxillary sinus septa was expressed as a proportion; differences according to sex were reported in terms of the odds ratio (OR) and 95% confidence interval (95% CI). Heterogeneity and sources of heterogeneity were evaluated by meta-regression. Publication bias was assessed by visual analysis of the funnel plot. Statistical significance was set at P < 0.05. The 62 studies identified and included in the review involved 13,701 patients (22,460 sinuses). The meta-analysis of 35 studies (14,664 sinuses) revealed an overall mean sinus septa prevalence per sinus of 33.2% (95% CI 27.8–38.5%; I 2 = 98.32%). The meta-analysis of 42 studies (9631 patients) found an overall mean sinus septa prevalence per patient of 41.0% (95% CI 36.0–46.0%, I 2 = 96.45%). The OR for the difference in septa prevalence between sexes was 0.785 (95% CI 0.590–1.046; P = 0.098, I 2 = 73.24%). Septa were most frequent in the middle area of the sinus and with a transverse orientation (86.0%). Within the limitations, the results suggest a high proportion of septa in the sinus, commonly in the middle area, which can interfere with the success of sinus floor elevation required for implant rehabilitation. [ABSTRACT FROM AUTHOR]

Objective: To compare the sequential healing of maxillary sinuses grafted with two different xenogeneic bone substitutes processed at either a low (300°C) or high (1200ºC) temperature. Methods: A sinus augmentation procedure was performed bilaterally in 20 rabbits and two different xenogeneic bone grafts were randomly used to fill the elevated spaces. Healing was studied after 2 and 10 weeks, in 10 rabbits during each period. Results: After 2 weeks of healing, very small amounts of new bone were observed in both groups, and were mainly confined to close to the sinus bone walls and osteotomy edges. After 10 weeks of healing, new bone was found in all regions, with higher percentages in those close to the bone walls and to the osteotomy. In this period of healing, the proportion of new bone in the 300°C group was 20.0% ± 4.3%, and in the 1200ºC group it was 17.2% ± 4.3% (P = 0.162). In the 1200ºC group, translucent, dark fog-like shadows in regions of the grafts were hiding portions of new bone (interpenetrating bone network). Conclusion: Both biomaterials provided conditions that allowed bone growth within the elevated space, confirming that both biomaterials are suitable to be used as a graft for sinus floor augmentation. [ABSTRACT FROM AUTHOR]

Dental implant treatment in the posterior maxilla encounters bone quality and quantity problems. Sinus elevation is a predictable technique to overcome height deficiency in this area. Transalveolar sinus elevation is a technique that is less invasive and less time-consuming, first introduced for ridges with at least 5 mm of bone height. Many modifications and innovative equipment have been introduced for this technique. This review aimed to explain the modifications of this technique with their indications and benefits. An exhaustive search in PubMed Central and Scopus electronic databases was performed until December 2020. Articles were selected that introduced new techniques for the transalveolar maxillary sinus approach that had clinical cases with full texts available in the English language. Finally, twenty-six articles were included. The data were categorized and discussed in five groups, including expansion-based techniques, drill-based techniques, hydraulic pressure techniques, piezoelectric surgery, and balloon techniques. The operator’s choice for transalveolar approach techniques for sinus floor elevation can be based on the clinician’s skill, bone volume, and access to equipment. If possible, a technique with simultaneous implant placement should be preferred.

This meta-analysis and systematic review focused on the following question: Does tobacco smoking increase the risk of intra- or postoperative complications of lateral maxillary sinus floor elevation? Materials and Methods: The following electronic databases were searched up to and including November 2015 without language restriction: CENTRAL, MEDLINE, Google Scholar, Scopus, Sirous, and Doaj. Studies were included if rates of intraor postoperative complications of sinus floor elevation in smokers and nonsmokers were recorded separately. The following complications were assessed: sinus membrane perforation, bleeding, wound dehiscence, wound infection, sinusitis, hematoma, and oroantral fistula. The Critical Appraisal Skills Programme was used to assess the risk of bias in included studies. Random-effects meta-analyses were used to assess the number of each complication in smokers and nonsmokers. Results: Out of 929 eligible publications, 11 articles were included. Meta-analysis of the studies revealed a significantly increased risk of developing wound dehiscence after sinus floor elevation among smokers compared with nonsmokers (Risk Ratio [RR]: 7.82; 95% confidence interval [CI]: 2.38, 25.74; P = .0007). Moreover, risk of developing wound infection was greater in smokers when prospective studies were included in the meta-analysis (RR: 5.33; 95% CI: 1.34, 21.25; P = .02). However, the meta-analysis of included studies did not show significant differences between smokers and nonsmokers concerning risk of sinus membrane perforation and bleeding during sinus floor elevation (P = .46 and P = .33, respectively). Conclusion: Considering the lack of randomized controlled trials and the small number of included studies, the results indicate that smoking seems to be associated with increased risk of wound dehiscence and infection after the sinus augmentation procedure. [ABSTRACT FROM AUTHOR]

Purpose: There is a paucity of studies that evaluate the treatment outcomes of transcrestal sinus elevation performed without using osteotomes. This study aims to evaluate the 4-year survival of short dental implants placed following transcrestal sinus elevation performed with a frontal cutting drill and to measure the marginal bone stability. Materials and Methods: Transcrestal sinus elevation was performed by sequential bone drilling using a frontal cutting drill. Short (≤ 8.5 mm) dental implants were placed. The patients’ demographic data were described. Implant details, survival, marginal bone loss, and complications were analyzed. The implant survival rate was calculated using the Kaplan-Meier method. Results: Fifty-eight implants were placed in 38 patients with a mean age of 56 ± 7 years. The residual bone height was 4.6 ± 1.2 mm and bone grafting was performed for 15 implants. The mean follow-up time was 47 ± 12 months and 41 ± 9 months after insertion and loading, respectively. The implant survival rate was 96.6%, due to 2 implant failures. Cox regression analysis failed to indicate that implant length had a significant effect on the survival rate. Mesial and distal bone loss amounts were 0.9 ± 1 mm and 1.1 ± 1.0 mm, respectively. Conclusion: The use of bone drills alone to perform transalveolar sinus floor elevation is not a risk factor for implant survival and marginal bone stability. A combination of short implants and transcrestal sinus elevation can be effective in the treatment of posterior maxillae with a mean residual bone height < 5 mm. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this retrospective study was to evaluate implant survival rates (ISRs) for implants placed in grafted sinuses where a membrane perforation occurred during augmentation using exclusively anorganic bovine bone (ABB) by means of clinical and radiographic examinations. Histologic information of five biopsy specimens taken from large membrane perforations is also presented. Materials and Methods: Consecutive patients who underwent sinus augmentation procedures at a private practice Dental Institute between 2004 and 2013 were collected from a computer database. The following profiles were selected for data analysis: computed tomography prior to treatment; perforated membrane information according to size: not perforated, small (≤ 5 mm), medium (> 5 and < 10 mm), or large (≥ 10 mm); sinuses grafted exclusively with ABB and lateral window covered with a collagen membrane (CM); and implant survival after at least 2 years of functional loading placed in augmented sinuses. Implants were considered survivals in the absence of infection, mobility, or pain. Results: The sample in this retrospective study comprised 531 patients; 214 required bilateral sinus augmentation, and 317 required unilateral sinus augmentation (total = 745 sinuses). A total of 1,588 implants were placed. From 745 augmented sinuses, 237 (31.8%; 523 implants) were perforated during the procedure. Among these, 48 perforations were large (20.2%; 107 implants), 67 (28.3%; 150 implants) were medium, and 122 were small (51.5%; 266 implants). Of 523 implants placed in perforated sinuses, 15 were lost (ISR = 97.1%). Comparison of the ISRs for small (97.7%), medium (97.3%), and large (95.3%) perforations with 1,065 implants placed in nonperforated sinuses (ISR = 97.7%) was not statistically significant. The histomorphometric analysis of the five biopsy specimens showed 24.52% ± 6.99% of new bone, 24.32% ± 6.42% of marrow space, and 51.2% ± 3.75% of the remaining ABB. Conclusion: The difference in ISR for implants placed in perforated and nonperforated sinuses was not statistically significant. Within the limits of the histologic data, histomorphometric results with 24.52% ± 6.99% of new bone formation in sinuses with large perforations showed similar bone formation compatible with nonperforated sinuses described in the literature. The authors attributed the high ISR shown in perforated sinuses in this study to the proper management of the perforations. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this systematic review was to assess the difference in the incidence of intraoperative and postoperative complications between the conventional and alternative surgical techniques, during sinus floor augmentation surgery. Data Sources: Electronic databases were searched for publications related to sinus floor augmentation surgery performed with different techniques (ie, conventional lateral window, piezosurgery, osteotome, trephine) and the incidence of complications. The articles were evaluated by independent reviewers, according to predetermined inclusion/ exclusion criteria and processed for meta-analysis, following the PRISMA protocol. Initial search returned 3,940 articles, after inclusion/exclusion criteria, and quality assessment 11 articles were included in the meta-analysis: five randomized clinical trials and six retrospective studies. All the 11 included studies compared the incidence of complications in conventional lateral window sinus augmentation surgery versus alternative techniques, including: osteotome (five articles), piezosurgery (four articles), sonic surgery (one article), and trephine (one article). Meta-analysis of the incidence of intraoperative and postoperative complications during conventional lateral window sinus floor augmentation surgery versus alternative techniques, showed a significantly lower incidence of intraoperative complications for the retrospective studies. However, when data from the clinical trials alone were included in the meta-analysis, a statistically significant difference could not be detected for the incidence of intraoperative and postoperative complications. Conclusions: The use of alternative techniques for sinus floor augmentation surgery (ie, piezosurgery, sonic surgery, osteotome, and trephine) does not necessarily reduce the incidence of intraoperative and/or postoperative complications compared to the conventional technique. [ABSTRACT FROM AUTHOR]

Purpose: To determine the clinical value of membranes in bone augmentation procedures such as ridge augmentation with simultaneous (one-stage) and delayed (two-stage) implant placement, sinus augmentation surgery, ridge preservation and immediate implant placement. Materials and methods: In April 2016, Embase, Medline (Ovid-SP), Cochrane Central, Web of Science and PubMed (as supplied by the publisher) were searched. There were no restrictions regarding language or publication date. Randomised controlled trials that reported membranes in bone augmentation procedures with a minimum follow-up period of 6 months after implant loading or that described geometrical changes of the bone graft at re-entry were included. Membrane placement had to be the only variable in the procedure. Outcomes were implant failure, complications, horizontal bone gain and resorption, graft resorption, defect height reduction, marginal bone loss around implants, aesthetic results and patient satisfaction. The results were pooled using fixed-effect models with mean differences (MDs) for continuous outcomes and odds ratios (ORs) for dichotomous outcomes. Results: After screening the titles and abstracts of 1843 papers, 32 potentially eligible articles were selected. Seventeen articles involving 10 trials were included in this review. These studies presented outcome data for 355 patients. Seven trials were considered to be at a high risk of bias, two at a low risk of bias and one at an unclear risk of bias. Insufficient evidence was found to determine whether there were differences in implant failure rates, marginal bone level changes, aesthetic results or patient satisfaction. For one-stage ridge augmentation (two trials; n = 52), there was evidence of more horizontal bone gain (MD: 0.84 mm, 95% CI: 0.46 to 1.21, P < 0.00001; two trials), defect height reduction (MD: 18.36%, 95% CI: 10.23 to 26.50, P < 0.00001; two trials), and prevention of graft resorption (P = 0.004; one trial) in favour of the membrane-covered group, although substantial heterogeneity was found for horizontal bone gain (Chi²; P = 0.05, I²=74%). There was insufficient evidence to determine whether any differences exist in two-stage ridge augmentation (three trials; n = 81), sinus augmentation (one trial; n = 104) and ridge preservation (one trial; n = 20). For immediate implant placement (three trials; n = 98), there was evidence of an increased defect height reduction in favour of the membrane-covered groups (MD: 6.25%, 95% CI: 1.67 to 10.82, P = 0.007; two trials), although with substantial heterogeneity (Chi²; P = 0.03, I² = 79%). More complications were observed when a membrane was used (OR: 2.52, 95% CI: 1.07 to 5.93, P = 0.03; three trials). Conclusions: There is insufficient evidence regarding the effects of membranes on bone augmentation procedures to support any definitive conclusions. Only 10 studies were included; they had limited sample sizes and short follow-up periods, and the majority were at a high risk of bias. However, no difference in implant failure was found, and the possible clinical value is still unknown, as long-term clinical parameters such as marginal bone loss, aesthetic results and patient satisfaction have been insufficiently studied. [ABSTRACT FROM AUTHOR]

Abstract Background Currently, insufficient bone volume always occurs in the posterior maxilla which makes implantation difficult. Short implants combined with transcrestal sinus floor elevation (TSFE) may be an option to address insufficient bone volume. Purpose The clinical performance of short implants combined with TSFE was compared with that of conventional implants combined with TSFE according to the survival rate. Method In this systematic review and meta-analysis, we followed the Meta-Analysis of Observational Studies in Epidemiology (MOOSE) guidelines. Articles were identified through PubMed, Embase, the Cochrane Library, and manual searching. Eligibility criteria included clinical human studies. The quality assessment was performed according to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. The odds ratio (OR) with its confidence interval (CI) was considered the essential outcome for estimating the effect of short implants combined with TSFE. Results The registration number is INPLASY202050092. Eleven studies met the inclusion criteria, including 1 cohort study and 10 cross-sectional studies. With respect to the 1-year survival rate, no significant effect was observed between short implants (length ≤ 8 mm) and conventional implants combined with TSFE (I 2=0%, OR=1.04, 95% CI: 0.55-1.96). Similarly, no difference was seen between the two groups regarding the survival rate during the healing period (I 2=10%, OR=0.74, 95% CI: 0.28-1.97) and 3-year loading (OR=1.76, 95% CI: 0.65-4.74). Conclusion There was no evidence that the survival rate of short implants combined with TSFE was lower or higher than that of conventional implants combined with TSFE when the residual bone height was poor and the implant protrusion length of short implants was less than or similar to conventional implants. Nevertheless, the results should be interpreted cautiously due to the lack of random controlled trials in our meta-analysis.

Abstract Background Osteotome-mediated sinus floor elevation with or without a grafting material is associated with high implant survival, intrasinus bone gain, and low frequency of complications. However, patient’s perception of recovery and satisfaction with the surgical intervention are rarely reported. The objective of the present randomized controlled trial was to assess patient’s perception of recovery after osteotome-mediated sinus floor elevation with Bio-Oss collagen compared with no grafting material. Forty healthy patients were randomly allocated to Bio-Oss collagen or no grafting material. Oral health-related quality of life was assessed by Oral Health Impact Profile-14 at enrollment. Patient’s perception of recovery was assessed by self-administrated questionnaires and visual analog scale evaluating pain, social and working isolation, physical appearance, duration and quality of life alterations, eating and speaking ability, diet variations, and sleep impairment after 1 week and 1 month, respectively. Descriptive statistics was expressed as mean percentage with standard deviation. Correlation between impaired oral health-related quality of life, age, gender, and recovery were assessed by T test. Level of significance was 0.05. Results Osteotome-mediated sinus floor elevation is associated with high patient satisfaction, limited postoperative discomfort, and willingness to undergo similar surgery. Influence on patient’s daily life activities seems to be minimal and limited to the first postoperative days. Most patients managed to return to work and their routine daily activities after 0-2 days. Impaired preoperative oral health-related quality of life, gender, or younger age seems not to predispose for delayed recovery. However, number of days with pain, eating difficulties, and sleep disturbances were significantly increased with Bio-Oss collagen compared with no grafting material (P

Background: This study aimed to evaluate peri-implant bone formation in rabbits after sinus grafting mediated by hydroxyapatite and beta-tricalcium phosphate (HA + β-TCP) in granule or paste configurations, concomitant with immediate implant installation. Material & methods: Thirty-four rabbit maxillary sinuses were grafted with HA + β-TCP, half of which were applied in a granule and half in a paste composition. Implant placement was performed simultaneously. At 7 and 40 days postoperatively, the animals were euthanized, and samples were prepared for tomographic, microtomographic, histological, histometric (hematoxylin and eosin staining, HE), and immunohistochemical (labeling of transcription factor Runx-2 [RUNX2], vascular endothelial growth factor [VEGF], osteocalcin [OCN], and tartrate-resistant acid phosphatase [TRAP]) analysis. Implant removal torque was also measured. Results: On tomography, maintenance of sinus membrane integrity was observed in both the groups. Higher values of morphometric parameters evaluated by micro-CT were found in the “paste group” after seven days. At 40 days, there were no significant differences between the groups in most of the microtomographic parameters evaluated. In histological sections stained with HE, a higher percentage of newly formed bone was observed in the “granule group” after 40 days. Similar positive immunolabeling was observed for both RUNX2 and OCN in both the experimental groups. TRAP immunolabeling was similar in both groups as well. VEGF labeling increased in the “granule group”, indicating a higher osteoconductive potential in this biomaterial. Similar removal torque values were observed in both groups. Thus, the two HA + β-TCP configurations showed similar healing patterns of simultaneously installed implants adjacent to sinus floor elevation. However, significantly higher bone values were observed for the “granule configuration”. Conclusions: The HA + β-TCP granules and paste presentations showed favorable long-term healing results, with bone formation in similar quantities and quality adjacent to the implants.

Sinus floor elevation (SFE) is a standard surgical technique used to compensate for alveolar bone resorption in the posterior maxilla. Such a surgical procedure requires radiographic imaging pre- and postoperatively for diagnosis, treatment planning, and outcome assessment. Cone beam computed tomography (CBCT) has become a well-established imaging modality in the dentomaxillofacial region. The following narrative review is aimed to provide clinicians with an overview of the role of three-dimensional (3D) CBCT imaging for diagnostics, treatment planning, and postoperative monitoring of SFE procedures. CBCT imaging prior to SFE provides surgeons with a more detailed view of the surgical site, allows for the detection of potential pathologies three-dimensionally, and helps to virtually plan the procedure more precisely while reducing patient morbidity. In addition, it serves as a useful follow-up tool for assessing sinus and bone graft changes. Meanwhile, using CBCT imaging has to be standardized and justified based on the recognized diagnostic imaging guidelines, taking into account both the technical and clinical considerations. Future studies are recommended to incorporate artificial intelligence-based solutions for automating and standardizing the diagnostic and decision-making process in the context of SFE procedures to further improve the standards of patient care.

Purpose: The objective of this retrospective study was to evaluate the long-term clinical outcomes of bone regeneration procedures using algae-derived plant hydroxyapatite (Algipore® FRIOS®) compared with demineralized anorganic bovine bone (Bio-Oss®), in combination with autologous blood-derived PRP. Materials and Methods: Partially edentulous patients with severe atrophy of posterior maxillary treated by means of the split bone technique in a two-stage grafting procedures were observed for up to seven years after implants placement. After surgeries, the natural porous fluorohydroxyapatite (FHA) (Algipore® FRIOS®; Group, n = 29) or anorganic bovine bone (Bio-Oss® Group, n = 28) with autogenous bone in a 50:50 composite ratio with PRP, were administered in a 2.8-mm critical-size defect (CSD). Four months later, implants were placed at second-stage surgery. Results: A sample of fifty-seven consecutive patients who required sinus augmentation was included in the study, and 57 implants were placed. There was no drop out or loss of follow-up of any case. Clinical and radiographic examinations revealed a comparable pattern of newly formed bone in both groups after seven years of functional loading for implants placed after sinus augmentation using porous fluorohydroxyapatite and anorganic bovine bone. No significant difference in marginal bone loss was found around implants in both groups. Conclusions: The favorable implant outcomes suggest both biomaterials are suitable for sinus grafting in severely atrophic maxillae. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study is to analyze if there is any statistical correlation between the surgery's complexity (easy to difficult—depending on the anatomical conditions) and the patient's sex, type of edentulism, and left or right side of the maxilla. Methods: Cone beam computed tomography records of 1192 maxillary sinuses were evaluated, measured, and statistically analyzed with respect to patient sex, type of edentulism, and left or right side, taking into consideration Wen's proposed sinus septum classification. Results: Our research suggests that most sinus augmentation procedures in patients presenting antral septum fall into the Moderate A category (31.94%) and that there is not a correlation between the surgery's complexity (easy to difficult) and the patient's sex, type of edentulism and left or right side of the maxilla. Conclusion: We suggest a minor modification to Wen's classification in view of the fact that our findings revealed a combination of medio-lateral and antero-posterior septa that we could not classify in one of the existing categories. [ABSTRACT FROM AUTHOR]

Objective: To develop prediction models for estimating the bone-graft volume needed for sinus floor elevation (SFE) based on the augmentation site, elevation height, and sinus width using cone-beam computed tomography (CBCT). Materials and methods: CBCT scans with a medium-to-large field-of-view with bilateral maxillary sinuses partially/entirely visible, acquired from February 2016 to October 2020, were initially screened. Ten defined regions, above the maxillary first (MM1) and second molar (MM2) sites, in the sinuses of the included CBCTs were semi-automatically segmented, and the volumes of the regions were automatically measured using the ITK-SNAP program. The sinus widths at the height ranging between 8 and 16 mm from the sinus floor were measured at the MM1 to MM2 sites, respectively. Multiple linear regression analyses were performed to establish prediction models for estimating the bone graft volume needed for SFE at the MM1 and/or MM2 sites with the sinus width and elevation height as predictors. Results: A total of 133 scans (224 sinuses) were included. Three developed prediction models, composed of the sinus width and elevation height, explained 89–91% of the variation in the bone graft volumes estimated for SFE at the MM1, MM2, and MM1-MM2 sites. The mean absolute deviations and absolute percentage deviations between the measured and predicted volumes ranged from 0.12 to 0.28cm3 and from 9.78 to 10.62%, respectively. Conclusion: The proposed prediction models may enable more patient-specific estimation of the bone graft volume needed for SFE. Clinical relevance. The proposed prediction models could facilitate the preparation of an adequate amount of bone graft material and patient-clinician communication about the cost of bone graft material. [ABSTRACT FROM AUTHOR]

Sinus graft infections are rare but serious complications, as they are associated with significant morbidity and sinus graft loss. The aim of this study was to systematically review the management of sinus graft infection in order to define which protocols should be implemented. The terms searched in each database were "sinus graft infection management", "maxillary sinus lift infection", "maxillary sinus graft infection", "maxillary sinus elevation infection", and "maxillary sinus augmentation infection". The management of the sinus graft infection was assessed. The outcomes evaluated were maxillary sinus health and dental implantation results. The initial search yielded 1190 results. Eighteen articles were included, reporting a total of 3319 patients and 217 sinus graft infections. Drainage was performed with an intraoral approach in 13 studies, an endoscopic approach in two studies, and a combined approach in three studies. In every study, a disease-free sinus was finally obtained in all patients, but the outcomes of the graft and the dental implant were more varied. It is not possible to define the best treatment protocol for sinus graft infections based on the published data, since the level of evidence is poor. Management is very heterogeneous. This review highlights the necessity of surgical treatment associated with antibiotic therapy. [ABSTRACT FROM AUTHOR]

Copyright of Hungarian Medical Journal / Orvosi Hetilap is the property of Akademiai Kiado and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The atrophic maxilla frequently requires bone grafting using an onlay graft (OG) or sinus lifting (SL) before implant rehabilitation. The resorption of bone grafts is influenced by the time until implantation, quality of donor bone, and grafting technique. The aim of this study was to investigate the impact of both grafting techniques on the time-related resorption of autologous iliac bone graft. Forty-three patients underwent either onlay grafting or a sinus lift at 73 sites in the maxilla. Graft height was measured by cone beam computed tomography after augmentation and during follow-up for up to 12 months prior to implant insertion. The effect of time and technique on graft resorption was evaluated retrospectively. The reduction in bone graft height was greater for OG than SL over the investigated time intervals (OG = 51%, SL = 28%; P = 0.002). Each technique followed a specific course of resorption, which was independent of the initial graft height and could be calculated by a non-linear regression model. Iliac bone graft undergoes rapid resorption when used as an OG prior to implant insertion. For SL, this resorption is reasonably lower. This is especially crucial to determine the optimal time for implant insertion after graft healing to improve implant survival. [ABSTRACT FROM AUTHOR]

Objective: Many authors have tried to face the anatomical limitations resulting from maxillary bone atrophy. Up to five millimeters bone height, the lateral sinus floor elevation is the most commonly used and validated strategy to achieve the prosthetic rehabilitation. However, the disadvantages of this technique are its invasiveness and delayed rehabilitation. The aim of this paper was to assess 5 years clinical outcome of implants placed with a technique that allows the percrestal sinus floor elevation and the immediate implant placement. Materials and Methods: 30 transcrestal sinus floor elevations with immediate implant placement were performed in severely atrophic maxillae. Implant survival, marginal bone level variation, harvested bone height variation and periodontal indices were assessed. Results: After a five year follow up none of the thirty implants were lost. The mean value of vertical harvested bone loss was 5%. The mean crestal bone loss was -0.33 mm (Standard Deviation (SD) 0.11 mm). The mean value of periodontal indices was respectively: PD 1.22 mm (SD 0.72 mm), PI 17.47% (SD 15.01 mm), BOP 9, 87 %.,( SD 19.17 mm). Conclusion: The results obtained are comparable with success criteria in implant rehabilitation. The reported technique proved to be successful in the population observed, with minimal trauma and reduced invasiveness.

Aim: To assess osteotome-mediated sinus floor elevation (OMSFE) with simultaneous implant placement using an in situ hardening biphasic calcium phosphate (BCP) compared to xenograft as a control. Methods: Patient in need for sinus floor augmentation in one or both sinuses were selected for this randomised controlled clinical trial. Sites presenting a residual sinus floor height of 3–6 mm and eligible for OMSFE were randomly assigned to receive either BCP (test) or xenograft particles (control). CBCT scans were performed before and at the time of implant loading (180 days). The difference in sinus floor height gain between the two groups was set as the primary endpoint parameter for equivalence testing. The implant insertion torque (ITV) was recorded and Implant stability quotients (ISQ) was assessed upon implant placement, abutment connection (160 days) and implant loading (180 days). Results: A total of 54 sinus lifts were performed in 42 patients including 12 bilateral cases. Four implants failed (two in each group) and a total of six patients were lost to follow-up. Statistical analysis of sinus floor height revealed no significant differences (p < 0.05) between groups at baseline nor at 180 days after augmentation. There was no statistical difference in sinus floor height gain between the two groups as supported by the 90% confidence intervals of the difference between groups. Good primary implant stability was confirmed in both treatment groups by ITV and ISQ measurements. Conclusions: Within the limits of this study, it can be concluded that OMSFE using in situ hardening BCP particles results in equivalent sinus floor height gain than using xenograft particles but offers an easier application.

Objectives: To test whether there is a difference in professional and patient‐reported outcome measures (PROM) after single‐crown restoration supported by short implants (SI) (6 mm) compared with standard length implants (SLI) (13 mm) in conjunction with maxillary sinus floor augmentation (MSFA) after 1 year of functional implant loading. Material and Methods: Forty patients were randomly allocated to SI or SLI/MSFA. PROM included Oral Health Impact Profile (OHIP‐14) questionnaire and subjective assessment of the peri‐implant soft tissue (A), implant crown (B), implant function (C) and overall implant treatment outcome (D) using visual analogue scale (VAS). Professional assessment included pink aesthetic score (PES) and white aesthetic score (WES). Results: No significant differences in professional or PROM between the two treatment modalities were revealed at any time point (p >.05). OHIP‐14 score decreased at baseline and 1 year after functional implant loading compared with preoperative measurements indicating improved quality of life with both treatment modalities. The 1‐year mean VAS score was 9.4 (A), 9.3 (B), 9.6 (C) and 9.3 (D) for SI compared with 9.3 (A), 9.6 (B), 9.7 (C) and 9.2 (D) for SLI. The 1‐year mean PES/WES scores were 11.3 and 8.1 for SI compared with 11.2 and 8.1 for SLI/MSFA. Conclusions: Prosthetic rehabilitation of the posterior part of the maxilla with SI or SLI/MSFA revealed no significant differences in professional and PROM after 1 year of implant loading. [ABSTRACT FROM AUTHOR]

Objective: The objective was to assess patient's perception of recovery after maxillary sinus membrane elevation (MSME) and blood coagulum (test) compared with maxillary sinus floor augmentation (MSFA) and 1:1 mixture of autogenous bone graft from the buccal antrostomy and deproteinized porcine bone mineral (DPBM) (control). Materials and methods: Forty healthy patients were randomly allocated to test or control. Oral health‐related quality of life (OHRQoL) was evaluated by Oral Health Impact Profile‐14 (OHIP‐14) at enrollment and 1 week postsurgical. Recovery was estimated by questionnaires and visual analog scale assessing pain, social and working isolation, physical appearance, eating and speaking ability, diet variations, sleep impairment, and discomfort after 1 week and 1 month. Mean differences were expressed with 95% confidence interval (CI). Association between OHRQoL and recovery was estimated. p‐value below.05 was considered statistically significant. Results: Maxillary sinus membrane elevation revealed 2.1 less days of pain (p =.03, 95% CI: 0.2–4.1) and 1.2 days of sick leave (p =.01, 95% CI: 0.3–2.1) compared with MSFA. No significant difference was observed in eating and speaking ability, physical appearance, work performance, and sleep impairment. No significant association between impaired OHRQoL and recovery was observed. Females reported 4.77 higher OHIP‐14 score compared with males (p =.01, 95% CI: 1.60–7.94), while association between age and OHIP‐14 was −0.10 (p =.28, 95% CI: −0.28 to 0.08). Conclusion: Maxillary sinus membrane elevation revealed significantly less days of pain and sick leave compared with MSFA. Harvesting of autogenous bone graft seems, therefore, to have a significant impact on perception of recovery. [ABSTRACT FROM AUTHOR]

Copyright of RGO: Revista Gaúcha de Odontologia is the property of RGO: Revista Gaucha de Odontologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The aim of this systematic review and meta-analysis was to critically evaluate the currently existing clinical evidence on the efficacy of graftless maxillary sinus membrane elevation for implantation in the atrophic posterior maxilla. A search protocol without limitations to November 2020 was followed by two independent researchers. Randomized controlled trials using the lateral window approach for graftless sinus membrane elevation were included. Uncontrolled, retrospective, non-comparative studies, case reports, and experimental studies in animals or cadavers were excluded. The search identified 2777 studies. Critical selection by two independent researchers then led to the inclusion of a total of nine studies. A risk of bias assessment was applied using the revised Cochrane risk-of-bias tool for randomized trials. A meta-analysis was conducted for seven studies. Results showed a high overall implant survival rate in both the graftless and bone-grafted sinus lift groups (97.92% and 98.73%, respectively). The graftless sinus lift group showed a significantly lower vertical bone height gain, with a mean difference of −1.73 mm (P = 0.01), and a significantly lower bone density, with a mean difference of −94.7 HU (P < 0.001). The implant stability quotient values did not differ significantly between the test and control groups (P = 0.07). [ABSTRACT FROM AUTHOR]

Copyright of RSBO: Revista Sul-Brasileira de Odontologia is the property of UNIVILLE and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background/purpose: Due to the pneumatization of the maxillary sinus, the sinus floor augmentation is often performed to implant placement in the maxillary posterior region. The aim was to perform radiographic and histomorphometric evaluation after placement of mixed allografts (cortical freeze-dried bone allograft [FDBA] 50%:cancellous FDBA 50%) during sinus floor augmentation. Materials and methods: In 37 patients, anorganic bovine bone (ABB, sites = 16), mineralized cancellous bone allograft (MCBA, sites = 15), and mixed allografts (Mixed AG, sites = 20) were placed during sinus floor elevation via the lateral approach (LSFE), at total 51 sites with residual alveolar bone height (RBH) 0.05). The mean ABH of ABB, MCBA, and mixed AG groups after 6 months was similar (13.72 ± 4.55 mm, 11.83 ± 3.31 mm, and 12.53 ± 2.97 mm, respectively; P > 0.05). In the ABB, MCBA, and mixed AG groups, the proportion of newly formed bone (NB) was similar (36.13 ± 10.01%, 39.26 ± 10.72%, and 31.27 ± 18.31%, respectively; P > 0.05). Conclusion: This result demonstrated that mixed AG led to sufficient bone augmentation and histologically comparable NB formation as compared to ABB and MCBA for sinus floor augmentation.

Aim: The aim of this study is to determine the incidence of obliterated osteomeatal complex (OMC) due to the presence of anatomic variants. Settings and Design: Retrospective Study. Materials and Methods: In this retrospective study, a total of 71 patients, 34 males and 37 females, aged 35–65 years were included in the study. Cone beam computed tomography (CBCT) scans of patients were assessed to identify the status of the OMC in the presence of anatomic variants and their incidence was recorded. The radiological assessment of the anatomical variants was made by viewing the coronal sections of the scans. The variants observed were deviated nasal septum, uncinate process), agger nasi, Haller cells, middle turbinate variants, enlarged bulla, accessory ostium, and maxillary sinus abnormalities). Ostium patency was evaluated in the coronal section of each sinus and classified as “patent” or “obstructed.” The most common variants observed were then correlated with the patency of the ostium. Statistical Analysis Used: Chi square test was performed to assess the association between the anatomic variants and the patency of the OMC. Results: In the present study, the incidence of an obliterated OMC due to the presence of anatomic variants was 73.2%. The four most common variants associated with the possibility of an obliterated OMC were the deviated nasal septum (76.2%), middle turbinate (86.4%), enlarged bulla (77.8%), and sinus cavity variants (80.0%). A statistically significant association was noted between middle turbinate variants and Haller cells and the patency of the OMC. Conclusion: Thorough pretreatment CBCT evaluation should be performed to assess the presence of anatomic variants and thereby, the patency of the ostium before sinus floor elevation procedures. The pre and postsurgical treatment plans and regimes can be modified according to anticipated postsurgical sequelae, thereby avoiding postsurgical complications and enhancing the success of the graft procedure.

The aim of the present study is to compare the biphasic calcium phosphate (BCP) using two different forms—(1) granules and (2) paste—in human maxillary sinus bone reconstruction as a split-mouth study using histomorphometric and immunolabeling for osteocalcin. Ten patients with bilateral maxillary posterior partial edentulism were selected in order to reconstruct bone height. They were divided into two groups: BCPG and BCP-P. After six months of bone healing, biopsies were harvested to assess the new bone formation and immunostaining for osteocalcin. The BCP g group had the following results: mean of bone formation in pristine bone 49.4 ± 21.6%, intermediate 49.4 ± 16.2%, and apical 55.3 ± 21.4%. The group BCP-P had a mean of 41.9 ± 17.3% in the pristine bone region, 37.5 ± 7.8% for intermediate, and 39.0 ± 13.5% for apical. The osteocalcin immunolabeling was high for both groups, demonstrating bone calcification. Thus, the two biomaterials present suitable results for the placement of dental implants.

Longstanding partial edentulism in the posterior segment of the maxilla is a challenging treatment and typically involves extensive and invasive sinus floor augmentation. Various methods have been employed for sinus floor elevation, including the application of hydraulic pressure using the balloon technique. This case report describes a modified ballooning technique to elevate the sinus floor using a Foley catheter to apply the hydraulic pressure method to elevate the Schneiderian membrane prior to the placement of bone grafts and an endosseous implant in a 37-year-old male patient who presented with an atrophic alveolar ridge height of 3.0 mm in the area of the extracted left first maxillary molar. Sinus floor elevation using the Foley catheter led to a sinus floor elevation of 7 mm and a gain in alveolar bone height of 7.8 mm. The patient was asymptomatic with a stable implant during the one-year follow-up period after prosthetic implant loading., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Sharanappa et al.)

Objective: To compare healing of collagenated and non-collagenated xenografts used for maxillary sinus floor elevation. Materials and Methods: Two different xenografts were used: deproteinized bovine bone (DBBM group) and collagenated corticocancellous porcine bone (collagenated group). Healing was studied after 2, 4, and 8 weeks. The loss of dimensions of the elevated area and the percentages of new bone, xenograft remnants, osteoclastic zones, vessels, inflammatory infiltrates, and soft tissues were analyzed. Three regions were evaluated: close to the bone walls (bone wall region), subjacent the sinus mucosa (submucosa region), and the center of the elevated area (middle region). The primary variables were the percentage of new bone and xenograft remnants. Results: Between 2 and 8 weeks, the elevated areas showed a reduction of 16.3% and 52.2% in the DBBM and collagenated groups, respectively (p < 0.01 between the two areas after 8 weeks). After 8 weeks, the highest content of new bone was observed in the bone wall region, which was higher in the collagenated group than in the DBBM group (41.6% and 28.6%, respectively; p < 0.01). A similar quantity of new bone was found between the two groups in other regions. A higher percentage of vessels in all regions evaluated (p < 0.01) and soft tissue in the sub-mucosa region (p < 0.05) was found in the collagenated group than in the DBBM group. Conclusions: The present study showed that both xenografts allowed new bone formation. In comparison with the non-collagenated xenograft, the collagenated xenograft underwent higher resorption, resulting in greater shrinkage of the elevated space after sinus lifting and a higher content of new bone in the regions close to the bone walls. Clinical relevance: In this study, the region adjacent to the bone wall showed the highest new bone content. This region resembles the base of the sinus, closest to the sinus floor and walls, and is the most important region from a clinical point of view because it is where the implant will be installed. Residues of the biomaterial remained after 8 weeks of healing. Other reports have shown that these biomaterial residues may interfere with the integration of implants.

Maxillary sinus augmentation (MSA) and guided bone regeneration (GBR) have shown successful clinical, radiological, and histological outcomes for implant-related bone reconstruction and have been used to augment bony defects of various shapes and sizes. This study demonstrated that the lateral sinus bony window obtained during MSA can be used as an autogenous block bone graft for the augmentation of wide post-extraction defects. During the uncovering procedure performed 6 months after surgery, the grafted lateral bony window was well integrated with the adjacent native bone, and complete bone filling was observed in all bony defects around the implants. All of the implants survived. Within the limitations of this study, autogenous block bone obtained from lateral window sites can be used as novel donors for the resolution of wide bony defects around implants.

Background : Maxillary sinus lift is a well-documented and accepted technique in the rehabilitation of the posterior maxilla. Schneiderian membrane perforation is the most common complication and may occur in between 7% and 56% of cases. Different materials and techniques have been described to achieve reparation of the perforation. The aim of this study was to establish whether the perforation of the Schneiderian membrane and its repair during maxillary sinus lift surgery results in a lower implant survival rate compared to those cases where the membrane has not been perforated. Materials and methods : A systematic review and meta-analysis of studies assessing the survival rate of implants placed in regenerated sinus using the lateral window approach, where the perforation of the Schneiderian membrane occur, was carried out. Statistical analysis was performed with Open Meta-Analyst, calculating the odds ratio of implants placed in perforated sinuses and non-perforated sinuses. Results : Ten articles were included in the qualitative analysis and seven articles in the quantitative analysis or meta-analysis. A total of 1224 maxillary sinus augmentation surgeries were performed without perforation of the Schneiderian membrane and 2725 implants were placed; 62 implants failed during the follow-up period with an overall survival rate of 97.7%. In 480 perforated sinuses, 1044 implants were placed, of which 30 failed; the overall survival rate was 97.1%. There were no significant differences between the implant survival rate of the implants in the two groups (OR = 0.78; CI = 0.49-2.23; p = 0.28 and I 2 heterogeneity: 0%, p = 0.44). Conclusions : Schneiderian membrane perforation, as long as it is repaired, does not appear to negatively influence implant survival rate. Membrane perforation should not be considered a reason to abort the procedure or an absolute contraindication to implant placement.

Sinus ridge augmentation is a surgical procedure aimed at increasing the volume of bone in the posterior maxilla to permit successful dental implant placement. The current review article presents an overview of various techniques used for sinus ridge augmentation, including the lateral window technique, crestal approach, transalveolar technique, and piezoelectric osteotomy. The article examines the advantages and limitations of each technique, such as invasiveness, surgical difficulty, and the requirement for additional procedures. Additionally, the article discusses the factors that influence the success of the procedure, including patient age, residual bone height, and the kind of bone graft substance used. The review also emphasizes the importance of proper case selection, surgical planning, and postoperative care to ensure optimal outcomes. Overall, the article provides valuable insights into the current techniques used for sinus ridge augmentation, highlighting the need for further research to improve patient outcomes and the success of placing dental implants over the long run., Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Chittoria et al.)