Maxillary sinus floor augmentation in patients with maxillary sinus pseudocyst: case report

The maxillary sinus floor elevation procedure has gained popularity with predictable results, and is a safe, acceptable technique for bone augmentation, providing a base for dental implant treatment. Faint radiopaque lesions at the base of the maxillary sinus are frequent diagnoses on radiographs and must be identified during dental implant planning. Pseudocysts classically appear hemispheric, homogeneously opaque, and well delineated in panoramic and periapical radiographs. The great majority of these lesions are asymptomatic and do not require surgical treatment. In this case report, we present 4 patients who had a maxillary sinus floor elevation procedure using either crestal or lateral approaches in the presence of antral pseudocysts. No complications were encountered during follow-up periods in these patients and all implants are functioning successfully.     

Osteotome sinus floor elevation and simultaneous, non-submerged implant placement: case report and literature review

The osteotome sinus floor elevation is a conservative technique for sinus elevation and immediate implant placement. The purpose of this report is to present a case using the sinus floor elevation technique for placement of a non-submerged implant with 12 months follow-up after permanent restoration and to review the literature regarding sinus floor elevation. The osteotome sinus floor elevation technique may be used successfully for the placement of nonsubmerged implants. It allows for shorter post-treatment waiting times and provides a less invasive approach compared to 1- or 2-step antrostomy procedures.     

上颌窦外提升及同期牙种植动物模型的建立

目的：建立一种可行上颌窦外提升及同期种植体植入的动物模型。方法：1-1.5岁的成年狗8只为实验对象,其中2只行上颌窦区解剖学观察,另6只拔除双侧上颌第一磨牙,使用上颌窦外提升法提升上颌窦,同期植入种植体及自体骨。术后3月处死动物,观察种植体的大体及新生骨的情况。结果：犬上颌窦有足够的体积行上颌窦外提升术.术后3月种植体稳固,牙槽嵴丰满,种植体顶部有新生骨形成。结论：建立犬上颌窦外提升及同期牙种植动物模型具有一定的可行性。     

Dental implant treatment for patients with psychiatric disorders

The literature with respect to whether or not psychiatric disorders represent a contraindication to dental implant treatment is sparse and contradictory. This paper describes three cases in which patients with psychiatric disorders were provided with dental implant retained prostheses. It is concluded that mental health disorders are not necessarily a contraindication to dental implant treatment and dental implant treatment can provide valuable psychological support. If any doubt exists about the effect of a psychiatric disorder on the prognosis of implant treatment the opinion of a psychiatrist should be obtained. The development of liaison psychiatry for dental hospitals should be seen as an ideal.     

Transcrestal sinus floor elevation: report of a case series

The technique of the osteotome-mediated transcrestal sinus floor elevation is described in a series of case reports. Fifty-five patients received a total of 66 implants over a period of 6 years. Bio-Oss was added in more than 60% of cases to increase the stability of the lifted area. The surgical procedure appeared to be a safe method that was well supported by the patients. It was applied for different prosthetic indications in partially and completely edentulous situations. The survival rate of the implants during the healing phase was 98.5%, and it was 100% after loading. The patients' responses to the Summers technique were evaluated by means of short interviews and visual analog scales (VAS), and the answers were compared with those from a group of patients who had received implants in the same location during the same period but without the osteotome technique. The answers regarding pain were not different between the groups. However, significantly more patients who had received the implants by means of the osteotome technique judged the surgical procedure as highly uncomfortable. It is concluded that patients need to be well prepared for the procedure.     

Dental implant reconstruction after endodontic failure: report of case

Avulsion of natural teeth caused by trauma may present an unusual problem for the general practitioner. Endodontic therapy and replantation of the tooth into the socket have a relatively low long-term prognosis because of internal or external root resorption. Dental implants can provide proper support and function for missing teeth with excellent esthetic results without preparation of natural dentition. In this case report, an implant system is used to restore an anterior space created by the loss of endodontically treated central and lateral incisors.     

上颌窦外提升技术在种植修复中的应用

目的:研究上颌窦外提升技术在上颌后牙区种植高度不足时的应用及临床效果.方法:2005年7月至2011年7月共完成52例、84枚种植体的上颌窦外提升种植修复病例.随访5年以上13例、3年以上24例、1年以上8例、1年以内7例.观察方法为临床检查和X线检查.患者上颌后牙区牙槽嵴顶至上颌窦底之间剩余骨高度小于7mm,无法植入足够长度的种植体,因此采用上颌窦外提升技术同期植入种植体.术中使用了Bio-Oss骨粉作为骨移植材料,采用非埋入式种植技术,6个月后进行修复.结果:总计52例患者,2例发生上颌窦黏骨膜破裂,但术后观察未发生上颌窦感染等并发症.84枚种植体均获得良好的骨结合并已完成种植修复,至2011年12月为止,无种植体脱落,患者对修复效果满意.结论:上颌窦外提升技术安全可行,是解决上颌后牙区骨高度不足时种植修复难题的有效方法.     

A human histologic report of an implant placed with simultaneous sinus floor elevation without bone graft

A titanium implant with an acid-etched surface was placed simultaneously with sinus floor elevation in a severely resorbed ridge of a 52-year-old man. The height of the residual crest was less than 3 mm, and no bone substitute was used to graft the sinus cavity. Six months after placement, the implants were uncovered, and no signs of mobility were recorded. The implant at the second molar site and surrounding bone were removed for prosthetic convenience. The specimen was harvested and processed for undecalcified histologic analysis. Poor bone quality around the implant was evident, characterized by large marrow spaces and scarce trabeculation. Signs of osseointegration could be seen mainly toward the apical third of the implant. A cortical wall was present apical to the implant, suggesting the formation of a new sinus floor. The relationship between the histologic evidence and possible clinical implications are discussed.     

上颌窦内提升技术在口腔种植修复中的应用

目的:研究上颌窦内提升技术在上颌后牙区种植修复中应用及临床效果.方法:2005年7月至2009年7月共完成32例、54枚种植体的上颌窦内提升种植修复病例.随访3年以上4例、2年以上12例、1年以上10例、1年以内6例.观察方法为临床检查和X线检查.患者上颌后牙区牙槽嵴顶至上颌窦底之间剩余骨高度在7--11mm之间,无法...     

Making bone: implant insertion into tissue-engineered bone for maxillary sinus floor augmentation-a preliminary report.

Autologous, allogenic and alloplastic materials for bony reconstruction in the cranio-maxillofacial area have many drawbacks thus stimulating the on-going search for new (bio-)materials. Whereas cultivated skin and mucosa are already in clinical routine use in head and neck reconstruction, so far there has been no successful clinical application to the best of our knowledge of periosteum-derived, tissue-engineered bone for augmentation of the edentulous posterior maxilla. In a pilot study, augmentation of the posterior maxilla was carried out using a bone matrix derived from mandibular periosteal cells on a polymer fleece. This paper demonstrates fabrication of the matrix, clinical application, and the histological results in two patients. The results suggest that periosteum-derived osteoblasts on a suitable matrix form lamellar bone within 4 months which allows reliable implant insertion.     

慢性肾脏病患者的口腔种植治疗

慢性肾脏病是威胁人类健康的全球公共卫生问题,影响全身多器官系统功能.随着疾病的进展,患者的口腔健康常受影响.种植牙已成为牙缺失的最佳修复方式,为慢性肾病患者提供安全可靠的牙种植治疗,是需要,也是挑战.口腔种植医师应从全局出发,综合评估患者的健康情况,充分了解患者既往及当前接受的治疗与药物使用情况;完善患者术前血液生化、...     

上颌窦底提升自体骨与异种骨移植延期种植的临床疗效评价

目的 评价经上颌骨前外侧壁的上颌窦底提升植骨延期种植术的长期临床效果,并比较两种不同的骨移植材料在种植修复不同时期的变化.方法 对2002年1月至2008年12月牙列缺损患者18例(21侧)上颌窦行经上颌骨前外侧壁的上颌窦底提升植骨延期种植术.延期(6～8个月)植入共46枚种植体.将牙列缺损区域剩余牙槽骨高度＜4 mm的患者分为两组:①混合材料组(自体骨+异种骨)5例6侧;②单纯异种骨组(Bio-Oss)13例15侧.在3个时间点(植骨术后即刻、种植体负荷即刻、＞12个月随访)拍摄曲面体层X线片,评估骨吸收率及种植体存留率.结果 在植入的46枚种植体中,除1枚因感染取出外,其余种植体骨结合良好并完成修复.在平均54个月随访期内,种植体存留率为98％ (45/46).3个时间点的X线片测量比较,移植骨量两组均减少,混合材料组(10.88％和7.77％),总吸收率18.65％;单纯异种骨组(4.40％和-2.47％),总吸收率1.93％.骨量变化的差异有统计学意义.结论 上颌窦底提升植骨的临床效果是可以预期的;单纯异种骨移植的骨吸收率低于自体骨+异种骨混合材料的骨吸收率.     

Long-term results with different bone substitutes used for sinus floor elevation

One of the surgical procedures preceding implantation is elevation of the base of the maxillary sinus. Numerous bone substituting materials (grafts) may be used for this purpose, including autogenous bone, heterografts, xenogenous bone, and synthetic materials alone or in combination or mixed with growth factors and bone morphogenetic protein (BMP) preparations. A study of the frequencies of the failures (graft material resorption or implant loss) after sinus elevations with various graft materials or their combinations was conducted. In the 5-year period from 1996 through 2001, a follow-up investigation of 810 maxillary sinus augmentations was performed, in which the sinus elevations involved the use of autogenous bone, a calcium carbonate-coated polymer, hydroxylapatite of algal origin, calcium carbonate gel produced from coral or beta-tricalcium phosphate alone, autogenous bone mixed with these bone substitutes, or a combination of beta-tricalcium phosphate and platelet-rich plasma. The incidences of graft resorption and implant loss after the augmentations with various bone substitutes were recorded. Total resorption (disappearance) of the bone substitute material was observed in 2.7% of the cases. An essential difference was not experienced between the various bone substitutes from this aspect, with the exception of the gel-state calcium carbonate, where 40% of the grafts were resorbed. In total, 5.46% of the implants were lost; the differences between the various materials were not significant.     

Dental implant and fungus ball in the ethmoid sinus

Dental migration into the ethmoid sinus is extremely rare. Furthermore, it is very unusual that a displaced dental implant is associated with a concomitant fungus ball in the ethmoid sinus. Herein, we report an unusual case of the coexistence of a dental implant and fungus ball in the ethmoid sinus. It appears that this condition has not been reported previously.     

Minimally invasive sinus floor elevation procedures for simultaneous and staged implant placement

Osteotome techniques are used as a less invasive alternative to the lateral window osteotomy to increase the volume of bone in the posterior maxilla. Implants may be placed simultaneously for four to six months after performing osteotome-mediated sinus floor elevation, depending upon the residual crestal bone remaining beneath the sinus floor. This article describes the clinical indications and techniques for localized internal sinus elevation using osteotomes. The incorporation of this minimally invasive crestal approach to sinus augmentation into the clinical practice results in increased case acceptance with reduced treatment duration, trauma and cost.     

Dental implant failure associated with bacterial infection and long-term bisphosphonate usage: a case report

Although the risk of developing osteonecrosis of the jaw for oral implants in patients using oral bisphosphonates (BPs) is low, the devastating complications still require caution. We document a case of severe periimplant infection that developed after the patient had used oral BPs for 3 years. Exposed bone and osteonecrosis persisted for more than 2 months after 1 infected implant was explanted by a dentist unaware that the patient was taking BPs. After oral BPs had been stopped, another involved implant was explanted, sequestra were removed, a primary closure was sutured, and the antibiotic was changed; then the wound was finally under control. The explanted implant with attached bone was processed for undecalcified ground sections, and specimens from the bony lesion were sent to pathology for examination. Osteonecrosis, severe inflammatory osteolysis, and heavy bacterial colonization were found. Patients at risk must be alerted about the potential risks of implant failure and developing BP-related osteonecrosis of the jaw.