상단 PDF The Efficacy of the Graft Materials after Sinus elevation

The Efficacy of the Graft Materials after Sinus elevation

The Efficacy of the Graft Materials after Sinus elevation

상악동의 재함기화 정도는 골이식재의 종류에 따라 달라지는 것으로 생각되며 이는 이식재의 흡수 정도에 따라 결정되는 것으로 여겨진다.골이식에 있어 자가 골은 gol ds t andar d로 알려져 있으며 골형성,골유도,골전도 능력을 모두 보유하 고 있고 면역 거부 반응이 없어 빠른 골치유를 보이는 장점을 갖고 있다.그러나 골채취를 위[r]

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Multicenter clinical study on the hydrodynamic piezoelectric internal sinus elevation (HPISE) technique

Multicenter clinical study on the hydrodynamic piezoelectric internal sinus elevation (HPISE) technique

Recently, dental implant placement is widely used from the restoration of a single tooth to the full-mouth reconstruction. However, it has been limited by the absorption of the alveolar bone and location of important anatomical structures. In particular, placing implants in the maxillary posterior region is very difficult due to the pneumatization of sinus and fast absorption of alveolar bone. To address such problems, various techniques have been used for atrophic alveolar bone, with sinus bone graft using various bone graft materials 1-3 .
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Porcine study on the efficacy of autogenous tooth bone in the maxillary sinus

Porcine study on the efficacy of autogenous tooth bone in the maxillary sinus

Note, however, that it has the disadvantages of limited area or quantity of harvesting, secondary defects caused in the donor site, and relatively high possibility of maxillary sinus repneumatization attributed to the resorption of the graft material over time. Hatano et al. 15 argued that, to avoid possible events of repneumatization for the first two or three years after grafting, non-absorbable or slowly absorbable graft materials should be used. Since defects in the maxillary sinus are a form of “contained-type defects” with their own bony housing, most of the biocompatible bone graft materials can yield satisfactory outcomes. Recently, various graft materials used for maxillary sinus bone grafting have been shown to have no statistically significant difference in the aspects of healing; autogenous bone, allogenic bone, xenogenic bone, and synthetic bone are known to be safe.
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Clinical evaluation of graft materials in sinus grafting

Clinical evaluation of graft materials in sinus grafting

original article Summary and discussion The maxillary sinus is connected to the nasal cavity through one or two inferior nasal meatus in the upper 1/3 of the internal wall of the maxillary sinus. If the maxillary sinus is elevated excessively, this area may be exposed, and care must be taken to avoid this. After birth, the maxillary sinus enlarges continuously and comes to occupy much of the maxilla. At adolescence, the maxillary sinus extends from the canine to the 3rd molar, and from the floor of the orbit superiorly to the root of the maxillary canine inferiorly. Consequently, the maxillary sinus interferes with implant placement near the maxillary canine. Therefore, implant placement requires elevation of the maxillary sinus mucosa. In addition, with loss of the maxillary canine, the alveolar bone is resorbed progressively from the buccal side, decreasing the height of the alveolar bone and shifting the crest of the alveolar bone toward the midline. Together with the pneumatization of the maxillary sinus, this makes implant placement difficult 12) .
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Novel approach to the maxillary sinusitis after sinus graft

Novel approach to the maxillary sinusitis after sinus graft

A 47-year-old patient was referred to our department with the chief complaint of foul odor, tenderness on the right sinus, and headache. Sinus elevation using the crestal socket osteotome, bone graft, and implant inser- tion had been initiated at a local clinic 10 days previ- ously. Further clinical examinations showed gingival redness and swelling of the right buccal gingiva, pus discharge from the right nose, and lymphadenopathy of the right. A Waters’ view plain-film radiograph showed haziness of the right maxilla confirming sinusitis of the right maxilla (Fig. 1).
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Histomorphometric study of rabbit’s maxillary sinus augmentation with various graft materials

Histomorphometric study of rabbit’s maxillary sinus augmentation with various graft materials

1 Department of Dentistry and Oral and Maxillofacial Surgery, Daegu Catholic University Medical Center, Daegu, 2 Department of Anatomy, Catholic University of Daegu School of Medicine, Daegu, Korea Abstract: The purpose of this animal study is to evaluate, by histomorphometric analysis, bone regeneration in rabbit’s maxillary sinuses with blood clots alone, Bio-Oss, β-tricalcium phosphate (β-TCP), and demineralized tooth dentin (DTD) grafting. Bilateral sinus augmentation procedures were performed in 18 adult male rabbits. Rectangular replaceable bony windows were made with a piezoelectric thin saw insert. In the group 1, blood clots were filled; group 2, anorganic bovine graft (Bio-Oss) was grafted; group 3, β-TCP was grafted; group 4, DTD was grafted, and covered by replaceable bony windows. Animals were sacrificed at 2, 4, and 8 weeks after surgical procedure. The augmented sinuses were evaluated by histomorphometric analysis using hematoxylin and eosin and Masson’s trichrome stains. Histologically, new bone formation was revealed along the elevated sinus membrane and all graft materials. The new bone area of the group 2 was significantly greater than the group 1, and of the group 3 was significantly greater than the group 2, and of the group 4 was significantly greater than the group 3 at 8 weeks with P<0.05. The bone marrow area of group 1 was significantly greater than other groups at 8 weeks. The DTD area was significantly lesser than Bio-Oss or β-TCP particles area at 8 weeks. This present study suggests that DTD can be effective graft materials for bone regeneration of the maxillary sinus augmentation.
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Comparison of autogenous tooth bone graft and synthetic bone graft materials used for bone resorption around implants after crestal approach sinus lifting: a retrospective study

Comparison of autogenous tooth bone graft and synthetic bone graft materials used for bone resorption around implants after crestal approach sinus lifting: a retrospective study

Purpose: This retrospective study compares the amount of bone resorption around implants between an autogenous tooth bone graft (AutoBT) and a synthetic bone graft after a bone- added crestally approached sinus lift with simultaneous implant placements. Methods: In all, 37 patients participated in this study. Seventeen patients were grouped as group I and underwent an AutoBT-added sinus lift using the crestal approach. The remaining 20 patients were grouped as group II and underwent synthetic bone grafting. Both groups received the implant placements simultaneously. Of the 37 participating patients, only 22 patients were included in the final results: Eleven patients of group I and 11 patients of group II. Before the surgery, the distance from the alveolar crest to the sinus floor was mea- sured using panoramic radiography. After the surgery, the distance was measured again from the neck of the implant thread to the most superior border of the added graft materials.
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A radiographic evaluation of graft height changes after maxillary sinus augmentation

A radiographic evaluation of graft height changes after maxillary sinus augmentation

DISCUSSION It is difficult to gain a sufficiently large amount of bone for implant placement when alveolar bone loss occurs after the extraction of maxillary posterior teeth and severe pneumatization. In situations where the alveolar bone has poor quality and short height, a sinus lift procedure should be the first option for treatment [14]. Although researchers have tried to compare different alloplastic and allograft materials, debate continues as to the best graft material and the proper criteria for ideal indications. Recently, it has been suggested that deproteinized Table 3. Comparison of mean graft height changes according to residual bone height
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Resorption of bone graft after maxillary sinus grafting and simultaneous implant placement

Resorption of bone graft after maxillary sinus grafting and simultaneous implant placement

The representative xenogeneic bone, Bio-Oss, which is decalcified bovine bone, has been used as a maxillary sinus bone graft material for a long time 8,9 . It is believed that it delays the initial resorption of the bone that is grafted within the maxillary sinus, it is well maintained for a long time and is healed by the mechanism of osteoconduction 10,11 . Nonethe- less, it has been pointed out that such bone graft materials which delay the resorption are inadequate for bone remod- eling and functional loading of implants 12,13 . On the other hand, in maxillary sinus bone grafts, autogenous bones are inadequate for the long-term formation of bones due to rapid revascularization and resorption, injury of the donor area, and limitations in the harvest volume; however, some stud- ies have shown that due to the osteogenesis capacity of cells within autogenous bones, with time they could provide os- seointegration capacity to the implant surfaces 1,14,15 . In our study, an average resorption of 3.42 mm was shown when a mixture of autogenous bones and other bone graft materials were used, and an average resorption of 2.73 mm was shown when allogeneic bones and xenogeneic bones were used without the addition of autogenous bones.
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A change of sinus floor level related to the amount of grafted material after bone added osteotome sinus floor elevation (BAOSFE) technique: A radiographic retrospective study

A change of sinus floor level related to the amount of grafted material after bone added osteotome sinus floor elevation (BAOSFE) technique: A radiographic retrospective study

Purpose: The purpose of this article is to evaluate a change o bone level on the sinus floor by a bone added osteotome sinus floor elevation (BAOSFE) technique, according to the amount of deproteinized bovine bone mineral (DBBM). And Changes in augmented bone height after BAOSFE procedure were also assessed for 6 months after the implant procedure. Materials and Methods: Forty eight single implants were placed in the posterior maxilla using BAOSFE technique. The implantation sites were classified into two groups according to the amount of grafted DBBM, 0.25 group (0.25g) and 0.5 group (0.5 g). Panoramic views or cone-beam computed tomography (CBCT) were taken at the time of implant placement with BAOSFE and after at least 6 months to assess the bone level changes in the elevated sites with DBBM.
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A radiographical study on the changes in height of grafting materials after sinus lift: a comparison between two types of xenogenic materials JPIS

A radiographical study on the changes in height of grafting materials after sinus lift: a comparison between two types of xenogenic materials JPIS

In the window opening procedure, a primary incision is made in the crestal bone and the flap is reflected bucally to reveal the lateral bony wall of the sinus. In the region of im- plant placement, the bony wall is carefully perforated, taking care not to damage the sinus mucosa. The caudal border of the window should be about 5 mm above the crest of the al- veolar ridge. The sinus mucosa is slowly separated from the bone, creating room for the bone graft. The created space is now filled with the augmentation material, and then covered completely by the mucoperiosteal flap, which must be secure- ly sutured. High success rates have been shown to be achieved using this procedure. Therefore, it is a highly recommended procedure among the optional treatments for the posterior region of the maxilla where the alveolar bone is severely re-
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A hybrid technique for sinus floor elevation in the severely resorbed posterior maxilla JPIS

A hybrid technique for sinus floor elevation in the severely resorbed posterior maxilla JPIS

Hinge-type openings might make tearing more likely when associated with septa [33] or an anatomically narrow-shaped sinus (in the sagittal section), which preclude window dis- tients showed septa or moderately inclined slopes that could have experienced perforations if the elevations were per- formed by conventional crestal or lateral approaches. How- ever, with the help of visual access and minimal reflection of the Schneiderian membrane, there was no excessive tension to cause rupture when the graft materials were pushed up- wards and no specific complications were observed.
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A prospective study on the effectiveness of newly developed autogenous tooth bone graft material for sinus bone graft procedure

A prospective study on the effectiveness of newly developed autogenous tooth bone graft material for sinus bone graft procedure

A slowly resorbable biomaterial might be suitable in sub-sinusal bone augmentation for preventing the re-expan- sion process and for augmenting the density of the regen- erated tissues. Bovine HA seems to be the most efficient fillers for 3 dimensional stability of sub-sinusal bone aug- mentation. 48 In this study, AutoBT and Bio-Oss showed similar healing pattern, excellent graft volume maintenance and active new bone formation, in microCT and histomor- phometric evaluation of biopsy specimen 4 months after graft procedure. So, if it was applied for sinus bone graft, it would be useful material struggling repneumatization against intra-sinus pressure. Bone formation was found sur- rounding both enamel and dentin portion of AutoBT material. New bone bridges between graft materials were also detected in AutoBT group. Also newly-formed and matured lamellar bone was detected surrounding AutoBT material, osteoblasts covering newly-formed bone accumu- lated osteoid.
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Lateral approach for maxillary sinus membrane elevation without bone materials in maxillary mucous retention cyst with immediate or delayed implant rehabilitation: case reports

Lateral approach for maxillary sinus membrane elevation without bone materials in maxillary mucous retention cyst with immediate or delayed implant rehabilitation: case reports

Ji-Deuk Han 1 , Seong-Ho Cho 1 , Kuk-Won Jang 1 , Seong-Gwang Kim 2 , Jung-Han Kim 1 , Bok-Joo Kim 1 , Chul-Hun Kim 1 1 Department of Oral and Maxillofacial Surgery, College of Medicine, Dong-A University, 2 CS Dental Hospital, Busan, Korea Abstract (J Korean Assoc Oral Maxillofac Surg 2017;43:276-281) This case series study demonstrates the possibility of successful implant rehabilitation without bone augmentation in the atrophic posterior maxilla with cystic lesion in the sinus. Sinus lift without bone graft using the lateral approach was performed. In one patient, the cyst was aspirated and simul- taneous implantation under local anesthesia was performed, whereas the other cyst was removed under general anesthesia, and the sinus membrane was elevated in a second process, followed by implantation. In both cases, tapered 11.5-mm-long implants were utilized. With all of the implants, good stability and appropriate bone height were achieved. The mean bone level gain was 5.73 mm; adequate bone augmentation around the implants was shown, the sinus floor was moved apically, and the cyst was no longer radiologically detected. Completion of all of the treatments required an average of 12.5 months. The present study showed that sufficient bone formation and stable implantation in a maxilla of insufficient bone volume are possible through sinus lift without bone materials. The results serve to demonstrate, moreover, that surgical treatment of mucous retention cyst can facilitate rehabilitation. These techniques can reduce the risk of complications related to bone grafts, save money, and successfully treat antral cyst.
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Effect of maxillary sinus graft on the survival of endosseous implants: A 10-year retrospective study

Effect of maxillary sinus graft on the survival of endosseous implants: A 10-year retrospective study

In this study, different graft materials did not sig- nificantly influence on survival rates of implants (p> 0.05). Autogenous bone is considered the gold stand- ard for intraoral bone grafting. However, it has high- er morbidity including risk of neural disturbances due to possible lesions of the inferior alveolar nerve branches, and gait disturbances in case of harvesting from the iliac crest. Furthermore, autogenous bone grafts have been reported to have a history of greater than average resorption 28) , leading to subsequent sinus repneumatization and/or implant failure 6) . The use of non-resorbable or slowly resorbable grafting materials should prevent this phenomenon 11,21) . Bone substitutes appeared to be reliable for sinus floor elevation, with no significant differences in clinical outcomes and im- plant survival. In a study by Froum et al. 9) implant survival rates for a xenograft when utilized with or without autogenous bone were similar. Several histo- logical studies 9,29,30) showed that similar percentages of vital bone can be achieved in bone substitutes and in grafts with autogenous bone, provided the bone sub- stitutes are allowed to a longer maturation period.
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Comparison of immunohistochemical analysis on sinus augmentation using demineralized tooth graft and bovine bone

Comparison of immunohistochemical analysis on sinus augmentation using demineralized tooth graft and bovine bone

Abstract (J Korean Assoc Oral Maxillofac Surg 2021;47:269-278) Objectives: The purpose of this animal research was to compare bone regeneration in augmented rabbit maxillary sinuses treated with demineralized particulate human-tooth graft and anorganic bovine bone by immunohistochemical analysis. Materials and Methods: Piezoelectric bilateral sinus augmentation was performed in eight adult rabbits. In the control group, anorganic bovine was grafted in the maxillary sinus following elevation of the sinus membrane. In the experimental group, demineralized human particulate tooth bone was grafted in the sinus. Bone regeneration in augmented sinuses was evaluated by immunohistochemical analysis using various markers of osteoprogeni- tor cells.
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Familial tooth bone graft for ridge and sinus augmentation: a report of two cases

Familial tooth bone graft for ridge and sinus augmentation: a report of two cases

good clinical outcomes. The impacted third molars of the patients themselves were extracted and prepared as autog- enous tooth bone-graft materials. Nonetheless, the volume was not sufficient, and thus, the bone-graft materials prepared from the impacted third molar of their children were used in parallel. Other bone-graft materials were not used. Four months after alveolar ridge augmentation and 3 months after maxillary bone graft, implants were placed secondarily. Bone healing was good, and the early stability of implants could be obtained readily. The results of histological tests of the speci- mens collected from case 2 showed excellent new bone for- mation and bone remodeling phenomena. In this study, only 2 cases were presented, and a mixture of autogenous tooth bone materials and family tooth bone materials was used.
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Correlations between anatomic variations of maxillary sinus ostium and postoperative complication after sinus lifting

Correlations between anatomic variations of maxillary sinus ostium and postoperative complication after sinus lifting

Given the close relationship between the Schneiderian membrane and the ostium of the maxillary sinus and the fact that inflammatory reaction after any surgical procedure is inevitable, surgeons must consider the risk of infectious se- quelae after sinus floor elevation. Because of the temporary interference of ciliary activity caused by the traumatic eleva- tion of the Schneiderian membrane, altered mucous composi- tion and bacterial infection can occur 10,11 . After sinus floor elevation, the maxillary sinus may be filled with hematoma or seroma, requiring removal. However, a mild inflammatory reaction can occur as a normal physiological activity of the mucosal airway system 12 , and this swelling of the mucosa can lead to obstruction of the patency of the ostio-meatal unit. As a result, sinus floor elevation might compromise the physi- ological drainage of the maxillary sinus into the middle me- atus by transient inflammatory swelling on the mucosa of the ostium or due to other mechanisms that can predispose the patient to acute maxillary sinusitis 13 and possibly lead to bone graft loss.
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Implant treatment to reduce complications : Maxillary sinus elevation and bone graft (lateral wall approach) Failures and Problem solving

Implant treatment to reduce complications : Maxillary sinus elevation and bone graft (lateral wall approach) Failures and Problem solving

상악동의 해부학적 3차원구조를 잘 파악하고 있어야 상악동저 거상술시 상악동막의 천공을 예방할 수 있다. CBCT 촬영을 통하여 상악동막의 두께, 상악동내 중격 의 위치 및 형태 상악동막의 기울기 등에 관한 정보를 사전에 인지하고 있어야 상악동막 천공이 발생하기 쉬 운 부분을 예측할 수 있고 상악동막 거상술시 상악동막 천공의 회[r]

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Implant risk factor of sinus bone graft (I):

Implant risk factor of sinus bone graft (I):

그 외에도 수술 도중 상악동 점액낭종이 발견되면서 내 용물이 터져 나오거나 발견되지 못한 만성 상악동염에 의한 화농이 배출된 증례가 일부 있었다. 특히 상악동염 은 외과적 수술 시 철저한 무균처치가 부적절하였거나, 상악동 점막 천공, 상악동내 이물질에 의한 natural ostium의 폐쇄, 기존의 상악동 병변이 존재하는 경우에 [r]

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