Orbital floor reconstruction in zygomatic-orbital-maxillary fracture with a fractured maxillary sinus wall segment as useful bone graft material

Author(s):  
Takahiro Kanno ◽  
Shintaro Sukegawa ◽  
Kazumichi Takabatake ◽  
Yuka Takahashi ◽  
Yoshihiko Furuki
2018 ◽  
Vol 12 (1) ◽  
pp. 820-826
Author(s):  
Nagla'a A. Abdel-Wahed ◽  
Maha Ahmed Bahammam

Introduction: The presence of an atrophic maxilla creates a serious challenge in cases of implant placement, while maxillary sinus pneumatization further complicates the surgery. This pilot study was performed to investigate the validity of two techniques used to estimate the volumes of bone graft material required in cases that included lateral window sinus augmentation. Materials and Methods: Cone beam computed tomography was used for preoperative volumetric analysis of the maxillary sinus. The analysis was performed using the manual measurement of sinus dimensions, as well as automated measurements via the segmentation technique. The estimated volumes of required bone graft material were compared with actual intraoperative findings in cases requiring lateral window sinus augmentation. For this pilot study, only 5 patients were selected to be included. Results: To achieve 80% power and confidence interval of 95%, the sample size should be 35 patients. The correlation coefficient between the segmented volume and mm3 used was – 0.5332, whereas the coefficient between the manual volume and mm3 used was – 0.6784. Consequently, both results indicate that the two methods have a moderate negative correlation with the mm3 used. Conclusion: Performing a similar study with an increased number of patients, according to the calculated sample size, increases the possibility of revealing higher correlation between the methods used to analyze the partial volume of the sinus cavity. The estimated sinus volume of the area of augmentation, obtained by using either manual or segmentation techniques, could be considered as a maximum estimate for the required amount of graft material. Furthermore, the segmentation technique may be valuable in preoperative planning of sinus augmentation, as it reveals the topographic shape and morphology of the sinus.


Dental Update ◽  
2017 ◽  
Vol 44 (10) ◽  
pp. 988-990
Author(s):  
Christina Evangelou ◽  
Georgina Peck ◽  
Nishma Somaia ◽  
Wayne Halfpenny

2021 ◽  
Vol 11 (3) ◽  
pp. 951
Author(s):  
Ji Hyoung Kim ◽  
Hyo Joon Kim ◽  
Ye Joon Jo ◽  
Jun Seok Choi ◽  
Seong Yong Moon

The aim of this study is to evaluate anatomical considerations and assess the volume of the maxillary sinus bone graft. There were sixty-three patients (eighty-three sinuses) who had taken CT scans for implant surgery. Patients included those whose height of the residual alveolar bone was less than 5 mm. The position of posterior superior alveolar artery, the thickness of the maxillary sinus wall, and the volume of the maxillary sinus according to the amount of sinus floor elevation were measured. The mean vertical distance of posterior superior alveolar artery was 11.91 ± 4.79 mm from 3.03 mm to 24.05 mm. The mean thickness of the lateral wall was 1.71 ± 0.55 mm in the range of 0.74 mm to 3.93 mm. The volume of 3 mm, 5 mm, 7 mm, and 10 mm from the sinus floor was 0.173 ± 0.11 cm3, 0.526 ± 0.25 cm3, 1.068 ± 0.43 cm3, and 2.184 ± 0.74 cm3 on average, respectively. The knowledge of the posterior superior alveolar artery position, the lateral wall thickness, and the volume of the maxillary sinus can help the clinician for sinus bone graft.


2021 ◽  
Vol 11 (9) ◽  
pp. 1497-1504
Author(s):  
Jinlong Liu ◽  
Yicai Zhang ◽  
Lin Qiu ◽  
Yujuan Zhang ◽  
Bin Gao

The material properties of nanocellulose (NC) can effectively enhance the structural stability of composite materials. However, the research related to NC/α-calcium sulfate hemihydrate (CSH) composites is largely lacking. In this paper, we explore the combination of these two materials and determine their elaborate biological activities in vivo. Using α-CSH as the matrix, the composite bone graft materials were produced according to different proportions of NC. Then the mechanical strength of the composite bone graft was measured, and the results were analyzed by X-ray diffraction and scanning electron microscopy (SEM). To conduct the material in vivo evaluation, 0% (CN0) and 0.75% (CN0.75) NC/α-CSH composite bone graft materials were implanted into a femoral condyle defect model. The results indicated that NC could significantly enhance the mechanical properties of α-CSH. The SEM analysis indicated that the NC shuttled between the crystal gaps and formed a three-dimensional network structure, which was firmly combined with the crystal structure. Meanwhile, the CN0.75 scaffold remained at 12 weeks postoperation, which provided a long-term framework for new bone formation. Overall, our findings demonstrate that, with a 0.75% NC/α-CSH composite demonstrating good potential as a bone graft material for clinical bone grafting.


2003 ◽  
Vol 17 (2) ◽  
pp. 97-100 ◽  
Author(s):  
Robert D. Thomas ◽  
Scott M. Graham ◽  
Keith D. Carter ◽  
Jeffrey A. Nerad

Background Enophthalmos in a patient with an opacified hypoplastic maxillary sinus, without sinus symptomatology, describes the silent sinus syndrome. A current trend is to perform endoscopic maxillary antrostomy and orbital floor reconstruction as a single-staged operation. A two-staged approach is performed at our institution to avoid placement of an orbital floor implant in the midst of potential infection and allow for the possibility that enophthalmos and global ptosis may resolve with endoscopic antrostomy alone, obviating the need for orbital floor reconstruction. Methods A retrospective review identified four patients with silent sinus syndrome evaluated between June 1999 and August 2001. Patients presented to our ophthalmology department with ocular asymmetry, and computerized tomography (CT) scanning confirmed the diagnosis in each case. Results There were three men and one woman, with ages ranging from 27 to 40 years. All patients underwent endoscopic maxillary antrostomy. Preoperative enophthalmos determined by Hertel's measurements ranged from 3 to 4 mm. After endoscopic maxillary antrostomy, the range of reduction in enophthalmos was 1–2 mm. Case 2 had a preoperative CT scan and a CT scan 9 months after left endoscopic maxillary antrostomy. Volumetric analysis of the left maxillary sinus revealed a preoperative volume of 16.85 ± 0.06 cm3 and a postoperative volume of 19.56 ± 0.07 cm3. This represented a 16% increase in maxillary sinus volume postoperatively. Orbital floor augmentation was avoided in two patients because of satisfactory improvement in enophthalmos. In the other two patients, orbital reconstruction was performed as a second-stage procedure. There were no complications. Conclusion Orbital floor augmentation can be offered as a second-stage procedure for patients with silent sinus syndrome. Some patients’ enophthalmos may improve with endoscopic antrostomy alone.


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