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This study evaluated radiographic graft changes following maxillary sinus floor augmentation with (A) autogenous bone, (B) 1:1 autogenous bone and deproteinized porcine bone mineral, or (C) 1:1 autogenous bone and biphasic bone graft material. Sixty patients were randomly allocated to groups A, B, and C (20 in each). CBCT scans were obtained at enrolment, after surgery (T1), after prosthetic rehabilitation (T2), and 1 year after implant loading (T3). Significant decreases in graft volume (3D) and graft height (2D) from T1 to T3 were observed in all groups (P < 0.05). However, at T2 and T3, graft volume was significantly higher in group B than in groups A and C (P < 0.05), and graft height was significantly higher in group B than in group A (P < 0.05). Bone density increased significantly from T1 to T2 in all groups (P < 0.001). However, bone density was significantly higher in group B than in groups A and C, at T2 and T3 (P < 0.05). No significant correlation between graft volume or height and implant protrusion length or residual bone height was found. In conclusion, 1:1 autogenous bone and porcine bone resulted in significantly higher graft volume, height, and bone density when compared with autogenous bone or a 1:1 ratio of autogenous bone and biphasic bone. However the higher graft volume, height, and bone density did not appear to lead to improved outcomes at 1 year of functional loading when compared to the other groups. [ABSTRACT FROM AUTHOR]

ABSTRACT Aim Materials and Methods Results Conclusion Technology improvement and a better understanding of sinus anatomy and wound healing in the past decade have allowed the development of minimally invasive surgical techniques. This systematic review focused on identifying and describing these techniques for vertical and lateral sinus augmentation (VSA and LSA).Electronic and hand search were conducted to screen the literature published from January 2003 to May 2024. The selected studies had to include detailed techniques for minimally invasive SA. Data extraction included the study types, sample size, technique/instrument details, and outcome measurements.A total of 36 articles (27 VSA, 8 LSA with an additional 1 article included both procedures) with 2732 sinus augmentation met the inclusion criteria. Minimally invasive VSA includes the use of modified rotary instruments with stopper, balloon, hydraulic pressure, digital planning, endoscope, and operating microscope. These techniques aim for conservative flap reflection, precise sinus window preparation, and/or controlled sinus membrane elevation. Most of the selected studies (n = 15) did not report the incidence of sinus membrane perforation.Within the limitations of this review, minimally invasive VSA and LSA achieved sufficient sinus augmentation and implant success with the potential advantages of reduced surgical complications and morbidity. Comparative studies with defined outcomes are encouraged to further validate these useful minimally invasive techniques for SA. [ABSTRACT FROM AUTHOR]

Introduction: The effect of antiplatelet and anticoagulant medications on the outcomes of sinus floor augmentation remains unclear. Methods: This retrospective cohort study analyzed data from electronic medical records of consecutive patients undergoing sinus floor augmentation at a single medical center. Patients were categorized into three categories: patients under antiplatelet medications, patients under anticoagulation medications, and healthy individuals. Data collected included tobacco smoking, residual alveolar bone height, timing of implant placement, materials used, vertical bone gain, early implant failure (EIF), and complications such as Schneiderian membrane perforation and postoperative bleeding. Multivariable analysis was performed to assess risk factors for EIF. Statistical significance was considered below 5%. Results: Among 110 patients with 305 implants, EIF occurred in 10% of patients and 4.65% of implants. No significant difference in postoperative bleeding or EIF was found between study groups. Univariate and multivariable analyses highlighted tobacco smoking (odds ratio [OR] = 7.92), lower residual alveolar ridge height (OR = 0.81), and staged implant placement (OR = 4.64) as significant EIF risk factors in this cohort. Conclusions: Anticoagulant and antiplatelet therapies do not significantly elevate the risk of EIF or postoperative bleeding following sinus floor augmentation. Tobacco smoking, residual alveolar ridge height and staged sinus floor augmentation were risk factors for EIF in patients using antiplatelet or anticoagulation medications undergoing sinus floor augmentation. [ABSTRACT FROM AUTHOR]

This systematic review and meta-analysis assesses the clinical outcomes of implants inserted during or following transcrestal sinus lifts. The study protocol was prospectively registered on PROSPERO (CRD42024504513). PubMed, Web of Science, Embase, and Scopus databases were searched up to 21 February 2024, and randomised clinical trials utilising transcrestal sinus lifts were included. Qualitative and quantitative syntheses were conducted. A random effects model was used to pool the survival rate of implants placed with transcrestal sinus lifts using hand osteotomes without grafting, along with meta-regression and subgroup analyses. Funnel plots and Egger's linear regression were used to explore possible publication bias. Probabilities of less than 0.05 were considered significant. A total of 1807 records were identified after the initial search. Seventeen studies were included with 10 of them considered for meta-analysis. Studies used hand osteotomes, a combination of piezoelectric and hand osteotomes, drills, and smart lifts for sinus elevation. Only studies that used hand osteotomes reported subsequent vertigo and dizziness in patients. The meta-analysis showed a 100% (95% CI: 99% to 100%) survival rate for both grafted and non-grafted transcrestal sinus lifts using hand osteotomes. Meta-regression showed that follow-up time did not significantly affect the implants' survival. Subgroup analyses showed no significant difference between bone-level and tissue-level implants and one-stage or two-stage implants. On considering the limitations of this study it can be concluded that closed maxillary sinus elevation can be considered a relatively safe technique that is associated with a high survival rate. However, caution should be taken when using hand osteotomes because of a higher rate of sinus lining perforation and reported patient vertigo. [ABSTRACT FROM AUTHOR]

Introduction Methods Results Conclusion Maxillary sinus floor elevation is a surgical procedure intended to increase the volume of the bone vertically to accommodate dental implant placement. This intervention is frequently required for implant installation in the posterior maxilla, where the bone may be insufficient for securing implants of necessary length and stability. Sinus floor elevation can be completed either through a direct approach with a “window” through the lateral wall of the alveolar ridge or an indirect “transcrestal/transalveolar” sinus floor elevation (TSFE), which accesses the sinus floor through the crest of the edentulous ridge. Our study aims to provide a comprehensive scoping review of research conducted over the past 25 years on TSFE, specifically.A literature search aimed at identifying pertinent literature for the purpose of this PRISMA‐ScR‐compliant scoping review was conducted. Only randomized controlled trials, non‐randomized controlled trials, prospective cohort studies, and case series that met the eligibility criteria were selected. Relevant data from these studies were extracted. Primary outcome measures included radiographic bone levels and implant failure >5 years. Secondary outcome measures included implant stability at time of placement and complications. Interventions reported in the selected studies were grouped based on treatment modality, which were then compared with the control therapy (traditional osteotome technique) after a minimum of 12 months healing period.Our search yielded 633 records, and after deduplication, 574 of these were screened. Application of the eligibility criteria led to the inclusion of 37 articles in the final selection. Case selection for included studies enrolling subjects: Four different transcrestal sinus elevation treatment modalities were identified: (a) osteotome, (b) piezoelectric surgery, (c) osseodensification, and (d) hydraulic techniques. Due to the heterogeneity of the studies, no superior approach for TSFE could be identified. Overall, all techniques demonstrated high implant survival rates.Comprehensive understanding of the patient's medical history, available armamentarium, and post‐operative complications/management strategies are all essential to the completion of a successful TSFE approach for implant placement in the posterior maxilla, regardless of the treatment modality used. [ABSTRACT FROM AUTHOR]

Introduction Purpose Materials and methods Results Conclusion Bidirectional vertical ridge augmentation in the posterior maxilla is very challenging.To evaluate the regenerative potential of micrografts, derived from periosteum or bone tissue, added to an anorganic xenograft in vertical reconstruction of the posterior maxilla, by a prospective, controlled study.After clinical selection and the analysis of CBCT scans, 24 posterior maxillary sites, in 19 patients, were treated by using Barbell Technique®. Sites requiring both inlay and onlay reconstruction were enrolled in the study. In the Control Group (CG, n = 8), a xenograft was used in the inlay site and for the onlay site, a 1:1 mix of xenograft and an autograft was used. In Test Group 1 (TG1, n = 8), both inlay and onlay sites were grafted with the xenograft associated with the micrografts derived from periosteum. In Test Group 2 (TG2, n = 8), both inlay and onlay sites were grafted with the xenograft associated with the micrografts derived from bone. Six months after the procedures, CBCT scans were obtained, and bone biopsy samples were harvested during implant placement surgery. The bone specimens were analyzed histomorphometrically, by measuring the percentages of vital mineralized tissue (VMT), non vital mineralized tissue (NVMT) and non mineralized tissue (NMT). Immunohistochemically, the levels of VEGF were categorized by a score approach.Histomorphometric analysis revealed, for the inlay grafts, no significant difference among the groups for VMT, NVMT and NMT. However, for onlay grafts, CG achieved a higher amount of VMT in comparison with TG2, and the opposite occurred for NMT values. In this regard, no statistical difference was observed between CG and TG1. Concerning immunohistochemistry, the VEGF values for CG and TG1 were slightly higher than those obtained by TG2 for both inlay and onlay grafts, but without statistical significance. CBCT analysis showed a similar level of gain for all groups, for both inlay and onlay bone augmentation sites. Clinically, one implant (in CG) within a total of 50 implants installed, had early failure and was replaced after 3 months. All patients received implant supported prosthesis.This study indicated that the clinical use of micrograft derived from periosteum may have some potential to increase bone formation in onlay reconstructions, unlike the micrograft derived from bone tissue. [ABSTRACT FROM AUTHOR]

The aim of this retrospective study was to assess the efficacy of recombinant human bone morphogenetic protein-2 (rhBMP-2) with hydroxyapatite (HA) granules and fibrin sealant (FS) in maxillary sinus floor augmentation (MSFA), with a focus on the volume change. Fifty-two of 137 patients who underwent MSFA with rhBMP-2/HA grafting between June 2016 and December 2022 met the study inclusion criteria; 25 had received rhBMP-2/HA without FS and 27 had received rhBMP-2/HA with FS. Computed tomography (CT) images were obtained preoperatively, immediately following the operation, and at 6 months postoperative. These images were three-dimensionally reconstructed to measure the volumetric and height changes following MSFA. The mean ± standard deviation percentage of volumetric change at 6 months was 48.75 ± 37.44% in the group with FS and 29.77 ± 13.42% in the group without FS (P = 0.019). The vertical height measured at a specific site of the grafted area showed a mean percentage change at 6 months of 4.05 ± 12.08% in the group with FS and 6.07 ± 10.15% in the group without FS (P = 0.518). The additional use of FS as a carrier for rhBMP-2/HA in MSFA was found to improve surgical convenience and bone regeneration ability. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to analyze and compare three-dimensional volumetric bone changes and stability of simultaneously placed dental implants following sinus augmentation using deproteinized human demineralized tooth matrix (dpDTM) and deproteinized bovine bone mineral (DBBM). Methods: Twenty-four patients who required lateral maxillary sinus floor augmentation with simultaneous dental implant placement were randomly assigned to receive either dpDTM (n = 12) or DBBM (n = 12). Cone-beam computed tomography and resonance frequency analysis of implant stability were conducted immediately after surgery and 6 months postoperatively. Changes in the graft sinus floor and graft height volumes in the sagittal and coronal views, along with the implant stability quotient (ISQ), were analyzed and compared. Results: Volumetric graft alteration was comparable between dpDTM (120.33 ± 77.48 mm3) and DBBM (108.51 ± 65.15 mm3) (p = 0.690). Reduction in the average graft height was also comparable: dpDTM group ranged from − 0.59 to − 0.93 mm and the DBBM group ranged from − 0.55 to − 0.82 mm (p > 0.05) at most examined levels. However, greater reduction in the mesial-graft height occurred in the dpDTM group (− 1.08 ± 0.70 mm vs. −0.58 ± 0.39 mm, p = 0.04). The ISQ values increased similarly in both groups to reach 70 at 6 months. Conclusion: dpDTM demonstrated comparable stability in graft volume and height during the healing process compared to DBBM and could serve as a viable alternative to DBBM for sinus floor augmentation with simultaneous implant placement. [ABSTRACT FROM AUTHOR]

In patients with severe atrophy of the posterior maxilla requiring lateral maxillary sinus floor elevation (MSFE), the window location and size are commonly designed according to the future implants and anatomical conditions. A window osteotomy becomes challenging when there is an extended edentulous space in the maxilla with no reference from the natural dentition, or when the surgical site involves anatomical variations, for example in the course of a large vessel or a sinus septum. Through preoperative planning and real-time visualization, the application of dynamic navigation allows an accurate location, optimal dimension, and customized shape during lateral window osteotomy. This article introduces a digital protocol for ensuring an accurate and safe window osteotomy for MSFE in complex clinical scenarios, by integrating dynamic navigation and a piezoelectric device. [ABSTRACT FROM AUTHOR]

Purpose: To determine whether a less invasive window repositioning technique could provide a feasible, safe, and reliable lateral sinus augmentation. Materials and Methods: The less-invasive window repositioning technique using a piezoelectric saw was performed on adult patient candidates for lateral sinus floor elevation. The augmented bone height (primary outcome variable), bone length, and posthealing outcome variables were evaluated to determine the augmentation adequacy, safety, and reliability of this technique overall and in one- and two-implant groups with different window dimensions. Data were analyzed using descriptive statistics, chi-square test, and Pearson correlation analysis. P < .05 was considered significant. Results: A total of 50 consecutive sinus floor elevations with simultaneous placement of 66 implants (one-implant: 34, two-implant: 16) were performed on 44 subjects (72% men) with a mean age of 46.7 ± 10.3 years and followed for a mean of 13.28 ± 3.5 months. The overall, one-implant, and two-implant group mean window sizes were 31.38 ± 6.78 mm2, 28.38 ± 4.2 mm2, and 37.75 ± 6.88 mm2, respectively. The mean overall augmented bone height and length were 12.3 ± 1.04 mm and 19.67 ± 2.01 mm, respectively. The mean window size was significantly smaller in the one-implant group versus the two-implant group (P < .001). However, there was no correlation between window size and augmented bone height (r = -0.9, P = .54) and length (r = 0.05, P = .68). The posthealing outcome variables showed perfect window integration without soft tissue ingrowth. Six sinus perforations (12%) during membrane elevation that were not related to window osteotomy were observed and were appropriately managed. Conclusion: The less-invasive window repositioning technique is feasible, safe, and reliable for appropriate sinus augmentation in height and length. The reduction of window dimension does not influence the feasibility, augmentation adequacy, and surgical safety and does not increase surgical risks or membrane perforation. The repositioned window showed proper integration. Also, sinus floor elevation through this technique is an experience-based surgery that requires delicate instruments. [ABSTRACT FROM AUTHOR]

Objectives: The primary aim of this in vitro study was to assess the effect of alveolar residual bone height in the posterior maxilla on the accuracy of the final implant position via free‐handed and static Computer‐Assisted Implant Placement (sCAIP). The secondary aim was to evaluate the influence of the maxillary sinus morphology on the accuracy of final implant position. Materials and Methods: Partially edentulous standardized maxillary models simulating three different residual bone heights and different sinus floor morphologies were investigated. One‐hundred eighty equally distributed implants, which were placed either free‐handed or sCAIP, constituted the study sample. 3D digital deviations were obtained by superimposing the post‐surgical scans on the initial treatment plan. Results: Angular and linear deviation assessment demonstrated higher implant position accuracy in the sCAIP group. sCAIP revealed similar outcomes independently of the alveolar bone height and sinus floor morphology. Contrarily, in the free‐handed group, alveolar bone height and sinus morphology statistically affected the final implant position. Non‐parametric three‐way ANOVA showed significance for implant placement protocol (p <.0001) and alveolar bone height (p ≤.02) when angular, and linear deviations were evaluated. Sinus morphology was statistically significantly associated with angular deviation (p =.0009). Conclusions: sCAIP demonstrated higher 3D implant position accuracy. Alveolar bone height (strongly) and sinus morphology are associated with the accuracy of final implant position when the free‐handed implant protocol is followed. However, these anatomical factors did not affect final implant position during sCAIP. [ABSTRACT FROM AUTHOR]

Several techniques have been described for maxillary sinus graft augmentation, including the lateral window technique and crestal approach with osteotomes or osseodensification. Platelet-rich fibrin has been used in maxillary sinus lift procedures due to its ability to accelerate soft and hard tissue healing. The aim of this study was to evaluate the potential of PRF in combination with the synthetic hydroxyapatite NanoBone® to enhance bone regeneration in sinus floor elevation with the lateral window technique. Out of the 50 individuals screened in a preoperative assessment visit from the CESPU—Famalicão clinical unit and intervened upon between January 2023 and December 2023, only 6 patients who met the study's inclusion criteria consented to participate. In a split-mouth study, twelve sinus graft surgeries were carried out. Our observations reveal that for the test group (NanoBone®/PRF), there is a 27.5 ± 4.9% increase new vital bone, 23.0 ± 3.7% increase in inert bone particles, and 49.4 ± 2.8% increase in connective tissue. Meanwhile, for the control group (NanoBone®), there is a 19.5 ± 3.0% increase in new vital bone, 23.4 ± 5.7% increase in inert bone particles, and 57.0 ± 3.5% increase in connective tissue. The results strongly indicate that mixing liquid PRF with NanoBone® does not have a negative influence on the amount of viable bone formation, and it seems to slightly increase the amount of new bone formation and revascularization in sinus bone graft procedures with the lateral window technique compared to the single use of NanoBone®. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to evaluate the implant survival rate, marginal bone loss (MBL), and surgical complications in single dental implants placed in the atrophic posterior maxilla using a transcrestal sinus lift with injectable graft materials. Materials and Methods: A prospective longitudinal study was conducted at IRCCS San Raffaele, Milan, Italy. Fifty-four patients with single edentulous sites and residual bone heights < 5 mm were included. A transcrestal sinus lift was performed using non-cutting drills (Cosci's technique) and xenogenic bone graft in gel form (Gel40, Tecnoss, Italy). Follow-up visits were at 1 week, 3 and 6 months, and annually for 3 years. Results: The implant survival rate was 98.04%, with one implant lost. MBL values were 0.71 ± 0.94 mm at 6 months, 1.00 ± 0.99 mm at 1 year, 1.03 ± 1.00 mm at 2 years, and 1.02 ± 1.01 mm at 3 years. Our ANOVA showed a significant MBL increase from 6 months to 1 year (p = 0.015), with no significant changes thereafter. Minimal surgical complications were observed, each occurring in 1.85% of cases. Conclusion: Transcrestal sinus lifts with injectable graft materials demonstrate high implant survival, acceptable MBL, and minimal complications, making it a reliable option for posterior maxilla rehabilitation. [ABSTRACT FROM AUTHOR]

Rehabilitation with dental implants has become the most widely accepted treatment protocol for rehabilitation of lost natural teeth. Direct sinus lift is one of the most predictable procedures for augmenting the deficient posterior maxillary ridges. The study was designed in patients with insufficient bone for implants in the maxillary posterior ridges. The test group received platelet-rich fibrin alone as filler, and the control group received a bone allograft. The residual bone height (RBH), implant mobility, and soft tissue characteristics between and within the groups were compared and analyzed. Both the groups had considerable gain in RBH, and the intragroup analysis revealed clinical gain in bone height in both the groups, with the test group exhibiting statistically significant gain which kept on improving from 6 months with z= -3.477 and a p value of 0.001 to 9 months with z=-3.531 and a p value of 0.027. The results suggest that the use of platelet-rich fibrin alone improves the bone regeneration, thereby achieving predictable and stable augmentation of the sinus floor required for the success of implant therapy. [ABSTRACT FROM AUTHOR]

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Objective: The objective was to assess the one year implant treatment outcome and patient‐related outcome measures (PROMs) following maxillary sinus floor augmentation (MSFA) with autogenous bone graft (ABG) from the zygomatic buttress (control) compared with 1:1 mixture of ABG and anorganic porcine bone mineral (APBM) (Test I) or biphasic bone graft material (BBGM) (Test II). Materials and Methods: Sixty healthy patients (34 females, 26 males) were randomly allocated to either control or test groups. Outcome measures included survival of suprastructures and implants, implant stability quotient, health status of peri‐implant tissue, peri‐implant marginal bone loss, frequency of complications, and PROMs using Oral Health Impact Profile‐14 combined with questionnaire assessing patient perception of peri‐implant soft tissue, prosthetic solution, implant function, and implant treatment outcome using visual analogue scale. Mean differences were expressed with standard deviation and 95% confidence interval. Level of significance was.05. Results: All suprastructures and implants were well‐functioning after one year of functional implant loading. There was no significant difference between control and test groups in any of the applied outcome measures. The implant stability significantly increased from implant placement to abutment connection within all groups (p <.001). High patient satisfaction and significant improvement in oral health‐related quality of life was also reported within all groups. Conclusion: This study demonstrates that MSFA with composite grafts containing minimal amounts of ABG reveals comparable implant treatment outcomes as compared with ABG alone, after one year of functional implant loading. Extensive ABG harvesting in conjunction with MSFA therefore seems not to be needed. [ABSTRACT FROM AUTHOR]

Introduction: Patients with mucosal cysts in the maxillary sinus require special consideration in patients who require implant therapy for the restoration when undergoing implant therapy for the restoration of the posterior maxillary dentition. Treatment strategies for these clinical situations remain controversial in the literature. Thus, this study seeks to describe a safe and effective therapeutic strategy for sinus augmentation in patients with pre‐existing maxillary antral cysts. Methods: A total of 15 patients and 18 sinuses were consecutively enrolled in this cohort study and underwent maxillary antral cyst treatment by needle aspiration and simultaneous maxillary sinus augmentation (MSA). During surgical procedures, threeimplants (Zimmer Biomet, Indiana, USA) were positioned in 11 sinuses and two implants (Zimmer Biomet, Indiana, USA) were positioned in 5 sinuses. Results: Overall implant success and survival rates were 100% and 97.8%, respectively at 1 year and 5‐year follow‐ups. Crestal bone resorption averaged 0.3 ± 0.2 mm 5‐year post‐loading, showing bone stability. Implant survival rate at 5‐year follow‐up expressed predictability of the technique comparable to historical data when MSA was performed alone. Crestal bone resorption averaged 0.3 ± 0.2 mm 5 years post‐loading and shows bone stability utilizing mucosal cyst aspiration with concomitant MSA procedures. Quality of life evaluation at 1‐week post‐op showed similar results to published historical data. In 81% (13 sinuses), the CBCT examination at 5‐year follow‐up showed no cyst reformation, in 19% (3 sinuses) cyst reformation was visible, but smaller in size when compared to the pre‐op CBCT evaluation, and all the patients were asymptomatic. Conclusions: Maxillary sinus mucosal cyst aspiration with concomitant MSA, may be a viable option to treat maxillary sinus cyst. [ABSTRACT FROM AUTHOR]

Background: Graftless sinus floor augmentation shows good results in bone gain, radiology and implant survival. Clinically, this technique can be recommended as an alternative to conventional procedures using augmentation materials. Objectives: This study aims to assess masticatory performance, masticatory ability and patient satisfaction after graftless sinus floor augmentation. Methods: The study group consisted of patients who had received a graftless sinus lift procedure in a split‐mouth design and was compared to patients with maxillary implant‐supported overdentures without augmentation and a natural dentition group. To assess objective masticatory performance, the mixing ability test was performed. Three questionnaires were used to assess patient reported outcomes related to mastication and patient satisfaction. Results: Each group included ten patients. Both the graftless sinus lift group and the edentulous control group had a worse masticatory performance compared to the natural dentition group. Masticatory ability, measured by patient reported outcomes, was not different between the graftless sinus floor augmentation group and implant‐retained overdentures group without augmentation, but the natural dentition group showed better results. Thereby, the better the masticatory performance in patients with a graftless sinus membrane elevation the better the patient satisfaction for 'prosthesis', 'appearance of prostheses', 'speech' and 'mastication and eating'. Conclusions: Patients with implant‐supported overdentures show inferior masticatory function compared to those with natural dentition. There were no significant differences in masticatory performance between patients with implant‐retained overdentures, with or without graftless augmentation. The decision on the preferred procedure should consider additional factors such as anatomical, surgical‐technical aspects and patient's preferences. [ABSTRACT FROM AUTHOR]

Purpose: To study whether the use of preventive antibiotic therapy reduces the sinus graft infection and/or dental implant failure rates in maxillary sinus elevation surgeries (primary outcome), and to identify the associated best protocol (secondary outcome). Materials and Methods: The MEDLINE (via PubMed), Web of Science, Scopus, LILACS, and OpenGrey databases were searched between December 2006 and December 2021. Prospective and retrospective comparative clinical studies with at least 50 patients and published in English were included. Animal studies, systematic reviews and meta-analyses, narrative literature reviews, books, case reports, letters to the editor, and commentaries were excluded. Assessment of the identified studies, data extraction, and risk of bias were performed independently by two reviewers. Authors were contacted if required. Collected data were reported by descriptive methods. Results: A total of 12 studies fulfilled the inclusion criteria. The only retrospective study comparing the use of antibiotics vs no use of them showed no statistically significant differences for implant failure; however, no data were reported for sinus infection rates. The only randomized clinical trial comparing different courses of antibiotics (only the day of surgery vs 7 additional postoperative days) reported no statistically significant differences between groups in terms of sinus infection rate. Conclusion: Not enough evidence is available to support either the use or nonuse of preventive antibiotic therapy for sinus elevation surgeries or to support the superiority of any protocol over others. [ABSTRACT FROM AUTHOR]

Background/purpose: The combination of recombinant human bone morphogenetic protein-2 (rhBMP-2) with a carrier material has not been extensively studied. This study aimed to evaluate the clinical, radiological, and histomorphometric outcomes of sinus floor augmentation using a 3:7 mixture of cancellous and cortical freeze-dried bone allografts (mixed AG) combined with rhBMP-2. Materials and methods: Mixed AG was used for sinus floor augmentation in a total of 21 patients with a residual alveolar bone height

The use of dental implants to restore edentulous jaws has become commonplace. Usually, in the maxilla, following a tooth extraction, the height of alveolar bone decreases. This alteration in bone increases the risk of implants migrating into the sinus. In general, Caldwell-Luc and endoscopic surgery are performed to retrieve dental implants. In this case series, we collected data from 39 patients who had the complication of implant displacement within the maxillary sinus for 25 years. All the implants were removed using the Caldwell-Luc technique. Implant migration happened following functional loading, during the prosthetic procedure, due to lack of osseointegration in 3 patients, and during implant placement into the fresh socket in 3 patients. In the remaining cases, migration occurred preoperatively or postoperatively and prior to implant loading. Insufficient bone quantity is sometimes causing the implant to migrate to the maxillary sinus. In case of minimal bone height, a sinus lift before implant placement should be conducted. Retrieval of an implant pushed inside the maxillary antrum using the Caldwell Luc approach proved to be a reliable technique.

Objective: Dental anxiety (DA) is a frequent and widespread phenomenon worldwide. There are few studies that have discussed the preoperative intervention of dental anxiety. The aim of this study was to explore the clinical efficacy of an online intervention to improve understanding and reduce dental anxiety in patients with transcrestal sinus floor elevation (TSFE) and to explore the correlation between patients' understanding and dental anxiety, pain perception, and satisfaction. Method and materials: This prospective randomized controlled trial enrolled patients who underwent TSFE and simultaneous implant placement. Patients were randomly allocated to the preoperative online intervention group (test group) and the non-online intervention group (control group). Two patient interview topic guide questionnaires were utilized to assess the extent and source of patients' understanding of the treatment process after a consultation at the hospital (T1) and prior to the surgery (T2). The preoperative dental anxiety was also assessed using the modified Corah dental anxiety scale (MDAS) at T1 and T2. All patients used the visual analog scale to describe their pain perception and satisfaction with the treatment process immediately after surgery (T3). A correlation analysis was performed to analyze the interrelationship between patient understanding, dental anxiety, pain perception, and satisfaction. Results: At T1, both groups were homogenous in their knowledge of the TSFE procedure and preoperative dental anxiety. At T2, the test group showed a better understanding of the TSFE procedure and lower preoperative dental anxiety than that of T1 and the control group at T2. Pain perception was significantly lower in the test group than in the control group at T3. Patients in the test group expressed significantly greater satisfaction with the treatment process than the control test group. There was a negative correlation between patients' understanding and preoperative dental anxiety. A positive correlation between preoperative dental anxiety and pain perception was found with a significant difference. Patients' satisfaction was positively correlated with understanding and negatively correlated with pain perception. Conclusions: Preoperative online intervention effectively increased patients' understanding of the treatment process. This resulted in decreased preoperative dental anxiety, decreased pain perception, and greater postoperative satisfaction from patients who underwent TSFE. Clinical relevance: Online medical care can be considered as an auxiliary tool to improve the effect of implant surgery. [ABSTRACT FROM AUTHOR]

Purpose: To identify the impact of residual bone height on 5-year implant survival and prosthetic complication rates in patients who underwent maxillary sinus grafting. Materials and Methods: A total of 87 consecutive patients were treated with 104 lateral approach maxillary sinus floor augmentation procedures with 100% deproteinized bovine bone and received 169 implants. The analysis considered patient age, sex, time of implant placement, and residual bone height. Patients with < 3 mm residual bone height were assigned to the study group; otherwise, they were placed in the control group. Results: The mean follow-up was 68.2 months (0 to 103 months). The mean residual bone height was 1.8 mm in the study group and 4.1 mm in the control group. The 5-year implant survival and prosthetic complication rates were, respectively, 97.4% and 8.0% in the study group and 100% and 12.5% in the control group. Residual bone height, sex, age, and time of implant placement were not significant factors for the 5-year implant survival or prosthetic complication rate. The lateral bone wall was significantly thinner in the study group. The grafted bone height reduction was significantly different at 6 months and 2 years postoperation in both groups, but there was no difference in the change in grafted bone height reduction over time between the two groups. Conclusion: A residual bone height < 3 mm did not impact the survival rates of implants placed in grafted maxillary sinuses or the prosthetic complication rate after 5 years of functional loading. [ABSTRACT FROM AUTHOR]

The aim of this study is to analyze the resorption rate of bone graft materials after crestal sinus floor elevation, study its influencing factors, and improve the long-term success rate of implants after crestal maxillary sinus floor elevation. Measurement and analysis were conducted at six postoperative timepoints (0 months, 6 months, 12 months, 18 months, 24 months, and 30 months) using cone beam computed tomography (CBCT) data on 31 patients from the Chenghuaxinguanghua Dental Clinic who underwent crestal maxillary sinus floor elevation, involving 38 graft sites. The materials resorption rates of the bone graft height (BH) and bone graft width (BW) were assessed. BH and BW resorption rates followed the same trend (p = 0.07), with BH and BW resorption rates decreasing with time (rBH = −0.32, p < 0.01; rBW = −0.18, p < 0.01), and were maximal in the 0–6 month interval, with BH and BW resorption rates of 3.42%/mth and 3.03%/mth, respectively. The average monthly BH and BW resorption rates in the 6–12 month interval rapidly decreased to 1.75%/mth and 1.29%/mth, respectively. The monthly BH and BW resorption rates in the 12–30 month intervals stabilized at 1.45%/mth (p > 0.05) and 1.22%/mth (p > 0.05), respectively. The higher the initial bone graft height (BH0), the lower the BH resorption rates (rBH = −0.98, p < 0.05), and the BW resorption rate was different for different graft sites (p = 0.01). The resorption rates of bone graft materials implanted through crestal maxillary sinus floor elevation decreased rapidly within the first 12 months post operation and remained stable after 12 months. BH0 was identified as a significant factor influencing the resorption rates of bone graft materials. These results could suggest dentists should pay attention to the trend of resorption rates over time and carefully manage the initial height of bone grafts and inspire the research of new bone grafting materials for crestal maxillary sinus floor elevation. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions Key points Maxillary sinus augmentation is one of the most performed procedures to increase the bone quantity of the atrophic maxilla to allow implant placement. The aim of the present case series was to describe a surgical protocol to perform maxillary sinus augmentation with the “bone lid technique,” and its outcomes in a cohort of patients eligible for the procedure.After the initial clinical evaluation, a cone‐beam computed tomography (CBCT) examination was performed for preoperative assessment. Patients were then scheduled for surgical intervention. At 6–9 months follow‐up, patients underwent a second CBCT scan to evaluate bone height following bone graft and to schedule implant placement.A total of 11 patients were enrolled in the study with a total of 13 sinus lift procedures. Membrane perforation was registered in 4 cases (30.76%). Mean surgical time was 67.69 min (SD 6.51). Postoperative period was uneventful in all patients, in the absence of complications. The mean graft volume increase was 2.46 cm3 (SD 0.85), and the mean height increase was 14.27 mm (SD 3.18). Mean membrane thickness was 1.40 mm (SD 0.75). In all the 4 cases with sinus membrane perforation, the membrane had a thickness lower than 1 mm.The present study highlights that the maxillary sinus augmentation with bone lid repositioning could provide repeatable results in terms of bone height increase. The technique appears reliable both in terms of bone gain and absence of complications. The bone lid technique for maxillary sinus augmentation provides repeatable results in terms of bone height increase. The favorable clinical outcomes can be related to an enhancement of bone formation due to the unique osteoconductive and osteoinductive properties of autogenous bone, along with a reduction of soft tissue ingrowth. Complications were not observed in any of the patients following the surgical procedures. The risk of Schneiderian membrane perforation is inversely proportional to membrane thickness; the thinner the membrane is, the higher the risk to perforate it. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to use a deep learning (DL) approach for the automatic identification of the ridge deficiency around dental implants based on an image slice from cone‐beam computerized tomography (CBCT). Materials and methods: Single slices crossing the central long‐axis of 630 mandibular and 845 maxillary virtually placed implants (4–5 mm diameter, 10 mm length) in 412 patients were used. The ridges were classified based on the intraoral bone‐implant support and sinus floor location. The slices were either preprocessed by alveolar ridge homogenizing prior to DL (preprocessed) or left unpreprocessed. A convolutional neural network with ResNet‐50 architecture was employed for DL. Results: The model achieved an accuracy of >98.5% on the unpreprocessed image slices and was found to be superior to the accuracy observed on the preprocessed slices. On the mandible, model accuracy was 98.91 ± 1.45%, and F1 score, a measure of a model's accuracy in binary classification tasks, was lowest (97.30%) on the ridge with a combined horizontal‐vertical defect. On the maxilla, model accuracy was 98.82 ± 1.11%, and the ridge presenting an implant collar‐sinus floor distance of 5–10 mm with a dehiscence defect had the lowest F1 score (95.86%). To achieve >90% model accuracy, ≥441 mandibular slices or ≥592 maxillary slices were required. Conclusions: The ridge deficiency around dental implants can be identified using DL from CBCT image slices without the need for preprocessed homogenization. The model will be further strengthened by implementing more clinical expertise in dental implant treatment planning and incorporating multiple slices to classify 3‐dimensional implant‐ridge relationships. [ABSTRACT FROM AUTHOR]

The objective of this study was to assess endo-sinus bone gain (ESBG) and bone density (BD) following maxillary sinus membrane elevation without graft (test) compared with maxillary sinus floor augmentation and 1:1 ratio of autogenous bone from the buccal antrostomy and deproteinized porcine bone mineral (control) using two- and three-dimensional radiographic methods. Forty healthy patients were randomly allocated to the test and control groups. Cone beam computed tomography scans were obtained at enrolment (T0), immediately after surgery (T1), at delivery of the prosthetic rehabilitation (T2), and 1 year after functional implant loading (T3). Mean differences were expressed with the 95% confidence interval. Significance was set at ≤ 0.05. ESBG and BD were significantly higher in the control group than test group at T1, T2, and T3 (P < 0.001). A significant decrease in ESBG and increase in BD was observed from T1 to T3 with both treatments (P < 0.001). There was a non-significant positive correlation of ESBG with implant protrusion length and non-significant negative correlation with residual bone height. In conclusion, test was associated with significantly lower ESBG and BD compared with control. However, the lower ESBG and BD did not appear to negatively affect the implant stability quotient or implant treatment outcome after 1 year of functional implant loading. [ABSTRACT FROM AUTHOR]

The combination of recombinant human bone morphogenetic protein-2 (rhBMP-2) with a carrier material has not been extensively studied. This study aimed to evaluate the clinical, radiological, and histomorphometric outcomes of sinus floor augmentation using a 3:7 mixture of cancellous and cortical freeze-dried bone allografts (mixed AG) combined with rhBMP-2. Mixed AG was used for sinus floor augmentation in a total of 21 patients with a residual alveolar bone height <5 mm. Among the total 47 sites, augmentation with and without rhBMP-2 was performed in 26 and 21 sites, respectively. Radiographic parameters were assessed using cone-beam computed tomography. After a six-month healing period, core biopsies were harvested for histomorphometric analysis. The bone gain after healing was 13.36 ± 3.9 mm and 12.07 ± 3.8 mm in the mixed AG alone and mixed AG with rhBMP-2 groups, respectively. The survival rate of implants in both groups was 100% during the follow-up period. The proportion of newly formed bone was 24.6 ± 10.2% and 39.7 ± 18.3% in the mixed AG alone and mixed AG with rhBMP-2 groups, respectively (P < 0.05). Moreover, the percentage of residual graft material was 21.0 ± 12.2% and 9.6 ± 10.0% in the mixed AG alone and mixed AG with rhBMP-2 groups, respectively (P < 0.05). Mixed AG combined with rhBMP-2 could be a suitable material for sinus floor augmentation. This combination may reduce the treatment time and improve the predictability of implant placement. [ABSTRACT FROM AUTHOR]

Maxillary sinus augmentation is one of the most predictable procedures for the rehabilitation of the posterior maxilla. The current overview aimed to summarize the findings provided by systematic reviews (SRs) and meta-analyses on the effectiveness of autologous platelet concentrates (APCs) in sinus lift and to assess the methodological quality of the included SRs. Three electronic databases have been explored. SRs and meta-analyses addressing the effectiveness of APCs in sinus lift technique were included. Clinical, radiographic and histomorphometric findings were considered for APCs as solely grafting materials and APCs in combination with biomaterials. Outcomes were implant survival rate (ISR), implant stability (IS), implant failure (IF), postoperative complications, histomorphometric findings, radiographic bone gain, bone volume and bone density. The methodological quality of the included SRs was assessed using the updated version of "A Measurement Tool to Assess Systematic Review" (AMSTAR-2). Thirty SRs were included. The methodological quality of the included reviews ranged from critically low (3 studies) to high (9 studies). The included SRs showed favorable clinical outcomes, short-term new bone formation and no biological complications when APCs were used both as solely graft material or in combination with other biomaterials. However, no significant additional effects in the long-term period were observed. APCs did not add any further positive effects compared to the physiological healing derived by the natural blood clot. The current overview of SRs highlighted the need for high-quality SRs evaluating the role of APCs in sinus lift though network meta-analyses, in order to identify the most powerful material for sinus lift augmentation. The use of APCs improves the healing of soft tissues and the postoperative quality of life in the short-term period. Thus, its application can be recommended. [ABSTRACT FROM AUTHOR]

Objectives: This systematic review and meta-analysis aim to provide detailed insights into the clinical performance of short and longer dental implants placed simultaneously with bone augmentation. Material and Methods: The search for literature was performed across MEDLINE (PubMed), ScienceDirect and the Cochrane Library databases, adhering to specific selection criteria and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Only articles published in English between 2014 and 2024 were considered for data collection. Primary outcomes were survival rate (SR), marginal bone loss (MBL) and complications. Clinical outcomes were as follows: bleeding on probing (BOP), periodontal pocket depth (PPD), and implant stability quotient (ISQ). Quality and risk of bias assessment were evaluated by the Critical Appraisal Checklist tool for randomized controlled trials developed by the Joanna Briggs Institute. Results: A total of 14678 articles were screened, with 9 meeting the inclusion criteria and being utilized for this systematic review and meta-analysis. A total of 495 patients with 984 implants (491 short and 493 longer implants) showing a SR of 93.91% for the short implants and 91.83% for the longer implants. Meta-analysis revealed statistically significant difference between short implants and longer implants simultaneously placed with alveolar bone augmentation in relation to MBL (-0.513 mm, 95% CI = -0.93 to -0.096; P = 0.02), and in PPD (-0.247, 95% CI = -0.515 to 0.022; P = 0.07). Conclusions: When comparing the results of treatment with short and longer dental implants combined with alveolar bone augmentation, short implants showed better clinical results regarding the parameters of survival rate, marginal bone loss and complications. [ABSTRACT FROM AUTHOR]

Given the anatomical difficulties of implantology in the posterior maxilla, related to maxillary sinus pneumatization, the need for surgical intervention to correct this condition is evident. Maxillary sinus lift is a simple and predictable procedure involving elevation of the sinus membrane, enabling bone neoformation in the alveolar bone and thereby facilitating the installation of dental implants. Fortunately, scientific advancement contributes positively to rehabilitative dentistry and should be taken into account when surgically approaching a patient. Among these advancements is the advent of leukocyte-platelet-rich concentrates. These blood concentrates are considered revolutionary in oral surgery because they possess desirable properties in this area. This study aims to conduct a literature review seeking scientific bases on the PubMed platform regarding the use of leukocyte-platelet-rich concentrates in maxillary sinus lift surgery, to prove the efficiency of these concentrates and demonstrate their properties and applications in this procedure. [ABSTRACT FROM AUTHOR]

The use of dental implants to restore edentulous jaws has become commonplace. Usually, in the maxilla, following a tooth extraction, the height of alveolar bone decreases. This alteration in bone increases the risk of implants migrating into the sinus. In general, Caldwell-Luc and endoscopic surgery are performed to retrieve dental implants. In this case series, we collected data from 39 patients who had the complication of implant displacement within the maxillary sinus for 25 years. All the implants were removed using the Caldwell-Luc technique. Implant migration happened following functional loading, during the prosthetic procedure, due to lack of osseointegration in 3 patients, and during implant placement into the fresh socket in 3 patients. In the remaining cases, migration occurred preoperatively or postoperatively and prior to implant loading. Insufficient bone quantity is sometimes causing the implant to migrate to the maxillary sinus. In case of minimal bone height, a sinus lift before implant placement should be conducted. Retrieval of an implant pushed inside the maxillary antrum using the Caldwell Luc approach proved to be a reliable technique. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate and compare the reported sinusitis occurrence after the sinus lift procedure and zygomatic implant placement. Methods: This meta-analysis has been registered at PROSPERO. Studies were searched on six databases. Two authors screened titles and abstracts and fully analyzed the studies against the inclusion and exclusion criteria. The RoB 2.0 and the ROBINS-I tools were used to assess the quality and risk of bias of the included studies. The random-effects model was used for the meta-analysis. The prevalence of sinusitis was calculated based on the total of patients. Subgroup analysis was performed by sinus lift or zygomatic implant surgery technique. Results: The search identified 2419 references. After applying the inclusion criteria, 18 sinus lift and 9 zygomatic implant placement studies were considered eligible. The pooled prevalence of sinusitis after sinus lift procedure was 1.11% (95% CI 0.30–2.28). The prevalence after zygomatic implant placement was 3.76% (95% CI 0.12–10.29). In the subgroup analysis, the lateral window approach showed a prevalence of sinusitis of 1.35% (95% CI 0.34–2.8), the transcrestal technique of 0.00% (95% CI 0.00–3.18), and the SALSA technique of 1.20% (95% CI 0.00–5.10). Regarding the techniques for zygomatic implant placement, the sinus slot technique showed a prevalence of 21.62% (95% CI 9.62–36.52) and the intrasinus technique of 4.36% (95% CI 0.33–11.08), and the prevalence after the extrasinus technique was 0.00% (95% CI 0.00–1.22). Conclusion: The sinusitis occurrence rate was higher after zygomatic implant placement than after sinus lift procedure and this occurrence was different depending on the used technique. [ABSTRACT FROM AUTHOR]

Objectives: This systematic review and meta-analysis aim to provide detailed insights into the clinical performance of short and longer dental implants placed simultaneously with bone augmentation. Material and Methods: The search for literature was performed across MEDLINE (PubMed), ScienceDirect and the Cochrane Library databases, adhering to specific selection criteria and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Only articles published in English between 2014 and 2024 were considered for data collection. Primary outcomes were survival rate (SR), marginal bone loss (MBL) and complications. Clinical outcomes were as follows: bleeding on probing (BOP), periodontal pocket depth (PPD), and implant stability quotient (ISQ). Quality and risk of bias assessment were evaluated by the Critical Appraisal Checklist tool for randomized controlled trials developed by the Joanna Briggs Institute. Results: A total of 14678 articles were screened, with 9 meeting the inclusion criteria and being utilized for this systematic review and meta-analysis. A total of 495 patients with 984 implants (491 short and 493 longer implants) showing a SR of 93.91% for the short implants and 91.83% for the longer implants. Meta-analysis revealed statistically significant difference between short implants and longer implants simultaneously placed with alveolar bone augmentation in relation to MBL (-0.513 mm, 95% CI = -0.93 to -0.096; P = 0.02), and in PPD (-0.247, 95% CI = -0.515 to 0.022; P = 0.07). Conclusions: When comparing the results of treatment with short and longer dental implants combined with alveolar bone augmentation, short implants showed better clinical results.

Abstract Purpose The purpose of this study was to evaluate the suitability, accuracy, and reliability of a non-invasive 3-Tesla magnetic resonance imaging technique (3 T-MRI) for the visualization of maxillary sinus grafts in comparison to conventional, X-ray-based, established standard imaging techniques. Methods A total of eight patients with alveolar bone atrophy who required surgical sinus floor augmentation in the course of dental implantation were included in this pilot study. Alongside pre-operative cone-beam computed tomography (CBCT), 3 T-MRI was performed before and 6 months after sinus floor augmentation. Two investigators measured the maxillary sinus volume preoperatively and after bone augmentation. Results In all cases, MRI demonstrated accurately the volumes of the maxillary sinus grafts. Following surgery, the bony structures suitable for an implant placement increased at an average of 4.89 cm3, corresponding with the decrease of the intrasinusidal volumes. In general, interexaminer discrepancies were low and without statistical significance. Conclusion In this preliminary study, we could demonstrate the feasibility of MRI bone volume measurement as a radiation-free alternative with comparable accuracy to CT/CBCT before procedures like sinus floor augmentation. Nevertheless, costs and artifacts, also present in MRI, have to be taken into account. Larger studies will be necessary to justify the practicability of MRI bone volume evaluation.

Many patients require edentulous ridge augmentation for dental implant placement. The main objective of this study was to evaluate the results of maxillary edentulous ridge augmentation exclusively with xenograft materials with and without simultaneous sinus floor elevation. This study reports the data retrieved from the records of 16 patients. The treatment outcome was assessed at least 6 months, postoperatively. Paired samples t-test or Wilcoxon Signed Rank test was used to compare the pre-and postoperative ridge dimensions. Dental implants were placed simultaneously in 7 patients, while 9 patients underwent delayed implant placement. In total, 68 implants were placed, and 12 patients also underwent maxillary sinus floor augmentation. A significant bone gain was achieved in both horizontal and vertical dimensions of edentulous maxillary ridges (P

Purpose: The stability and density of the grafted bone in the maxillary sinus are essential for dental implant survival. This study aimed to compare bone density following mineralized allogeneic bone and deproteinized bovine bone and evaluate the volumetric changes as the secondary outcome. Materials and Methods: In this prospective cohort study, subjects were randomly allocated into two groups of mineralized bone and deproteinized bone to augment the maxillary sinus. Subjects underwent CBCT immediately after augmentation and 9 months later. The relative bone density was the primary outcome, and the volumetric change after 9 months was the secondary outcome of the study. The authors used an independent t test for assessing the bone density and volumetric change between the two groups. Results: Fifty patients were studied (n = 25 in each group). At 9 months after sinus elevation, the mean bone density was 237.20 ± 55.72 Hounsfield units (HU) in group 1 (mineralized bone) and 634.8 ± 166.11 HU in group 2 (deproteinized bone). There was a substantial difference statistically for the mean of HU between groups 1 and 2 (P < .001). The mean volume change was 0.25 ± 0.13 cm3 in group 1 (mineralized bone) and 0.06 ± 0.05 cm3 in group 2 (deproteinized bone). Assessment of the data showed a substantial difference in the mean volume change at 9 months after sinus elevation between groups 1 and 2 (P < .001). Conclusion: Considering the results of this study, the deproteinized bone was associated with higher relative bone density than the mineralized bone 9 months after sinus elevation. The volume change of the deproteinized bone was less than the mineralized bone in the study time. [ABSTRACT FROM AUTHOR]

Introduction: The present investigation compared the stability and volumetric changes of two different grafting material used for lateral window sinus floor augmentation (LWSFA). Methods: Sixteen patients with a total 20 maxillary sinuses in need of LWSFA were included in the present study. The sinuses were grafted with either 100% anorganic bovine bone mineral (ABBM) alone (Group 1) or a mixture (0.8:1 ratio) of ABBM and mineralized cortical allograft (MCA) (Group 2). Cone beam computer tomography (CBCT) was obtained pre‐operatively, and at 2‐weeks, and 6‐months after LWSFA to perform linear measurements including lateral window dimensions, sinus anatomy, residual bone height/thickness (RBH/RBT), and Schneiderian membrane thickness (SMT), among others. Three‐dimensional segmentation analysis was used to evaluate changes of bone graft volume/height (GV/GH). Results: A total of 10 sinuses per group were included in the analysis. No statistically significant difference was found in between groups regarding mean reduction of GV (Group 1: 14.87% ± 16.60%, Group 2: 18.06% ± 9.81%, p = 0.33). Among the linear measurements, only SMT revealed a significant increase after 2‐weeks more pronounce in Group 1 (8.70 mm) when compared with Group 2 (5.70 mm) with plausible effect upon LWSFA outcomes. Sinus width showed weak positive correlation with GH reduction after 6 months. Conclusion: This study demonstrated that both ABBM alone and ABBM + MCA represent suitable alternatives for LWSFA with adequate graft stability as they revealed similar volumetric and linear dimensional changes 6 months postoperatively. [ABSTRACT FROM AUTHOR]

To date, there is no systematic anatomical classification available that could help clinicians in choosing between the lateral and palatal approach in sinus lift procedures. The aim was to provide a simple-to-use and memorable classification of the maxillary sinus concerning the thickness of lateral and palatal walls to facilitate the most adequate choice for the window location during direct sinus floor elevation. Cone beam computed tomography scans were consecutively obtained for 200 maxillary sinuses of patients needing dental implant placement with potential maxillary sinus augmentation. The thickness and height of the alveolar bone of the lateral and palatal walls of the maxillary sinuses were assessed. Four variants were distinguished. Class 0: an adequate sub-sinus residual bone height; without the need for sinus floor augmentation. Classes 1–3 had a reduced sub-sinus residual bone height. Class 1: a thinner lateral than palatal sinus wall. Class 2 (the most frequent; 49%): the comparable thickness of both walls in which either lateral, palatal, or crestal window osteotomies can be applied. Class 3 (the least frequent; 3%): a thinner palatal sinus wall in comparison to the lateral wall. The presented anatomical classification simplifies the decision-making process of choosing the most adequate window location and osteotomy technique. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to evaluate the suitability, accuracy, and reliability of a non-invasive 3-Tesla magnetic resonance imaging technique (3 T-MRI) for the visualization of maxillary sinus grafts in comparison to conventional, X-ray-based, established standard imaging techniques. Methods: A total of eight patients with alveolar bone atrophy who required surgical sinus floor augmentation in the course of dental implantation were included in this pilot study. Alongside pre-operative cone-beam computed tomography (CBCT), 3 T-MRI was performed before and 6 months after sinus floor augmentation. Two investigators measured the maxillary sinus volume preoperatively and after bone augmentation. Results: In all cases, MRI demonstrated accurately the volumes of the maxillary sinus grafts. Following surgery, the bony structures suitable for an implant placement increased at an average of 4.89 cm3, corresponding with the decrease of the intrasinusidal volumes. In general, interexaminer discrepancies were low and without statistical significance. Conclusion: In this preliminary study, we could demonstrate the feasibility of MRI bone volume measurement as a radiation-free alternative with comparable accuracy to CT/CBCT before procedures like sinus floor augmentation. Nevertheless, costs and artifacts, also present in MRI, have to be taken into account. Larger studies will be necessary to justify the practicability of MRI bone volume evaluation. [ABSTRACT FROM AUTHOR]

Many patients require edentulous ridge augmentation for dental implant placement. The main objective of this study was to evaluate the results of maxillary edentulous ridge augmentation exclusively with xenograft materials with and without simultaneous sinus floor elevation. This study reports the data retrieved from the records of 16 patients. The treatment outcome was assessed at least 6 months, postoperatively. Paired samples t -test or Wilcoxon Signed Rank test was used to compare the pre-and postoperative ridge dimensions. Dental implants were placed simultaneously in 7 patients, while 9 patients underwent delayed implant placement. In total, 68 implants were placed, and 12 patients also underwent maxillary sinus floor augmentation. A significant bone gain was achieved in both horizontal and vertical dimensions of edentulous maxillary ridges (P < 0.001). Ridge width increased by an average of 4.35 ± 1.90 mm (95% CI: 3.84 to 4.85 mm) while ridge height in areas of sinus floor augmentation increased by 8.19 ± 2.91 mm (95% CI: 7.33 to 9.05 mm). Within the study limitations, it appears that maxillary ridge augmentation according to the guided bone regeneration (GBR) protocols with exclusive use of xenograft particulate materials can provide optimal bone quantity for dental implant placement. [ABSTRACT FROM AUTHOR]

Objective: Test the hypothesis of no difference in bone regeneration after maxillary sinus floor augmentation (MSFA) with different ratios of iliac or mandibular autogenous bone (AB) graft and deproteinized bovine bone mineral (DBBM). Materials and Methods: Forty minipigs were randomly allocated to bilateral MSFA using: (A) 100% AB, (B) 75% AB and 25% DBBM, (C) 50% AB and 50% DBBM, (D) 25% AB and 75% DBBM, or (E) 100% DBBM. The animals were euthanized 12 weeks after surgery. Percentage of bone, non‐mineralized tissue, and residual DBBM were estimated by histomorphometric analysis in a randomly selected region of interest and summarized as mean percentage with 95% confidence interval (CI). Results: Mean percentage of bone following MSFA with iliac or mandibular AB graft was: (A) 55.5% and 64.2%, (B) 60.3% and 61.6%, (C) 54.4% and 52.1%, (D) 51.8% and 53.1%, and (E) 47.6%, respectively. There was a significant trend toward a higher percentage of bone, with a higher ratio of AB within the graft (p <.01), regardless of the origin of AB graft (iliac or mandible). Conclusions: The hypothesis was rejected since percentage of bone was significantly increased with larger proportions of AB within the graft. Consequently, AB or a mixture of AB and diminutive quantities of DBBM seem to be the preferred graft for MSFA based solely on histomorphometric assessment. However, it should be emphasized that newly formed bone and residual AB graft particles could not be distinguished by the applied histologic procedure. [ABSTRACT FROM AUTHOR]

Objective: The aim was to evaluate the 1‐year implant outcome and patient‐related outcome measures (PROMs) after maxillary sinus membrane elevation and coagulum (test) compared with maxillary sinus floor augmentation and a 1:1 ratio of autogenous bone graft from the buccal antrostomy and deproteinised porcine bone mineral (DPBM) (control). Materials and methods: Forty patients (30 female, 10 male) with a mean age of 50 years (range 25–71 years) and an alveolar ridge height between 4 and 7 mm were randomly allocated to test or control. Outcome measures included survival of suprastructures and implants, implant stability quotient, health status of the peri‐implant tissue, peri‐implant marginal bone loss, frequency of complications and PROMs using Oral Health Impact Profile‐14 combined with questionnaires assessing patient's perception of the peri‐implant soft tissue, implant crown, function of the implant, and total implant treatment outcome using visual analogue scale. Mean differences were expressed with standard deviation and 95% confidence interval. Level of significance was 0.05. Results: All suprastructures and implants were well‐functioning after 1‐year of functional implant loading. No significant difference in any of the applied outcome measures was observed between test and control. Both treatments revealed high patient satisfaction scores and significant improvement in oral health‐related quality of life. Conclusion: There were no significant differences in implant outcome and PROMs between test and control, after 1‐year of functional implant loading. Neither of the treatments can therefore be considered better than the other. Thus, long‐term randomized controlled trials are needed before definitive conclusions can be provided about the two treatment modalities. [ABSTRACT FROM AUTHOR]

(1) Background: The desire to avoid autograft harvesting in implant dentistry has prompted an ever-increasing quest for bioceramic bone substitutes, which stimulate osteogenesis while resorbing in a timely fashion. Consequently, a highly bioactive silicon containing calcium alkali orthophosphate (Si-CAP) material was created, which previously was shown to induce greater bone cell maturation and bone neo-formation than β-tricalcium phosphate (β-TCP) in vivo as well as in vitro. Our study tested the hypothesis that the enhanced effect on bone cell function in vitro and in sheep in vivo would lead to more copious bone neoformation in patients following sinus floor augmentation (SFA) employing Si-CAP when compared to β-TCP. (2) Methods: The effects of Si-CAP on osteogenesis and Si-CAP resorbability were evaluated in biopsies harvested from 38 patients six months after SFA in comparison to β-TCP employing undecalcified histology, histomorphometry, and immunohistochemical analysis of osteogenic marker expression. (3) Results: Si-CAP as well as β-TCP supported matrix mineralization and bone formation. Apically furthest away from the original bone tissue, Si-CAP induced significantly higher bone formation, bone-bonding (bone-bioceramic contact), and granule resorption than β-TCP. This was in conjunction with a higher expression of osteogenic markers. (4) Conclusions: Si-CAP induced higher and more advanced bone formation and resorbability than β-TCP, while β-TCP's remarkable osteoconductivity has been widely demonstrated. Hence, Si-CAP constitutes a well-suited bioactive graft choice for SFA in the clinical arena. [ABSTRACT FROM AUTHOR]

Introduction: In this retrospective study stabilities of 24 implants simultaneously placed at posterior maxillae with sinuses grafted by advanced platelet rich fibrin (A-PRF) and newly formed bone around them were evaluated. Patient and Methods: Fourteen augmented maxillary sinuses of 11 patients with a mean residual alveolar bone height of 4.55 mm were involved in this study. Maxillary sinus lifting via lateral window approach and implant site osteotomy were performed, and prepared A-PRF clots were used as sole graft material. Each of the implants was immediately placed with a good primary stability. Postoperative sixth month tomography images were compared with preoperative ones in order to calculate the gained bone height and implant stability quotient (ISQ) values were recorded. Results: The new vertical mean bone height of 24 implant sites was 12.21 mm with an implant survival rate of 100%. ISQ values of the implants were ranging from 62 to 75 with a mean value of 68. Statistically the diameter of implant did not have any effect on new bone formation and the ISQ values, however the length of them did. Conclusion: A-PRF as a graft material for sinus lifting with simultaneous implant placement is a reliable technique with its low cost and lack of immunogenic reaction risk. [ABSTRACT FROM AUTHOR]

Abstract Objectives The main purpose of this study was to evaluate whether large granular bovine bone can be as effective as small granular bovine bone in maxillary sinus floor elevation. Methods A comprehensive online search of eligible articles was conducted using PubMed, EMBASE, Cochrane Library, Scopus, and Web of Science, and a systematic review and meta-analysis was performed from establishment to February, 2023. The outcome indicators were the percentage of connective tissue, the percentage of newly formed bone and the percentage of residual xenograft respectively. The meta-analysis was conducted by using the Stata 15.1 (Stata Conpernarn, USA) and Review Manager software5.4.1. Results After careful screening and review, a total of 4 studies were included for systematic review and meta-analysis. The data were extracted to compare the histological performance of bovine bones with different particle sizes after maxillary sinus elevation. No significant differences were found in the percentage of connective tissue, the percentage of newly formed bone, and the percentage of residual xenograft. Conclusion In this study, a systematically review of the previous literature showed that similar histological results were obtained for both large-particle bovine bone and small-particle bovine bone. Therefore, the large granular bovine bone and the small granular bovine bone were equally effective in maxillary sinus elevation. It is difficult to make conclusion from limited evidence from four studies. More clinical evidence was needed.

Several techniques have been described for maxillary sinus graft augmentation, including the lateral window technique and crestal approach with osteotomes or osseodensification. Platelet-rich fibrin has been used in maxillary sinus lift procedures due to its ability to accelerate soft and hard tissue healing. The aim of this study was to evaluate the potential of PRF in combination with the synthetic hydroxyapatite NanoBone® to enhance bone regeneration in sinus floor elevation with the lateral window technique. Out of the 50 individuals screened in a preoperative assessment visit from the CESPU—Famalicão clinical unit and intervened upon between January 2023 and December 2023, only 6 patients who met the study’s inclusion criteria consented to participate. In a split-mouth study, twelve sinus graft surgeries were carried out. Our observations reveal that for the test group (NanoBone®/PRF), there is a 27.5 ± 4.9% increase new vital bone, 23.0 ± 3.7% increase in inert bone particles, and 49.4 ± 2.8% increase in connective tissue. Meanwhile, for the control group (NanoBone®), there is a 19.5 ± 3.0% increase in new vital bone, 23.4 ± 5.7% increase in inert bone particles, and 57.0 ± 3.5% increase in connective tissue. The results strongly indicate that mixing liquid PRF with NanoBone® does not have a negative influence on the amount of viable bone formation, and it seems to slightly increase the amount of new bone formation and revascularization in sinus bone graft procedures with the lateral window technique compared to the single use of NanoBone®.

Aim: This study aimed to evaluate the implant survival rate, marginal bone loss (MBL), and surgical complications in single dental implants placed in the atrophic posterior maxilla using a transcrestal sinus lift with injectable graft materials. Materials and Methods: A prospective longitudinal study was conducted at IRCCS San Raffaele, Milan, Italy. Fifty-four patients with single edentulous sites and residual bone heights < 5 mm were included. A transcrestal sinus lift was performed using non-cutting drills (Cosci’s technique) and xenogenic bone graft in gel form (Gel40, Tecnoss, Italy). Follow-up visits were at 1 week, 3 and 6 months, and annually for 3 years. Results: The implant survival rate was 98.04%, with one implant lost. MBL values were 0.71 ± 0.94 mm at 6 months, 1.00 ± 0.99 mm at 1 year, 1.03 ± 1.00 mm at 2 years, and 1.02 ± 1.01 mm at 3 years. Our ANOVA showed a significant MBL increase from 6 months to 1 year (p = 0.015), with no significant changes thereafter. Minimal surgical complications were observed, each occurring in 1.85% of cases. Conclusion: Transcrestal sinus lifts with injectable graft materials demonstrate high implant survival, acceptable MBL, and minimal complications, making it a reliable option for posterior maxilla rehabilitation.

Introduction: Lateral window sinus augmentation is done to augment the vertical sinus height for implant placement. Putty alloplasts have been used due to their longer resorption time and provide resistance to implant insertion. Although, widely used, the stability and bone loss around implants placed simultaneously following sinus augmentation with putty bone graft has not been evaluated. Aim: To evaluate the effect of putty alloplastic bone substitute on implant stability. Materials and Methods: This prospective interventional study was conducted in the Outpatient Department (OPD) of Oral and Maxillofacial surgery at SGT Dental College and Research Institute, Gurugram, Haryana, India. The duration of the study was two years and 11 months, from December 2014-November 2016. A total of 15 implants were placed simultaneously after lateral window sinus augmentation. Primary implant stability measurements were done using Resonance Frequency Analysis (RFA). Vertical Bone Height (VBH), Maximum Insertion Torque (MIT) and Crestal Bone Loss (CBL) were measured till six months of follow-up. The data was analysed using standard statistical analyses with Shapiro-Wilk-test, Wilcoxon signed-rank test and Spearman’s correlation co-efficient. Results: The mean age of the study participants was 58±3.04 years. A total of 15 implants were placed in 12 patients. Adequate primary stability was achieved with MIT >36 N/cm2 in 9/15 patients whereas, in 6/15 patients the MIT was ≤36 N/cm2 . The implants showed 100% survival rate. Postoperative bone gain obtained was in the range of 7.89 mm to 11.9 mm, with a mean of 9.92 mm. Acceptable levels of implant stability were obtained after six months. Conclusion: Within the limitations of the study, it can be concluded that, putty bone alloplast can serve as an adequate bone substitute in simultaneous implant placement after lateral window sinus augmentation and help in achieving stability.

The objective of this study was to assess endo-sinus bone gain (ESBG) following osteotome-mediated sinus floor elevation with Bio-Oss Collagen (test) compared with no grafting material (control) using two- and three-dimensional radiographic methods, as part of a randomized controlled trial (ClinicalTrials.gov, NCT04618900). Forty healthy patients who met the necessary eligibility criteria were allocated by block randomization to either the test group (20 patients) or control group (20 patients). Cone beam computed tomography scans were obtained at enrolment (T0), immediately after surgery (T1), at delivery of the prosthetic rehabilitation (T2), and 1 year after functional implant loading (T3). Mean differences were expressed with the 95% confidence interval; significance was set at P < 0.05. ESBG was significantly increased with Bio-Oss Collagen compared with no grafting material at T1, T2, and T3 (P < 0.001). A gradual decrease in ESBG was observed over time with both treatment modalities (P < 0.001), which diminished the difference between the test and control groups at T2 and T3. ESBG was observed to be positively correlated with implant protrusion length and negatively correlated with the residual bone height. In osteotome-mediated sinus floor elevation, the application of Bio-Oss Collagen underneath the elevated Schneiderian membrane improved ESBG significantly when compared with no grafting material. However, the increased ESBG seems not to have positively improved the treatment outcomes in terms of the implant stability quotient or the survival of the implants or suprastructures. [ABSTRACT FROM AUTHOR]