scholarly journals Navigated Antral Bone Expansion (NABE): a prospective study on 35 patients with 4 months of follow-up post implant loading

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Luigi V. Stefanelli ◽  
Nicola Pranno ◽  
Francesca De Angelis ◽  
Silvia La Rosa ◽  
Antonella Polimeni ◽  
...  
Keyword(s):  
Angular Deviation ◽  
Alveolar Ridge ◽  
Invasive Approach ◽  
Native Bone ◽  
Paired Samples ◽  
Posterior Maxilla ◽  
Before And After ◽  
Bone Expansion ◽  
Sinus Floor ◽  
Bone Height

Abstract Background The insertion of dental implants in the atrophic posterior maxilla can be a challenge. One option is to modify the residual native bone in preparation for proper, prosthetically-driven implant placement. The procedure presented in this study is called Navigated Antral Bone Expansion (N.A.B.E). This procedure employs the use of a navigation system to plan and guide the initial pilot drilling, bone expansion, final site preparation, and implant insertion. The aim of this study was to compare the distance between the alveolar ridge and the sinus floor measured before and after the surgery performed using the N.A.B.E. technique. Methods Thirty-seven partially edentulous patients who were candidates for implant supported restoration in the posterior maxilla, with a bone height ranging from 4 to 7 mm were enrolled. The N.A.B.E procedure was used to increase the bone height. Paired-samples t-test evaluated the distance between the alveolar ridge and the sinus floor measured before and after surgery. The occurrence of post-surgical complications, and the angular deviation between the planned osteotomy and the actual placed implant trajectories were evaluated. Results Out of the 37 consecutive patients enrolled in the study, 35 were considered in the data analyses. Patients’ bone height after surgery compared to the bone height before surgery showed a statistically significant increase (p < .0005) of 3.96 mm (95% CI, 3.62 mm to 4.30 mm). No post-operative complications were observed in the 35 patients. The mean angular deviation between the planned osteotomy trajectory and the placed implant trajectory ranged between 12.700 to 34.900 (mean 25.170 ± 5.100). Conclusions This study provides evidence that N.A.B.E. technique is able to provide a significant bone increase, and could be considered an alternative method to the management of the atrophic posterior maxilla with a minimally invasive approach.

scholarly journals Comparison between Osseo densification burs and osteotome technique for closed sinus lift in partially edentulous maxilla (clinical and radiological study)

2021 ◽  
Vol 23 (05) ◽  
pp. 392-411
Author(s):  
Dr. Ali Nahi Hamdi ◽  
◽  
Dr. Shehab Ahmed Hemd ◽  
Keyword(s):  
Primary Stability ◽  
Controlled Clinical Trial ◽  
Height Loss ◽  
Implant Stability ◽  
Implant Placement ◽  
First Choice ◽  
Posterior Maxilla ◽  
Atrophic Maxilla ◽  
Sinus Floor ◽  
Bone Height

Dental implants are considered the first choice to replace lost or non-restorable teeth. However, the posterior maxilla remains a challenge in its management because of the quality of bone in the posterior maxilla. Osseo densification (OD) concept has been proposed in the literature to improve primary implant stability, which is an important aspect of osseointegration. Densah bur is novel drills specially designed to enhance a bone density by Osseo densification, which in turn increases primary stability. This present study was conducted to assess crestal sinus floor elevation by osteotome in comparison to Densah bur in the posterior atrophic maxilla. This was a randomized controlled clinical trial conducted on 20 patients to evaluate available crestal bone height loss, implant stability after implant placement in healed posterior maxillary alveolar ridge, whole bone height, Schneiderian membrane trauma, and post-operative complication.

scholarly journals Different techniques in transalveolar maxillary sinus elevation: A literature review

2021 ◽  
Vol 13 (1) ◽  
pp. 35-42
Author(s):  
Ardeshir Lafzi ◽  
Fazele Atarbashi-Moghadam ◽  
Reza Amid ◽  
Soran Sijanivandi
Keyword(s):  
Maxillary Sinus ◽  
English Language ◽  
Hydraulic Pressure ◽  
New Techniques ◽  
Implant Placement ◽  
Posterior Maxilla ◽  
Piezoelectric Surgery ◽  
Sinus Floor ◽  
Bone Height ◽  
Implant Treatment

Dental implant treatment in the posterior maxilla encounters bone quality and quantity problems. Sinus elevation is a predictable technique to overcome height deficiency in this area. Transalveolar sinus elevation is a technique that is less invasive and less time-consuming, first introduced for ridges with at least 5 mm of bone height. Many modifications and innovative equipment have been introduced for this technique. This review aimed to explain the modifications of this technique with their indications and benefits. An exhaustive search in PubMed Central and Scopus electronic databases was performed until December 2020. Articles were selected that introduced new techniques for the transalveolar maxillary sinus approach that had clinical cases with full texts available in the English language. Finally, twenty-six articles were included. The data were categorized and discussed in five groups, including expansion-based techniques, drill-based techniques, hydraulic pressure techniques, piezoelectric surgery, and balloon techniques. The operator’s choice for transalveolar approach techniques for sinus floor elevation can be based on the clinician’s skill, bone volume, and access to equipment. If possible, a technique with simultaneous implant placement should be preferred.

scholarly journals Paradigm Shift in the Management of the Atrophic Posterior Maxilla

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Rabah Nedir ◽  
Nathalie Nurdin ◽  
Paul Khoury ◽  
Marc El Hage ◽  
Semaan Abi Najm ◽  
...  
Keyword(s):  
Lateral Sinus ◽  
Efficient Treatment ◽  
Sinus Floor Elevation ◽  
Implant Placement ◽  
Single Crown ◽  
Posterior Maxilla ◽  
Atrophic Maxilla ◽  
Sinus Floor ◽  
Osteotome Sinus Floor Elevation ◽  
Bone Height

When the posterior maxilla is atrophic, the reference standard of care would be to perform sinus augmentation with an autologous bone graft through the lateral approach and delayed implant placement. However, placement of short implants with the osteotome sinus floor elevation technique and without graft can be proposed for an efficient treatment of clinical cases with a maxillary residual bone height of 4 to 8 mm. The use of grafting material is recommended only when the residual bone height is ≤4 mm. Indications of the lateral sinus floor elevation are limited to cases with a residual bone height ≤ 2 mm and fused corticals, uncompleted healing of the edentulous site, and absence of flat cortical bone crest or when the patient wishes to wear a removable prosthesis during the healing period. The presented case report illustrates osteotome sinus floor elevation with and without grafting and simultaneous implant placement in extreme conditions: atrophic maxilla, short implant placement, reduced healing time, and single crown rehabilitation. After 6 years, all placed implants were functional with an endosinus bone gain.

Vertical Alveolar Ridge Expansion and Simultaneous Implant Placement in Posterior Maxilla Using Segmental Osteotomy: Report of Two Cases

2008 ◽  
Vol 34 (6) ◽  
pp. 313-318 ◽  
Author(s):  
Atsushi Fujita
Keyword(s):  
Distraction Osteogenesis ◽  
Surgical Procedure ◽  
Functional Results ◽  
Alveolar Ridge ◽  
Sinus Floor Elevation ◽  
Radiologic Findings ◽  
Implant Placement ◽  
Posterior Maxilla ◽  
Sinus Floor ◽  
Minimal Invasion

Abstract Implant placement in vertically insufficient alveolar ridges of the posterior maxillae may require bone augmentation, such as sinus floor elevation, onlay grafting, and distraction osteogenesis. The purpose of this report is to evaluate the feasibility of vertical alveolar ridge expansion and simultaneous implant placement in the posterior maxilla using segmental osteotomy without sinus floor elevation, onlay grafting, and distraction osteogenesis. Two patients presenting with vertically insufficient alveolar ridges in the posterior maxillae were treated with the surgical procedure as follows. The edentulous ridge was split vertically using a segmental osteotomy before the preparation of an implant bed, and 1 implant body was placed simultaneously in the ridge with the vertical split. Three months later, abutments were connected and prosthetic loading of the implants was started. The follow-up was performed with the aid of dental and panoramic radiographs, evaluation of peri-implant probing depths, and Periotest values. In both patients, alveolar ridge expansion and implant placement were carried out without problems, good functional results were performed, and the clinical and radiologic findings were satisfactory. The outcome of the surgical procedure showed minimal invasion and good functional results.

scholarly journals Single-Crown, Short and Ultra-Short Implants, in Association with Simultaneous Internal Sinus Lift in the Atrophic Posterior Maxilla: A Three-Year Retrospective Study

Materials ◽  
2020 ◽  
Vol 13 (9) ◽  
pp. 2208 ◽  
Author(s):  
Giorgio Lombardo ◽  
Mauro Marincola ◽  
Annarita Signoriello ◽  
Giovanni Corrocher ◽  
Pier Francesco Nocini
Keyword(s):  
Contact Point ◽  
Invasive Technique ◽  
Sinus Lift ◽  
Sinus Floor Elevation ◽  
Single Crown ◽  
Posterior Maxilla ◽  
Sinus Floor ◽  
Osteotome Sinus Floor Elevation ◽  
Bone Height

As the atrophic posterior maxilla often presents serious limitations for dental implant procedures, a minimally invasive technique was proposed. The study aimed to retrospectively evaluate the outcomes of short and ultra-short locking-taper implants, placed in combination with a modified osteotome sinus floor elevation procedure (internal sinus lift technique) in the posterior maxilla. A total of 31 patients received 51 locking-taper implants. Clinical and radiographic examinations were performed before treatment, at loading time, and after three years. Seven implants of 8.0 mm, 23 implants of 6.0 mm, and 21 implants 5.0 mm in length were rehabilitated with single-crown restorations. Implant survival at three-year follow-up was 96.08%. Pre-operative residual crestal bone height of 5.2 (1.41) (median (interquartile range)) mm increased to 7.59 (1.97) mm at the 36-month follow-up, with an average intra-sinus bone height gain of 3.17 ± 1.13 (mean ± standard deviation) mm. Mean peri-implant crestal bone loss was 0.29 (0.46) mm and mean first bone-to-implant contact point shifted apically to 0.12 (0.34) mm. It can be suggested with confidence that implants used in the study, placed in conjunction with an internal sinus floor elevation technique, can be restored with single crowns as a predictable treatment for the edentulous regions of the posterior maxilla.

scholarly journals Osteotome-Induced Blood Clot and Subsequent Bone Formation with the Use of Collagen Sponge for Integration of Single Dental Implants into the Atrophied Posterior Maxilla: A Retrospective Follow-Up of 36 Implants after 5 to 13 years

2022 ◽  
Vol 2022 ◽  
pp. 1-8
Author(s):  
Stefano Volpe ◽  
Michele Di Girolamo ◽  
Paolo Pagliani ◽  
Sandro Zicari ◽  
Lars Sennerby
Keyword(s):  
Bone Formation ◽  
Maxillary Sinus ◽  
Bone Grafting ◽  
Collagen Sponge ◽  
Implant Placement ◽  
Posterior Maxilla ◽  
Second Surgery ◽  
Sinus Floor ◽  
Bone Height

Background. Atrophy of the posterior maxilla as a consequence of tooth loss and sinus pneumatization is a frequent condition encountered in the clinical practice. Prosthetic rehabilitation with implants in these patients often requires some kind of bone regeneration procedure to increase the bone volume. Aim. The aim of the present retrospective study is to analyze the survival and success rates of a series of implants placed in the atrophic posterior maxilla with a transcrestal osteotome procedure, without placing a bone grafting material. Materials and Methods. From 2006 to 2014, 36 dental implants (Neoss Ltd., Harrogate, UK) were inserted in 36 patients with at least 4 mm of bone below the maxillary sinus using transcrestal osteotome sinus floor elevation and placement of collagen sponge below the sinus membrane. ISQ measurements were made after implant placement and at abutment surgery after 4 to 6 months. The vertical bone height (VBH) was evaluated in intraoral radiographs taken prior to surgery and in radiographs from annual check-up appointments 5 to 13 years after implant placement. In addition, marginal bone loss (MBL) was evaluated. Results. One implant was lost after four years of prosthetic loading. The remaining 35 implants showed no complications and were loaded with single crowns after 4–6 months of healing. All 35 implants showed clinical success after 8.5 ± 2.8 years of prosthetic loading (from 5 to 13 years). The vertical bone height was 5.9 ± 1.4 mm at surgery, 9.7 ± 1.1 mm at second surgery after 4–6 months, and 8.3 ± 1.8 at the follow-up at 8.5 ± 2.8 years (from 5 to 13 years). The implant stability registered was 73.2 ± 6.2 ISQ at the surgery and 75.8 ± 3.9 at the second surgery after 4–6 months. Conclusions. The present long-term follow-up study showed that the crestal approach for sinus floor bone augmentation without additional bone grafting results in predicable bone formation and high implant survival. The osteotome technique is a valid alternative to the more invasive lateral window technique in single cases with a minimum of 4 mm of VBH below the maxillary sinus.

Effect of a Rapidly Resorbable Calcium Alkali Phosphate Bone Grafting Material on Osteogenesis after Sinus Floor Augmentation in Humans

2017 ◽  
Vol 758 ◽  
pp. 239-244 ◽  
Author(s):  
Christine Knabe ◽  
Tom Knauf ◽  
Doaa Adel-Khattab ◽  
Barbara Peleska ◽  
Wolf Dietrich Hübner ◽  
...  
Keyword(s):  
Bone Formation ◽  
Bone Substitutes ◽  
Apical Region ◽  
Graft Material ◽  
Matrix Mineralization ◽  
Native Bone ◽  
Ridge Augmentation ◽  
Posterior Maxilla ◽  
Sinus Floor Augmentation ◽  
Sinus Floor

Sinus floor augmentation (SFA) has become a well-established pre-implantology procedure for alveolar ridge augmentation of the posterior maxilla. Using bioceramic bone substitutes avoids second-site surgery for autograft harvesting. Compared to the bone substitutes which are currently clinically available, there is a significant need for bone substitutes which degrade more rapidly, but still stimulate osteogenesis at the same time. This has led to the development of bioactive, rapidly resorbable calcium alkali orthophosphate (CAOP) materials, which have a greater solubility than tricalcium phosphate. In this study the biodegradability and effect of a silica containing CAOP (Si-CAOP) on osteogenesis was evaluated in human biopsies sampled 6 months after SFA and compared to that of TCP utilizing hard tissue histology, histomorphometry and immunohistochemical analysis of osteogenic marker expression. Both materials facilitated bone formation and matrix mineralization, which were still actively progressing from the sinus floor in an apical direction 6 months after SFA. With the Si-CAOP grafting material however, bone formation, the bone-biomaterial-contact, i.e. bone-bonding, and particle degradation were significantly greater compared to TCP in the apical region of the biopsies, i.e. at the largest distance from the native bone of the sinus floor. This was accompanied by greater expression of Col I, BSP and OC in the newly formed bone tissue in the Si-CAP samples compared to TCP. Six months after implantation Si-CAOP facilitated greater bone formation and biodegradability than the TCP graft material, whose excellent osteoconductive properties have been widely documented. Consequently, Si-CAOP can be regarded as excellent grafting material for SFA in a clinical setting.

Indirect Osteotome Maxillary Sinus Floor Elevation: An Update

2012 ◽  
Vol 38 (6) ◽  
pp. 799-804 ◽  
Author(s):  
Javier Romero-Millán ◽  
Luis Martorell-Calatayud ◽  
Maria Peñarrocha ◽  
Berta García-Mira
Keyword(s):  
Maxillary Sinus ◽  
Survival Rates ◽  
Graft Material ◽  
Sinus Floor Elevation ◽  
Posterior Maxilla ◽  
Membrane Perforation ◽  
Maxillary Sinus Floor ◽  
Sinus Floor ◽  
Bone Height ◽  
Maxillary Sinus Floor Elevation

The objective was to review publications on indirect osteotome maxillary sinus floor elevation (OMSFE) procedures. Studies published between 1999 and 2010 on patients with a minimum of 1 year of follow-up were analyzed. Fourteen studies were included. Indirect OMSFE is indicated for a bone height of 6–8 mm. More bone height was gained when graft material was used. Schneiderian membrane perforation was the most frequent complication. Survival rates varied between 93.5% and 100%. Osteotome sinus membrane elevation is a predictable and effective procedure for placing implants in areas of the posterior maxilla with low bone height.

scholarly journals Surgical Complications Associated to Maxillary Sinus Floor Elevation in Implantology

2019 ◽  
pp. 155-164
Author(s):  
Deisy E. Quispe Damián DDS, MSc ◽  
Carmen T. Castro-Ruiz DDS, MSc ◽  
Gerardo Mendoza Azpur DDS, MSc
Keyword(s):  
Literature Review ◽  
Maxillary Sinus ◽  
Surgical Complications ◽  
Sinus Floor Elevation ◽  
Posterior Maxilla ◽  
Maxillary Sinus Floor ◽  
Sinus Floor ◽  
Implant Therapy ◽  
Bone Height ◽  
Maxillary Sinus Floor Elevation

Maxillary sinus floor elevation has been extensively documented as a safe and predictable procedure for gaining vertical bone height in the atrophic posterior maxilla. Even though, complications have been reported, which can potentially jeopardize the outcome of the regeneration and implant therapy. Therefore, the purpose of this literature review is to present, debate and analyze the different complications that can occur during a sinus floor elevation.

Cone Beam CT Evaluation of Maxillary Sinus Floor and Alveolar Crest Anatomy for the Safe Placement of Implants

2020 ◽  
Vol 16 (7) ◽  
pp. 913-920
Author(s):  
Başak Kuşakçi Şeker ◽  
Kaan Orhan ◽  
Emre Şeker ◽  
Gülbahar Ustaoğlu ◽  
Oğuz Ozan ◽  
...  
Keyword(s):  
Maxillary Sinus ◽  
Alveolar Bone ◽  
Cone Beam ◽  
Alveolar Crest ◽  
Posterior Maxilla ◽  
Maxillary Sinus Floor ◽  
Sinus Floor ◽  
The Mean ◽  
Bone Height ◽  
Anterior Median

Background: Alveolar bone height in the posterior maxillary region is very important and critical for dental implant planning and placement. Objective: This study aimed to evaluate the anatomy of the maxillary sinus floor in relation to the alveolar crest and to determine variations in the vertical measurements between the maxillary sinus floor and the alveolar bone crest tip in the posterior edentulous maxilla with the use of cone beam computerized tomography. Methods: This analysis enrolled 234 retrospectively selected patients (123 males with mean age 52.95±11.74 (range 32-76 years) and 111 females with mean age 58.14±11.92 (range 32-75 years)) with edentulous posterior maxillary regions. The maxillary sinus floor was divided into three anatomical segments (anterior, median and posterior) in relation to the transverse palatine suture. The measurements were performed on 3D surface rendered volumetric images by using rotation and translation of the views. Landmarks for measurement were specified by using a cursor driven pointer. Vertical lines were marked on the cross-sectional images between the alveolar ridge and the deepest point of the maxillary sinus floor for each of the three regions. P < 0.05 was regarded as statistically significant. Results: The mean distance values between the sinus floor and the alveolar crest in the anterior, median and posterior regions were 8.74±3.97 mm, 5.37±3.23 mm and 7.06±3.28 mm, respectively. Measurements in the anterior region were found to be high in both total and gender groups compared to other regions. Also, subsinus alveolar bone heights decreased with increasing age in both genders in all three regions. Conclusion: This study emphasizes that the mean subsinus alveolar bone height is highest in the anterior segment of the edentulous posterior maxilla. These results may guide clinicians to make the decision of implant placement area and lead to less invasive alternative surgery methods for edentulous posterior segments.

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