Rupture length of the sinus membrane after 1.2 mm puncture and surgical sinus elevation: an experimental animal cadaver study.
01 Nov 2011-Oral Surgery Oral Medicine Oral Pathology Oral Radiology and Endodontology (Oral Surg Oral Med Oral Pathol Oral Radiol Endod)-Vol. 112, Iss: 5, pp 568-572
TL;DR: The HUCSL technique yielded the lowest increase of rupture length compared with BASL and Summers lift and therefore shows the lowest risk of a growing rupture of the sinus membrane in case of an iatrogenic puncture during preparation of the transcrestal approach.
Abstract: Objectives To evaluate the rupture length of the sinus membrane after applying a defined 1.2 mm defect comparing 3 different techniques: Summers lift, balloon-assisted technique (BASL), and hydrodynamic ultrasonic cavitational sinus lift (HUCSL). Study design Thirty fresh sheep heads (60 maxillary sinuses) were investigated. The sinus membrane was ruptured using a 1.2 mm pilot drill. Then Summers lift, BASL, and HUCSL were each performed on 20 sinuses, creating a 5 mm vertical lift of the sinus membrane. The length of the ruptured sinus membrane was measured before and after the experiment. The results of the different sinus lift techniques were compared using t tests. Results The t test showed that the Summers lift leads to a significantly higher rupture length (P = .05) than BASL. The comparison between Summers lift and HUCSL showed a significantly higher rupture length with the Summers lift (P Conclusions The HUCSL technique yielded the lowest increase of rupture length compared with BASL and Summers lift. The technique therefore shows the lowest risk of a growing rupture of the sinus membrane in case of an iatrogenic puncture during preparation of the transcrestal approach.
Citations
More filters
TL;DR: The results of this paper prove the key role of the sinus membrane as the main carrier of bone reformation after sinus lift procedures as multiple experimental studies suggested and the importance of minimal invasive and rupture free sinuslift procedures is underlined and does not depend on the type of grafting material used.
Abstract: Introduction. Sinus lift procedures are a commonly accepted method of bone augmentation in the lateral maxilla with clinically good results. Nevertheless the role of the Schneiderian membrane in the bone-reformation process is discussed controversially. Aim of this study was to prove the key role of the sinus membrane in bone reformation in vivo. Material and Methods. 14 patients were treated with the minimal invasive tHUCSL-Intralift, and 2 ccm collagenous sponges were inserted subantrally and the calcification process followed up with CBCT scans 4 and 7 months after surgery. Results. An even and circular centripetal calcification under the sinus membrane and the antral floor was detected 4 months after surgery covering 30% of the entire augmentation width/height/depth at each wall. The calcification process was completed in the entire augmentation volume after 7 months. A loss of approximately 13% of absolute augmentation height was detected between the 4th and 7th month. Discussion. The results of this paper prove the key role of the sinus membrane as the main carrier of bone reformation after sinus lift procedures as multiple experimental studies suggested. Thus the importance of minimal invasive and rupture free sinuslift procedures is underlined and does not depend on the type of grafting material used.
26 citations
TL;DR: L-PRF as a sole graft material during simultaneous SFE and implant placement proved to be a practical, safe, and economical subsinus graft material, resulting in natural bone formation.
Abstract: Purpose Sinus floor elevation (SFE) and simultaneous implant placement is predictable and reproducible. However, the graft material for the antral cavity remains a topic of debate. Considering the high osteogenic potential of the sinus membrane, most graft materials are generally accepted. This study aimed to assess the outcome of simultaneous SFE and implant placement, using leukocyte- and platelet-rich fibrin (LPRF) as a sole graft material. Materials and methods This study was designed as a single cohort prospective study. Clinical and radiographic measurements (cone beam computed tomography [CBCT]) were performed immediately after implant placement and at abutment connection (6 months later). The amount of newly formed bone was linearly recorded on cross-sectional images. Four measurements (mesial, distal, buccal, palatal) were registered with the axis of the implant as reference. Results Six lateral and 22 transalveolar SFEs were performed in 26 patients with simultaneous implant placement. Six months after surgery, 27/29 implants were clinically integrated. The mean vertical bone gain was 3.4 ± 1.2 mm and 5.4 ± 1.5 mm for transalveolar SFE and lateral SFE, respectively. The level of the new sinus floor was in all cases in continuation with the apex of the implant, and the peri-implant crestal bone height was stable. Conclusion L-PRF as a sole graft material during simultaneous SFE and implant placement proved to be a practical, safe, and economical subsinus graft material, resulting in natural bone formation.
23 citations
TL;DR: Within the limits of this study the results suggest self-hardening solid-block-like bone-graft-materials to achieve significantly better DTV/ITV than loose granulate biomaterials for its suspected improvement of vascularization and mineralization of the subantral scaffold by full immobilized of the augmentation site towards pressure changes in the human sinus at normal breathing.
Abstract: Implant-Insertion-Torque-Value (ITV) proved to be a significant clinical parameter to predict long term implant success-rates and to decide upon immediate loading. The study evaluated ITVs, when four different and commonly used biomaterials were used in sinuslift-procedures compared to natural subantral bone in two-stage-implant-procedures. The tHUCSL-INTRALIFT-method was chosen for sinuslifting in 155 sinuslift-sites for its minimal invasive transcrestal approach and scalable augmentation volume. Four different biomaterials were inserted randomly (easy-graft CRYSTAL n = 38, easy-graft CLASSIC n = 41, NanoBone n = 42, BioOss n = 34), 2 ccm in each case. After a mean healing period of 8,92 months uniform tapered screw Q2-implants were inserted and Drill-Torque-Values (DTV) and ITV were recorded and compared to a group of 36 subantral sites without need of sinuslifting. DTV/ITV were processed for statistics by ANOVA-tests. Mean DTV/ITV obtained in Ncm were: Control Group 10,2/22,2, Bio-Oss 12,7/26,2, NanoBone 17,5/33,3, easy-graft CLASSIC 20,3/45,9, easy-graft CRYSTAL 23,8/56,6 Ncm, significance-level of differences throughout p < 0,05. Within the limits of this study the results suggest self-hardening solid-block-like bone-graft-materials to achieve significantly better DTV/ITV than loose granulate biomaterials for its suspected improvement of vascularization and mineralization of the subantral scaffold by full immobilization of the augmentation site towards pressure changes in the human sinus at normal breathing.
20 citations
TL;DR: The results of the present study suggest tHUCSL-INTRALIFT should be used to perform predictable and safe detachment of the periosteum from the bony sinus floor as a prerequisite for undisturbed and successful physiologic subantral bone regeneration.
17 citations
14 Aug 2017
TL;DR: Evaluating most recent evidence, when surgical procedures performed with drills or burs are compared with laser- and/or piezotome-surgical procedures in experimental and clinical studies and to assess possible advantages of their use in daily practice.
Abstract: Background: New tools for bone-cutting were introduced to oral and maxillofacial surgery in the last
decade, such as lasers and piezotomes.
Purpose: to evaluate most recent evidence, when surgical procedures performed with drills or burs
are compared with laser- and/or piezotome-surgical procedures in experimental and clinical studies and
to assess possible advantages of their use in daily practice.
13 citations
References
More filters
Journal Article•
TL;DR: The author concludes that the osteotome technique is superior to drilling for many applications in soft maxillary bone and allows more implants to be inserted in a greater variety of sites during a routine office procedure.
Abstract: This article reviews the limitations of drilling into soft bone to place endosseous implants. Differences among bone types and the anatomy of the maxilla are described. The osteotome technique, which is a new method of placing implants into maxillary bone without drilling, and the rationale for two other procedures, the osteotome sinus floor elevation and the ridge expansion osteotomy, are detailed. How osteotomes conserve osseous tissue and may improve bone density around the implant is also discussed. A pilot study that shows excellent results with several types of press-fit implants using the osteotome technique is provided. The author concludes that the osteotome technique is superior to drilling for many applications in soft maxillary bone. Furthermore, the osteotome technique allows more implants to be inserted in a greater variety of sites during a routine office procedure.
697 citations
TL;DR: Support is provided for a role of systemic bone loss in the development of tooth loss among postmenopausal women by contributing to the resorption of toothsupporting alveolar bone.
Abstract: Increased systemic bone loss may be a risk factor for tooth loss by contributing to the resorption of toothsupporting alveolar bone. Concurrent longitudinal associations between tooth loss and bone loss at the whole body, femoral neck, and spine were examined in 189 healthy, white, dentate, postmenopausal women who participated in three intervention trials conducted within a 7-year period. None of the subjects was taking estrogen. Bone mineral density (BMD) was measured by dual photon or dual energy X-ray absorptiometry. Teeth were counted at baseline; number and timing of teeth lost over the observation period were assessed by questionnaire. All analyses were controlled for years since menopause, body mass index, number of teeth at baseline, smoking status, and the assigned treatment during each study. These interventions were calcium (Ca) or placebo (P) in Study I, vitamin D+Ca or P+Ca in Study II, and 1 of 2 doses of vitamin D+Ca in Study III. Age at baseline (mean±SD) was 59±6 years and the number of teeth remaining was 23±7. Women who lost teeth during the 7-year follow-up (n=45) experienced less favorable changes in BMD at all sites compared with 144 women who lost no teeth (whole body mean±SE, -0.35±0.08%/year versus -0.11±0.05, P<0.01; femoral neck -0.48±0.38%/year versus -0.14±0.35, P<0.05; and spine, +0.05±0.21%/year versus +0.45±0.16, P<0.05). For each 1%/year decrement in BMD, relative risks (and 95% CI) of losing a tooth were significantly elevated at the whole body (RR=relative risks, CI=confidence interval) (RR=4.83, CI=1.72–13.52, n=180), femoral neck (1.50, 1.02 to 2.22, n=189), and spine (1.45, 1.00 to 2.11, n=167). These results provide support for a role of systemic bone loss in the development of tooth loss among postmenopausal women.
193 citations
TL;DR: A marked increase in the prevalence of root resorption and alveolar bone loss occurred over the course of treatment and may be higher for incisors than in previously reported adolescent studies.
182 citations
TL;DR: A review of maxillary sinus floor elevation as an integral part of restoring the posterior maxilla is discussed and the related anatomy of the area and the current techniques available are reviewed.
Abstract: A review of maxillary sinus floor elevation as an integral part of restoring the posterior maxilla is discussed. The related anatomy of the area and the current techniques available are reviewed. The classic lateral antrostomy pioneered by Tatum appears to be the most common sinus lift procedure. The more conservative crestal approach, advocated by Summers, provides another effective way of allowing implant fixture placement in the atrophic maxilla.
144 citations
TL;DR: The experience suggests that hydraulic sinus condensing is a predictable and minimally invasive alternative for prosthetic rehabilitation of maxillary anterior and posterior regions in the presence of anatomical restrictions to implant placement.
Abstract: Background: For many clinicians, inadequate alveolar bone height and anatomical features of the maxillary sinus complicate sinus lift procedures and placement of endosseous implants. We present a new internal crestal approach that addresses these issues. Methods: Sinus burs and condensers of increasing width are used in conjunction with pliable atraumatic bone grafting mixture and hydraulic pressure from a surgical handpiece. The risk of a membrane perforation is minimized when the surgeon's tactile skill is administered in a two-stage process to first loosen and then graft bone particulate under the Schneiderian membrane. Threaded implants can then be placed in the same visit and secured via primary closure. Results: A retrospective investigation of 1,100 cases showed that eight implants failed and 14 required longer healing periods in patients with alveolar ridge heights varying between <1 to 5 mm. Conclusions: Our experience suggests that hydraulic sinus condensing is a predictable and minimally invasi...
139 citations
"Rupture length of the sinus membran..." refers background or methods in this paper
...Some studies evaluate the success rate by using the survival rates of the placed implants(9,10,19,25) and some studies evaluate the rupture rates of the sinus membrane.(13,22,26,31) Recent studies showed that the application of pneumatic pressure requires significantly higher pressure than hydraulic pressure to lift up the sinus membrane....
[...]
...The risk rate of a rupture of the sinus membrane is reported in the literature as 11%-56%,(13) whereas the Summers lift shows a success rate of 94%(22) and BASL shows a success rate of 92%-100%.(19,31,32) Although these figures give an indication, an analysis of Fig....
[...]
...The HUCSL (Intralift) was performed by using the published standard procedure.(31) The cavity was prepared by using the oscillating diamond cylinders TKW 1 (diameter 1....
[...]
...These results led to the development of the Intralift technique, which uses oscillating water pressure to lift up the sinus membrane.(31) The present investigation was performed to compare the Intralift technique with 2 commonly used transcrestal sinus lift techniques....
[...]