Radiological changes in maxillary sinus morphology after lateral sinus floor augmentation

2021 ◽  
Vol 75 (2) ◽  
pp. 1-8
Author(s):  
Oleksandr Shpachynskyi ◽  
Vyacheslav Didkovskyi ◽  
Andrii Kopchak
Keyword(s):  
Maxillary Sinus ◽  
Mucous Membrane ◽  
Clinical Signs ◽  
Membrane Thickness ◽  
Lateral Sinus ◽  
Posterior Maxilla ◽  
Sinus Floor Augmentation ◽  
Sinus Floor ◽  
Radiological Changes ◽  
Mucosal Thickening

<b>Background:</b> Restoration of the masticatory function in patients with edentulous posterior maxilla is often challenging due to the severe atrophy of the alveolar ridges and proximity of the maxillary sinus, resulting in insufficient bone quantity for implant-supported dentures. <br><b>Aim:</b> The purpose of this study was to analyze the changes in Schneiderian membrane thickness after lateral sinus floor augmentation (LSFA) using cone beam computed tomography (CBCT). <br><b>Material and methods:</b> W LSFA procedures using different bone grafting materials were performed in 87 patients, operated on in two clinical institutions from 2016 to 2018. CBCT examination was performed in all patients before the LSFA procedure, at 1 month after surgery, and after 6 months, before implant placement or loading. <br><b>Results:</b> Minor r adiological changes in mucous membrane morphology were observed preoperatively in 17.1% of patients. Postoperative CBCT in the early postsurgical period demonstrated that the number of intact non-specific sinuses decreased significantly, i.e. from 86.7% to 26.7%. The number of cases with local hypertrophia of the mucous membrane increased from 20.3% to 26.7%. Mucosal thickening was observed in 41.7% vs 7.5%. The number of intact sinuses increased to 57.8%. The number of cases with local membrane hypertrophia also increased – to 37.4%. The number of cases with mucosal thickening or fluid accumulation decreased significantly to 11.8 and 5.3% respectively. In 2 cases the development of chronic sinusitis required secondary surgeries. <br><b>Conclusion:</b> The present retrospective study revealed that minor radiological changes in the morphology of the maxillary sinus mucosa were observed preoperatively in 17.1% of patients who underwent LSFA procedures. In the early and late postoperative period their frequency increased to 68.5% and 47.1%, r espectively. However, the clinical signs o f sinusitis developed only in 19.26% of patients. No significant correlations were found between the frequency and severity of postoperative radiological changes and residual bone height, sinus anatomy, initial state of the mucous membrane and type of the grafting material.

RADIOLOGICAL CHANGES IN MAXILLARY SINUS MORPHOLOGY AFTER LATERAL SINUS FLOOR AUGMENTATION

2020 ◽  
Vol 74 (4) ◽  
pp. 1-5
Author(s):  
Oleksandr Shpachynskyi ◽  
Viacheslav Didkovskij ◽  
Andrii Kopchak
Keyword(s):  
Medical Center ◽  
Clinical Signs ◽  
Endoscopic Examination ◽  
Membrane Thickness ◽  
Bovine Bone ◽  
Lateral Sinus ◽  
Posterior Maxilla ◽  
Sinus Floor Augmentation ◽  
Sinus Floor ◽  
Radiological Changes

Background: Restoration of the masticatory function in patients with edentulous posterior maxilla is often challenging due to the severe atrophy of the alveolar ridges and insufficient bone quantity for implant supported dentures. The purpose of this study was to analyze the change in Shneiderian membrane thickness after lateral sinus floor augmentation (LSFA) using cone beam computed tomography (CBCT). Methodology/Principal: LSFA procedures using different bovine bone materials with and withaut immediate implantation were performed at the Stomatological Medical Center of Bohomolets National Medical University in 87 patients, from 2016 to 2018. CBCT examination was performed before LSFA procedure in all patients, postoperative period: up to 1 month after surgery; and after 6 months, before implant placement or loading. Results: Postoperative CBCT performed in early postsurgical period demonstrated that the number of cases with type A decreased significantly from 86,67 to 26,75%. Type B radiological picture increased from 20,33% to 26,75 %. Type C was observed in 7,5 vs 41,73%. Type D and E were observed in 13.91 and 2.14%. The clinical signs of the acute sinusitis or specific complaints were recorded only in 2 cases. In 3 cases radiological findings resembled to F type. Conclusions: The minor radiologic changes in mucous morphology were observed preoperatively in 17.12% of patients who underwent LSFA procedures. The incidence of sinusitis consisted 19.26 % while the frequency of asymptomatic radiological changes was significantly higher. It consisted 68.48 in early and 47.1 % in late (6 months). As the differential diagnosis for such changes based only on clinical and radiological data is difficult, the obtained results prove the importance of preoperative endoscopic examination.

Axial Triangle of the Maxillary Sinus, and its Surgical Implication With the Position of Maxillary Sinus Septa During Sinus Floor Elevation: A CBCT Analysis

2020 ◽  
Vol 46 (4) ◽  
pp. 415-422
Author(s):  
Junho Jung ◽  
Jung Soo Park ◽  
Seoung-Jin Hong ◽  
Gyu-Tae Kim ◽  
Yong-Dae Kwon
Keyword(s):  
Maxillary Sinus ◽  
Surgical Techniques ◽  
Lateral Sinus ◽  
Sinus Floor Elevation ◽  
Second Molar ◽  
Sinus Wall ◽  
Posterior Maxilla ◽  
Significant Difference ◽  
Sinus Floor ◽  
Molar Region

The aim of this study was to measure the convexity of the lateral wall of the maxillary (Mx) sinus and identify the locational distribution of antral septa in relation to the zygomaticomaxillary buttress (ZMB), in order to suggest another anatomical consideration and surgical modification of sinus floor elevation procedures. This study was designed as a cross-sectional study, and a total of 134 patients and 161 sinuses containing edentulous alveolar ridges were analyzed. The angle between the anterior and lateral walls of the Mx sinus (lateral sinus angle [LSA]), and the angle between the midpalatal line and the anterior sinus wall (anterior sinus angle [ASA]) were measured. Mean LSAs and ASAs were 105.9° ± 9.86° and 58.4° ± 6.43°, respectively. No significant difference between left and right sides was found (LSA, P = .420; right = 105.5° ± 9.27°; left = 105.5° ± 9.27° and ASA, P = .564; right = 57.9° ± 6.80°; left = 58.8° ± 6.02°). The prevalence of septa was 37.3%, and it was most frequently noted in the second molar region (32.8%), followed by the first molar (20.9%), retromolar (16.4%), and second premolar regions (14.9%). Septa were most frequently located posterior to the ZMB (49.2%), while ZMB was mostly located in the first molar region (66.4%). Narrow LSAs may complicate the surgical approach to the posterior maxilla, especially when sinus elevation should be used in the second molar region. Considering the occasional presence of antral septa, membrane elevation may be complicated when a septum is encountered during the procedure. These results suggest that 3-dimensional examination of the convexity of the Mx sinus should be performed preoperatively to choose proper surgical techniques and minimize surgical complications.

A Sinus Floor Reaugmentation Technique Around an Apically Exposed Implant Into the Maxillary Sinus

2019 ◽  
Vol 45 (3) ◽  
pp. 213-217
Author(s):  
Daisuke Ueno ◽  
Noriko Banba ◽  
Akira Hasuike ◽  
Kazuhiko Ueda ◽  
Toshiro Kodama
Keyword(s):  
Case Report ◽  
Maxillary Sinus ◽  
Dental Implants ◽  
Treatment Option ◽  
Prolonged Treatment ◽  
Sinus Cavity ◽  
Posterior Maxilla ◽  
Sinus Floor Augmentation ◽  
Sinus Floor ◽  
Recovery Approach

Sinus floor augmentation (SFA) is the most predictable treatment option in the atrophic posterior maxilla. However, exposure of the apical implant body into the maxillary sinus cavity is an occasionally observed phenomenon after SFA. Although most penetrating dental implants remain completely asymptomatic, they may induce recurrent rhinosinusitis or implant loss. Removal of the implant should be considered if there is significant implant exposure that results in prolonged treatment and increased costs. This case report demonstrates a recovery approach using sinus floor reaugmentation without implant removal in a patient with an apically exposed implant into the maxillary sinus cavity.

scholarly journals Surgeons’ Performance Determining the Amount of Graft Material for Sinus Floor Augmentation Using Tomography

2017 ◽  
Vol 28 (3) ◽  
pp. 385-390 ◽  
Author(s):  
Adriana Dibo Cruz ◽  
Guilherme Alvares Peixoto ◽  
Marcelo Freitas Aguiar ◽  
Gabriela Alessandra Cruz Galhardo Camargo ◽  
Nicolas Homs
Keyword(s):  
Maxillary Sinus ◽  
Diagnostic Tools ◽  
Graft Material ◽  
Convenience Sample ◽  
Computed Tomography Images ◽  
Posterior Maxilla ◽  
Sinus Floor Augmentation ◽  
Maxillary Sinus Floor ◽  
Sinus Floor ◽  
Maxillary Sinus Floor Augmentation

Abstract This study aimed to assess the performance of surgeons in determining the amount of graft material required for maxillary sinus floor augmentation in a preoperative analysis using cone-beam computed tomography images. A convenience sample of 10 retrospective CBCT exams (i-CAT®) was selected. Scans of the posterior maxilla area with an absence of at least one tooth and residual alveolar bone with an up to 5 mm height were used. Templates (n=20) contained images of representative cross-sections in multiplanar view. Ten expert surgeons voluntarily participated as appraisers of the templates for grafting surgical planning of a 10 mm long implant. Appraisers could choose a better amount of graft material using scores: 0) when considered grafting unnecessary, 1) for 0.25 g in graft material, 2) for 0.50 g, 3) for 1.00 g and 4) for 1.50 g or more. Reliability of the response pattern was analyzed using Cronbach’s a. Wilcoxon and Mann-Whitney tests were performed to compare scores. Regression analysis was performed to evaluate whether the volume of sinuses (mm3) influenced the choose of scores. In the reliability analysis, all values were low and the score distribution was independent of the volume of the maxillary sinuses (p>0.05), which did not influence choosing the amount of graft material. Surgeons were unreliable to determine the best amount of graft material for the maxillary sinus floor augmentation using only CBCT images. Surgeons require auxiliary diagnostic tools to measure the volume associated to CBCT exams in order to perform better.

scholarly journals Histological and Histomorphometric Analyses after Sinus Floor Augmentation with Different Grafting Materials

2021 ◽  
Vol 1 (4) ◽  
Author(s):  
Luís Otávio Palhari
Keyword(s):  
Maxillary Sinus ◽  
Alveolar Bone ◽  
Bone Matrix ◽  
Microscopic Analysis ◽  
Invasive Technique ◽  
Osseointegrated Implants ◽  
Posterior Maxilla ◽  
Sinus Floor Augmentation ◽  
Sinus Floor ◽  
Grafting Materials

Homogeneous grafts from a bone bank, heterogeneous grafts and allow plastic grafts have already been studied and used for maxillary sinus elevation in order to reconstruct the bone for placement of dental implants. The present work aims to histologically assess bone neoformation from autogenous and heterogeneous (or xenogenous) bone grafts, in maxillary sinus lift surgery, an invasive technique. Six patients (total of 10 elevated maxillary sinuses) participated in the study with an alveolar bone remnant in the posterior region of the maxilla, less than 5mm, classification by Misch SA-4, evidenced through panoramic radiography. After a waiting period of tissue repair of 8 months, samples were collected and microscopic analysis was performed in 3 groups: autogenous group, Bio-Oss® group and Endobon® group. It was observed that the autogenous group has a statistically higher amount of bone matrix when compared to the other 2 groups. These did not differ from each other. The three types of grafts used promoted the expected new bone formation. Thus, one can choose any of the grafts evaluated to enable the installation of Osseointegrated implants and prosthetic rehabilitation in patients with the atrophic posterior maxilla.

scholarly journals Sinus Augmentation by Platelet-Rich Fibrin Alone: A Report of Two Cases with Histological Examinations

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Naofumi Aoki ◽  
Takeo Kanayama ◽  
Michinori Maeda ◽  
Koichiro Horii ◽  
Hironori Miyamoto ◽  
...  
Keyword(s):  
Tissue Sample ◽  
Lateral Sinus ◽  
Graft Material ◽  
Sinus Augmentation ◽  
Platelet Rich Fibrin ◽  
First Case ◽  
Posterior Maxilla ◽  
Sinus Floor Augmentation ◽  
Sinus Floor ◽  
The Right

In sinus floor augmentation of an atrophic posterior maxilla, platelet-rich fibrin (PRF) has been used as a graft material. We herein report two cases with histological evaluations of PRF after the surgery. The first case was a 28-year-old female with an atrophic right posterior maxilla who was treated with sinus floor augmentation and simultaneous implant placement using PRF as the sole graft material in our hospital. Twenty-four months after surgery, the implant was unfortunately removed because of occlusal overloading by parafunctional habits. During implant replacement, a tissue sample was obtained from the site of augmentation with PRF and was evaluated histologically. The second case was a 58-year-old man with severe alveolar atrophy of the right maxilla who underwent lateral sinus augmentation using only PRF in a two-stage procedure in our hospital. Samples were obtained at the second-stage surgery and histological examinations were performed. As a result, new bone formation was confirmed histologically in both cases. Our findings show that the use of PRF as a graft material during sinus floor augmentation induces natural bone regeneration.

Effect of Maxillary Sinus Floor Augmentation on Sinus Membrane Thickness in Computed Tomography

2012 ◽  
Vol 83 (5) ◽  
pp. 551-556 ◽  
Author(s):  
Bernhard Pommer ◽  
Gabriella Dvorak ◽  
Philip Jesch ◽  
Richard M. Palmer ◽  
Georg Watzek ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Maxillary Sinus ◽  
Membrane Thickness ◽  
Sinus Floor Augmentation ◽  
Maxillary Sinus Floor ◽  
Sinus Floor ◽  
Maxillary Sinus Floor Augmentation ◽  
Sinus Membrane

scholarly journals Long-Term Clinical Study of Implants Placed in Maxillary Sinus Floor Augmentation Using Beta-Tricalcium Phosphate

2021 ◽  
Vol 18 (19) ◽  
pp. 9975
Author(s):  
Eugenio Velasco-Ortega ◽  
Angela Sierra-Baztan ◽  
Alvaro Jiménez-Guerra ◽  
Antonio España-López ◽  
Iván Ortiz-Garcia ◽  
...  
Keyword(s):  
Maxillary Sinus ◽  
Tricalcium Phosphate ◽  
Sinus Surgery ◽  
Lateral Sinus ◽  
Beta Tricalcium Phosphate ◽  
Sinus Floor Augmentation ◽  
Maxillary Sinus Floor ◽  
Sinus Floor ◽  
Maxillary Sinus Floor Augmentation

Introduction. The aim of this study was to show the long-term clinical outcomes of implants placed in maxillary sinus floor augmentation (MFSA) using beta-tricalcium phosphate (β-TCP). Patients and methods. Maxillary patients were diagnosed for MFSA and used beta- β-TCP. After the lateral sinus surgery, implants were loaded at 6 months with restorations. The clinical follow-up was at 10 years. Results. One hundred and one patients (58 females and 43 males) were treated with MFSA. Twenty-nine patients (28.7%) had a history of periodontitis. Thirty-three patients (32.7%) were smokers. One hundred and twenty-one MFSA, 81 unilateral and 20 bilateral sites, with 234 implants were performed. The average vertical bone height available was 4.92 ± 1.83 mm. The average vertical bone gain obtained was 6.95 ± 2.19 mm following MFSA. The implant cumulative survival rate was 97.2%. Three implants (1.3%) were lost during the healing period. Six implants (2.6%) were lost by peri-implantitis. One hundred and fifteen restorations were placed in the patients. Mean marginal bone loss was 1.93 mm ± 1.03 mm. Six patients (27.3%) showed technical complications. Thirty-six implants (15.3%) in 14 patients (13.9%) were associated with peri-implantitis. Conclusions. This study indicates that treatment with implant-supported restoration by MFSA using β-TCP constitutes a successful implant approach.

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