scholarly journals Removal of Displaced Dental Implants in the Maxillary Sinus Using Endoscopic Approaches

2020 ◽  
pp. 014556132093130
Author(s):  
Po-Hung Chang ◽  
Yi-Wei Chen ◽  
Chi-Che Huang ◽  
Chia-Hsiang Fu ◽  
Chien-Chia Huang ◽  
...  
Keyword(s):  
Maxillary Sinus ◽  
Dental Implants ◽  
Dental Implant ◽  
Good Alternative ◽  
Sinus Surgery ◽  
Surgical Indications ◽  
Panoramic View ◽  
Posterior Teeth ◽  
Dental Implantation ◽  
Implant Displacement

With the broad indications for dental implantation, complications rates have increased. Dental implant displacement into the maxillary sinus, although rare, can occur during the restoration of maxillary posterior teeth. We performed a 6-year retrospective review and found 3 cases with displaced implants in the maxillary sinus. Detailed information, including surgical indications and dental implant removal methods, is provided. Dental implants can be dislocated to the maxillary sinus perioperatively or postoperatively. Endoscopic sinus surgery can be performed to remove the implant and restore sinus patency. If the implant is displaced to deeper areas (commonly anterior and inferior) of the maxillary sinus, a prelacrimal recess approach can provide a panoramic view of the maxillary sinus and is a good alternative to the Caldwell-Luc operation in terms of mucosal preservation and postoperative complications.

scholarly journals Management of the maxillary sinus complications after dental implantation: a systematic review and meta-analysis

2020 ◽  
Vol 23 (2) ◽  
Author(s):  
Samira Jamali ◽  
Navid Nasrabadi ◽  
Salar Payahoo ◽  
Maryam Darvish ◽  
Hashem Ahmadizadeh ◽  
...  
Keyword(s):  
Maxillary Sinus ◽  
Dental Implants ◽  
Meta Analysis ◽  
Final Analysis ◽  
Implant Failure ◽  
Sinus Surgery ◽  
Cochrane Library ◽  
Membrane Rupture ◽  
Dental Implantation ◽  
Membrane Perforation

Background and aim: Endoscopic sinus surgery owing to its satisfactory prognosis and low complication is considered as the first line of surgical procedure. Implant failure is often reported despite efforts in recent years. The purpose of this study was to review the factors leading to side effects in dental implantation of the maxillary sinus. Material and Methods: The systematic search was performed on electronic databases of MEDLINE, PubMed, Cochrane Library, Embase, ISI, Google scholar to find corresponding articles regarding dental literature during 2010 to 2019. Electronic title management was carried out by Endnote X9 software. Searches were based on the keywords of “dental implants”, “Implants”,” dental”,” maxilla”, “sinusitis”. Results: The searched potentially relevant titles and abstracts were related to 294 articles, 104 of which were excluded due to lack of study inclusion criteria. At last, 11 articles were included into the final analysis. Postoperative sinusitis was found in 78 patients within 9 articles among 1195 patients. The implant failure was reported in 136 cases and the sinus membrane perforation in 185 sinuses within 11 articles among 1372 sinus lift procedures. Conclusion: The findings showed that the risk factors of sinusitis after implant surgery were Schneiderian membrane rupture and preoperative sinusitis, as well as smoking and residual bone height were the parameters elevating the dental implant failure risk.KEYWORDSSinusitis; Dental implants; Implant failure.

Cytomorphometric characteristics of imprints of the contact area between the gingiva and the dental implant after one-step implantation

2017 ◽  
pp. 77-82
Author(s):  
А.С. Рыбалко ◽  
А.С. Григорьян ◽  
А.А. Орлов
Keyword(s):  
Dental Implants ◽  
Dental Implant ◽  
Contact Area ◽  
Inflammatory Reactions ◽  
Diagnosis And Prognosis ◽  
Dental Implantation ◽  
Data Points ◽  
One Step ◽  
Cytological Method ◽  
Clinical Pictures

Цель исследования состояла в разработке неинвазивного метода диагностики состояния тканей периимплантационной зоны после постановки дентальных имплантатов, а также прогноза течения послеоперационного периода и ранней диагностики послеоперационных осложнений, таких, как мукозит и периимплантит, при одноэтапном методе дентальной имплантации. Методы. В исследовании представлена цитологическая характеристика отпечатков из области контакта имплантата с десной, в которых оценивали состояние эпителиальных клеток при различных проявлениях цитопатологии. Определяли индекс деструкции (ИД) и воспалительно-деструктивный индекс (ВДИ) в клетках воспалительного инфильтрата, которые сопоставляли с клинической картиной течения послеоперационного периода. Сроки забора цитологического материала 1, 5, 15, 25, 30, 60, 120 дней после постановки имплантатов. Количество исследованных цитограмм - 442 от 11 пациентов (по 1-2 имплантата). Общий массив использованных для вычисления интегральных показателей составил »2550. Результаты. Было установлено, что в сроки 1-5 дней после постановки дентальных имплантатов происходит резкое повышение показателей ИД (до 7500 ± 15) и ВДИ (до 80 ± 20), что отражает процесс развития в области имплантатов острых воспалительных реакций. В отдаленные сроки наблюдений отмечалось 2 варианта развития событий. Первый из них характеризовался сохранением во все сроки высоких показателей ИД и ВДИ. Для второго варианта динамики показателей было характерно их падение, что соответствовало развитию процесса остеоинтеграции дентальных имплантатов. The objectives of the investigation were to develop protocols evaluating the validity and effectiveness of the cytological method for diagnosis and prognosis of tissue conditions adjacent to a dental implant. Methods. This study examined the cytological characteristics of imprints of the gingiva-implant contact area, a. the correlation of quantitative ratios of epithelial cells either with or without hystopathological manifestations (an index of destruction, ID); b. ratio of cells of the inflammatory infiltrate (an inflammatory and destructive index, IDI); these data were researched in relation with dynamics of the clinical pictures during a postoperative period.The cytological material was obtained 1, 5, 15, 25, 30, 60, 120 days after dental implantation. Totally 442 cytogramme from 11 patients (1-2 implant per a patient) were assayed. The data array for computation of integrated indicators was composed of ca. 2550 data points. Results. A significant increase of ID (7500 ± 15) and IDI (80 ± 20) indicators, which reflects the development of acute inflammatory reactions in tissues neighboring an implant, was observed within 1-5 days following the insertion of dental implants. Long-term observations revealed two scenarios. The first scenario was characterized by the retention of high levels of ID and IDI over the period of observations. The second scenario featured the reduction of ID and IDI indices, which corresponded to the development of the osseointegration of dental implants.

Dental Implants and Plasma Rich in Fibrine: A Wide Literary Review

2021 ◽  
pp. 34-41
Author(s):  
Carlos Fernando Almeida da Silva ◽  
Tayná Toder Santos ◽  
Idiberto José Zotarelli Filho ◽  
Elias Naim Kassis
Keyword(s):  
Bone Formation ◽  
Maxillary Sinus ◽  
Dental Implants ◽  
Case Reports ◽  
Bone Grafts ◽  
Sinus Surgery ◽  
Autogenous Bone ◽  
Platelet Concentrates ◽  
Surgical Access ◽  
Short Implants

Introduction: When a dental element is lost in the posterior region of the maxilla, there is natural reabsorption of the alveolar process and at the same time there will be pneumatization of the maxillary sinus. It will increase its volume towards the place where the roots existed and this will often make it difficult or impossible to restore implants in place. For this reason, the procedure for elevating the floor of the maxillary sinus or short implants should be performed when possible. In this context, allogeneic, xenogenous, and alloplastic bone grafts are an alternative for the treatment of bone defects in the jaws, since they avoid the need for a second surgical access. However, due to the need for processing to eliminate antigenic components, these grafts are only osteoconductive with a lower bone formation potential compared to autogenous bone grafts. Also, in this context, in the last 20 years, platelet concentrates have been proposed as regenerative materials in tissue regeneration procedures. Among the platelet concentrates proposed in the literature, PRP and FRP are found to act as autogenous platelet aggregates with osteoinductive properties. Objective: The present study aimed to conduct a wide literature review on maxillary sinus surgery using fibrin-rich plasma. Methods: Experimental and clinical studies (case reports, retrospective, prospective and randomized) with qualitative and/or quantitative analysis were included. Results: The total of 48 articles were found involving Maxillary sinus surgery, Fibrin-rich plasma, and Biomaterials, of which 22 were selected to compose the present study. Conclusion: Based on the literary findings, it was shown that the FRP is favorable for bone formation processes for dental implants, especially when combined with xenografts.

scholarly journals Surgical Treatment of Chronic Rhinosinusitis after Sinus lift

2017 ◽  
Vol 31 (4) ◽  
pp. 271-275 ◽  
Author(s):  
Nicole Tin-Lok Jiam ◽  
Andrew N. Goldberg ◽  
Andrew H. Murr ◽  
Steven D. Pletcher
Keyword(s):  
Dental Implants ◽  
Chronic Rhinosinusitis ◽  
Endoscopic Sinus Surgery ◽  
Functional Endoscopic Sinus Surgery ◽  
Implant Removal ◽  
Sinus Surgery ◽  
Sinus Lift ◽  
Presenting Symptoms ◽  
Dental Implantation ◽  
Imaging Results

Background The sinus lift (or sinus augmentation) is a common procedure to improve maxillary bone stock before dental implantation. Chronic rhinosinusitis (CRS) is a potential complication of this procedure and may be refractory to medical treatment. Functional endoscopic sinus surgery has previously been used to address CRS, however, results of previous studies indicated that implant removal is required. There are limited follow-up data available. Objective The purpose of this study was to characterize the long-term outcomes and efficacy of endoscopic sinus surgery for refractory CRS after sinus lift, including the ability to salvage dental implants. Methods This was a retrospective case series that described nine patients who, between June 2011 and September 2016, underwent endoscopic sinus surgery for CRS after a sinus lift procedure. The presenting symptoms of the patients, medical management, imaging results, operative procedures, and outcomes were reviewed. Results The majority of patients developed symptoms (mucopurulent nasal drainage, facial pain and/or pressure, nasal congestion, and foul smell) within 3 months of implant placement and were treated with at least three courses of antibiotics before referral to an otolaryngologist. All the patients underwent wide endoscopic maxillary antrostomy, with no surgical complications or postoperative reports of infection. There was a statistically significant improvement in 22-item Sino-Nasal Outcome Test scores (t(8) = -2.908; p = 0.02) and discharge, inflammation, and polyps/edema endoscopic scores ([z = -2.539; p = 0.011) between pre- and postsurgical treatment. Four patients had their dental implants removed before presentation. Among the five patients who presented with intact dental implants, none required removal before or after functional endoscopic sinus surgery. Conclusion Functional endoscopic sinus surgery was a reasonable and efficacious treatment option for patients who presented with paranasal sinus disease after a sinus lift. Dental implant removal may not be a requirement for successful treatment of CRS associated with sinus lift procedures.

scholarly journals Removal of a Dental Implant Displaced into the Maxillary Sinus by Means of the Bone Lid Technique

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Pietro Fusari ◽  
Matteo Doto ◽  
Matteo Chiapasco
Keyword(s):  
Foreign Body ◽  
Maxillary Sinus ◽  
Dental Implants ◽  
Dental Implant ◽  
Low Incidence ◽  
Edentulous Jaws

Background. Rehabilitation of edentulous jaws with implant-supported prosthesis has become a common practice among oral surgeons in the last three decades. This therapy presents a very low incidence of complications. One of them is the displacement of dental implants into the maxillary sinus. Dental implants, such as any other foreign body into the maxillary sinus, should be removed in order to prevent sinusitis.Methods. In this paper, we report a case of dental implant migrated in the maxillary sinus and removed by means of the bone lid technique.Results and Conclusion. The migration of dental implants into the maxillary sinus is rarely reported. Migrated implants should be considered for removal in order to prevent possible sinusal diseases. The implant has been removed without any complications, confirming the bone lid technique to be safe and reliable.

scholarly journals Disease Management in the Fungal Body of the Maxillary Sinus in People with Planned Dental Implantation

2021 ◽  
Vol 6 (3) ◽  
pp. 206-211
Author(s):  
Ya. V. Shkorbotun ◽  
◽  
Keyword(s):  
Maxillary Sinus ◽  
Complete Removal ◽  
Sinus Surgery ◽  
Endoscopic Endonasal ◽  
Main Method ◽  
Maxillary Bone ◽  
Fungal Ball ◽  
Dental Implantation ◽  
Group 2 ◽  
Maxillary Sinuses

The fungal ball is the most common clinical form of fungal etiology sinusitis. The main method of treatment of patients with this pathology is surgery. Achieving complete removal of the fungal body is important, especially in patients who will have planned dental implantation. Among the accesses to the maxillary sinus in cases of the fungal body of the sinus, the most common one is through the middle meatus, but it does not provide visual control of the anterior parts of the sinus during the intervention. The use of modified infraturbinal access provides better opportunities for examination of the anterior parts of the maxillary sinus. The purpose of the study is to increase the effectiveness of surgical treatment of patients with fungal bodies of the maxillary sinus by optimizing access during endoscopic endonasal intervention. Materials and methods. The data of 113 patients with fungal ball of maxillary sinuses who underwent sinusotomy in preparation for dental implantation were analyzed. Cone beam computed tomography of paranasal sinuses of patients were performed twice – before functional endoscopic sinus surgery and before subantral augmentation of the maxillary bone. Group 1 included 78 patients to whom the fungal balls were removed from the sinus through the middle nasal meatus, group 2 – 35 patients to whom, in cases when it was impossible to visually confirm the completeness of removal of the fungal ball from the anterior area of the sinus, an additional infraturbinal approach was performed in our modification. Results and discussion. According to tomography before rhinosurgery it was established that "blackout" of more than 60% of the sinus space is observed in 50.5% of patients with fungal bodies, with the vast majority of patients (88.1%) fungal bodies in the maxillary sinus are located in its lower parts and spread forward from the nasolacrimal canal level. During sinus rehabilitation, the need for additional infraturbinal access arose in 5 (14.3%) patients of the second group. As a result of its performance in all 5 operated patients polyposis-altered tissues were found in "blind zones" and in 2 (5.7%) – there were also remains of a fungal body. Residual fungal bodies in the maxillary sinus were detected in 3 (3.9% CI 95% – 0.01; 11.6) patients of the first group, and were not observed in the second group. All cases of residual fungal masses in the sinus were not accompanied by specific complaints. A revision of sinusitis with fungal masses removing was performed on 3 patients due to the appearance of residual fungal bodies by preformed antrostomy with local anesthesia. Conclusion. Anthrostomy using additional endoscopic infraturbinal access when removing the fungal body from the lower anterior maxillary sinus is the optimal combined access that allows maximum visualization of the maxillary sinus and avoid recurrence of the disease

scholarly journals Pathomorphological Features of the Mucoperiostasis of the Processus Uncinatus in Discrete Diseases of the Maxillary Sinus

2021 ◽  
Vol 6 (5) ◽  
pp. 255-262
Author(s):  
Ya. V. Shkorbotun ◽  
◽  
O. G. Kuryk ◽  
◽  
Keyword(s):  
Maxillary Sinus ◽  
Chronic Rhinosinusitis ◽  
Nasal Polyps ◽  
Sinus Surgery ◽  
Histological Features ◽  
Dental Implantation ◽  
Ostiomeatal Complex ◽  
History Of ◽  
Group 3 ◽  
Group 2

The state of the mucoperiostasis of the maxillary sinus is one of the important factors that affect the effectiveness of dental implantation, especially in case of need for augmentation of the maxillary bone. Chronic rhinosinusitis with nasal polyps, chronic rhinosinusitis with fungal bodies, and sinus cysts are among the most common pathological processes in the maxillary sinus that are encountered when performing subantral augmentation. In addition, a separate category of patients is made up of those with a history of sinus surgery in their anamnesis. The condition of sinus mucoperiosteum can be estimated based on results of processus uncinatus research, because it has a similar histological structure, directly contacts with all maxillary sinus excretion and, as usual, gets removed while endoscopic sinusotomy. The purpose of the work was to study the histological features of mucoperiostasis and adjacent bone in the ostiomeatal complex in discrete diseases of paranasal sinuses: chronic rhinosinusitis with nasal polyps, maxillary sinus cysts, fungal balls and postoperative scar changes in the ostium. Materials and methods. Histological features of processus uncinatus fragments removed during endoscopic interventions in 45 patients were investigated: with sinus cysts – 12 patients (group 1), chronic rhinosinusitis with nasal polyps – 13 patients (group 2), sinus fungal body – 13 patients (group 3) and postoperative scarring changes in the ostiomeatal complex – 7 patients. The condition of the epithelial layer of the mucoperiosteum, the structure of its own plate, the periosteal layer and the bone to be treated were evaluated. Results and discussion. In 91.67 ± 0.08% of patients with maxillary sinus cysts, there were no changes in the mucoperiostasis and the bone of processus uncinatus. Most patients in groups 2 and 3 showed mucoperiostal edema with a predominant reaction of the mucosal layer and lamina propria. Fibrous changes of the processus uncinatus were most often detected after the intervention was performed at 71.43 ± 0.13% and in chronic rhinosinusitis with nasal polyps – 53.85 ± 0.14%. This confirms the significance of the mucoperiostasis injury factor with the underlying bone for the development of gross adhesive changes between the periosteum and bone tissue. Osteitis of the processus uncinatus was detected in 38.46 ± 0.13% of patients in group 2, 15.38 ± 0.1% in group 3, and 28.57 ± 0.17% in group 4. Conclusion. Signs of periostitis and processus uncinatus osteitis were most often detected in patients with neutrophilic mucoperiosteum infiltration in chronic rhinosinusitis with nasal polyps and in fungal balls sinus. History of surgery with periosteal and bone trauma promotes scarring and results in a tight connection between bone and periosteum, which can be regarded as a risk factor in relation to the rupture of the later in its peeling off during sinus lifting procedure. Therefore, when performing surgery on the maxillary sinus, in order to maintain conditions for possible dental implantation, excessive trauma of the periosteal layer of mucoperiosteum should be avoided

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