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Brazilian Oral Research 2018This study compared the survival rate of dental implants, amount of marginal bone loss, and rates of complications (biological and prosthetic) between short implants and... (Meta-Analysis)
Meta-Analysis Review
This study compared the survival rate of dental implants, amount of marginal bone loss, and rates of complications (biological and prosthetic) between short implants and long implants placed after maxillary sinus augmentation. This systematic review has been registered at PROSPERO under the number (CRD42017073929). Two reviewers searched the PubMed/MEDLINE, Embase, LILACS, and Cochrane Library databases. Eligibility criteria included randomized controlled trials, comparisons between short implants and long implants placed after maxillary sinus augmentation in the same study, and follow-up for >6 months. The Cochrane Collaboration's tool for assessing the risk of bias in randomized trials was used to assess the quality and risk of bias of the included studies. The search identified 1366 references. After applying the inclusion criteria, 11 trials including 420 patients who received 911 dental implants were considered eligible. No significant difference was observed in the survival rate [p = 0.86; risk ratio (RR): 1.08; 95% confidence interval (CI): 0.46-2.52] or in the amount of marginal bone loss (p = 0.08; RR: -0.05; 95%CI: -0.10 to 0.01). However, higher rates of biological complications for long implants associated with maxillary sinus augmentation were observed (p < 0.00001; RR: 0.21; 95%CI: 0.10-0.41), whereas a higher prosthetic complication rate for short implants was noted (p = 0.010; RR: 3.15; 95%CI: 1.32-7.51). Short implant placement is an effective alternative because of fewer biological complications and similar survival and marginal bone loss than long implant placement with maxillary sinus augmentation. However, the risk of mechanical complications associated with the prostheses fitted on short implants should be considered.
Topics: Alveolar Bone Loss; Bias; Dental Implantation; Dental Implants; Dental Prosthesis Design; Dental Restoration Failure; Humans; Maxillary Sinus; Postoperative Complications; Risk Factors; Sinus Floor Augmentation; Treatment Outcome
PubMed: 30231176
DOI: 10.1590/1807-3107bor-2018.vol32.0086 -
International Journal of Implant... Jul 2021This systematic review aimed to propose a treatment protocol for repairing intraoperative perforation of the Schneiderian membrane during maxillary sinus floor... (Meta-Analysis)
Meta-Analysis Review
Management of Schneiderian membrane perforations during maxillary sinus floor augmentation with lateral approach in relation to subsequent implant survival rates: a systematic review and meta-analysis.
BACKGROUND
This systematic review aimed to propose a treatment protocol for repairing intraoperative perforation of the Schneiderian membrane during maxillary sinus floor augmentation (MSFA) procedures with lateral window technique. In turn, to assess subsequent implant survival rates placed below repaired membranes compared with intact membranes and therefore determine whether membrane perforation constitutes a risk factor for implant survival.
MATERIAL AND METHODS
This review was conducted according to PRISMA guidelines. Two independent reviewers conducted an electronic search for articles published between 2008 and April 30, 2020, in four databases: (1) The National Library of Medicine (MEDLINE/PubMed) via Ovid; (2) Web of Science (WOS); (3) SCOPUS; and (4) Cochrane Central Register of Controlled Trials (CENTRAL); also, a complementary handsearch was carried out. The Newcastle-Ottawa Quality Assessment Scale was used to assess the quality of evidence in the studies reviewed.
RESULTS
Seven articles fulfilled the inclusion criteria and were analyzed. A total of 1598 sinus lift surgeries were included, allowing the placement of 3604 implants. A total of 1115 implants were placed under previously perforated and repaired membranes, obtaining a survival rate of 97.68%, while 2495 implants were placed below sinus membranes that were not damaged during surgery, obtaining a survival rate of 98.88%. The rate of Schneiderian membrane perforation shown in the systematic review was 30.6%. In the articles reviewed, the most widely used technique for repairing perforated membranes was collagen membrane repair.
CONCLUSIONS
Schneiderian membrane perforation during MFSA procedures with lateral approach is not a risk factor for dental implant survival (p=0.229; RR 0.977; 95% CI 0.941-1.015). The knowledge of the exact size of the membrane perforation is essential for deciding on the right treatment plan.
Topics: Maxillary Sinus; Nasal Mucosa; Prostheses and Implants; Sinus Floor Augmentation; Survival Rate; United States
PubMed: 34250560
DOI: 10.1186/s40729-021-00346-7 -
Cells Jul 2023The current review aims to provide an overview of the most recent research on the potentials of concentrated growth factors used in the maxillary sinus lift technique. (Review)
Review
Maxillary Sinus Augmentation Using Autologous Platelet Concentrates (Platelet-Rich Plasma, Platelet-Rich Fibrin, and Concentrated Growth Factor) Combined with Bone Graft: A Systematic Review.
BACKGROUND
The current review aims to provide an overview of the most recent research on the potentials of concentrated growth factors used in the maxillary sinus lift technique.
MATERIALS AND METHODS
"PRP", "PRF", "L-PRF", "CGF", "oral surgery", "sticky bone", "sinus lift" were the search terms utilized in the databases Scopus, Web of Science, and Pubmed, with the Boolean operator "AND" and "OR".
RESULTS
Of these 1534 studies, 22 publications were included for this review.
DISCUSSION
The autologous growth factors released from platelet concentrates can help to promote bone remodeling and cell proliferation, and the application of platelet concentrates appears to reduce the amount of autologous bone required during regenerative surgery. Many authors agree that growth factors considerably enhance early vascularization in bone grafts and have a significantly positive pro-angiogenic influence in vivo when combined with alloplastic and xenogeneic materials, reducing inflammation and postoperative pain and stimulating the regeneration of injured tissues and accelerating their healing.
CONCLUSIONS
Even if further studies are still needed, the use of autologous platelet concentrates can improve clinical results where a large elevation of the sinus is needed by improving bone height, thickness and vascularization of surgical sites, and post-operative healing.
Topics: Maxillary Sinus; Bone Regeneration; Platelet-Rich Plasma; Intercellular Signaling Peptides and Proteins; Fibrin
PubMed: 37443831
DOI: 10.3390/cells12131797 -
International Journal of Oral and... Jun 2022The aim of this systematic review and meta-analysis was to determine the prevalence and characteristics of maxillary sinus septa using cone beam computed tomography and... (Meta-Analysis)
Meta-Analysis Review
The aim of this systematic review and meta-analysis was to determine the prevalence and characteristics of maxillary sinus septa using cone beam computed tomography and computed tomography data. Publications were searched until October 5, 2020 in three electronic databases. Additionally, article bibliographies were searched, and authors were contacted if required. This review has been registered in PROSPERO (CRD42019124933). Two independent evaluators assessed methodological quality using the Joanna Briggs Institute levels of evidence; inter-rater reliability tests were performed (Cohen's κ). The prevalence of maxillary sinus septa was expressed as a proportion; differences according to sex were reported in terms of the odds ratio (OR) and 95% confidence interval (95% CI). Heterogeneity and sources of heterogeneity were evaluated by meta-regression. Publication bias was assessed by visual analysis of the funnel plot. Statistical significance was set at P < 0.05. The 62 studies identified and included in the review involved 13,701 patients (22,460 sinuses). The meta-analysis of 35 studies (14,664 sinuses) revealed an overall mean sinus septa prevalence per sinus of 33.2% (95% CI 27.8-38.5%; I = 98.32%). The meta-analysis of 42 studies (9631 patients) found an overall mean sinus septa prevalence per patient of 41.0% (95% CI 36.0-46.0%, I = 96.45%). The OR for the difference in septa prevalence between sexes was 0.785 (95% CI 0.590-1.046; P = 0.098, I = 73.24%). Septa were most frequent in the middle area of the sinus and with a transverse orientation (86.0%). Within the limitations, the results suggest a high proportion of septa in the sinus, commonly in the middle area, which can interfere with the success of sinus floor elevation required for implant rehabilitation.
Topics: Cone-Beam Computed Tomography; Humans; Maxillary Sinus; Prevalence; Reproducibility of Results; Sinus Floor Augmentation
PubMed: 34742634
DOI: 10.1016/j.ijom.2021.10.008 -
Frontiers in Surgery 2020Bone augmentation techniques have increasingly been indicated for re-creating adequate bone height and volume suitable for dental implant sites. This is particularly...
Bone augmentation techniques have increasingly been indicated for re-creating adequate bone height and volume suitable for dental implant sites. This is particularly applicable in the severely atrophic posterior maxilla where sinus perforation (ruptured Schneiderian membrane) is a very common complication and sinus floor elevation or lift is frequently considered a standard procedure. The augmentation of the maxillary sinus can be performed with or without grafting biomaterials. Herein, numerous biomaterials and bone substitutes have been proposed, primarily to sustain the lifted space. In addition, cytokines and growth factors have been used to stimulate angiogenesis, enhance bone formation as well as improve healing and recovery period, either as the sole filling material or in combination with bone substitute materials. Within such, is the family of autologous blood extracts, so-called platelet concentrates, which are simply the "product" resulting from the simple centrifugation of collected whole blood samples of the patient, immediately pre-surgery. Platelet-Rich Fibrin (PRF), a sub-family of platelet concentrates, is a three-dimensional (3-D) autogenous biomaterial obtained, without including anti-coagulants, bovine thrombin, additives, or any gelifying agents during the centrifugation process. Today, it is safe to say that, in implant dentistry and oral and maxillofacial surgery, PRFs (particularly, the pure platelet-rich fibrin or P-PRF and leukocyte and platelet-rich fibrin or L-PRF sub-classes) are receiving the most attention, essentially due to their simplicity, rapidness, user-friendliness/malleability, and cost-effectiveness. Whether used as the sole "bioactive" filling/additive material or combined with bone substitutes, the revolutionary second-generation PRFs have been very often associated with clinical results. Hence, this review aims to provide a 10-years update on the clinical effectiveness of L-PRF when applied/used as the "sole" biomaterial in maxillary sinus augmentation procedures. An electronic search using specific keywords for L-PRF and maxillary sinus augmentation was conducted in three main databases (PubMed-MEDLINE database, Google Scholar and Cochrane library) for the period between January 2009-February 2020. The quest yielded a total of 468 articles. Based on the pre-established inclusion/exclusion criteria, only seven articles were deemed eligible and included in the analysis. Surprisingly, of the 5 studies which used de-proteinized bovine bone mineral (DBBM) in combination with L-PRF, 60% acclaimed no significant effects and only 40% declared positive effects. Of the two articles which had used allogenous bone graft, 50% declared no significant effects and 50% acclaimed positive effects. Only one study had used L-PRF as the sole grafting material and reported a positive effect. Likewise, positive effects were reported in one other study using L-PRF in combination with a collagen membrane. Due to the heterogeneity of the included studies, this review is limited by the inability to perform a proper systematic meta-analysis. Overall, most of the published studies reported results of L-PRF application as a grafting material (sole or adjuvant) in maxillary sinus augmentation and dental implant restorative procedures. Yet, distinct technical processing for L-PRF preparation was noted. Hence, studies should be approached with caution. Here in, in sinus lift and treatment of Schneider membrane, the formation of mature bone remains inconclusive. More studies are eagerly awaited in order to prove the beneficial or detrimental effects of PRFs, in general and L-PRFs, in specific; especially in their tissue regenerative potential pertaining to the promotion of angiogenesis, enhancing of cell proliferation, stimulation of cell migration and autocrine/paracrine secretion of growth factors, as well as to reach a consensus or a conclusive and distinct determination of the effect of leukocytes (and their inclusion) on inflammation or edema and pain; a call for standardization in PRFs and L-PRFs composition reporting and regimenting the preparation protocols.
PubMed: 33330603
DOI: 10.3389/fsurg.2020.537138 -
Stomatologija 2018To review all of the possible uses for maxillary sinus lateral wall bony window in an open maxillary sinus lift procedure and to evaluate the influence of each method to... (Review)
Review
AIM
To review all of the possible uses for maxillary sinus lateral wall bony window in an open maxillary sinus lift procedure and to evaluate the influence of each method to the rate of sinus membrane perforations.
METHODS
A systematic literature review was performed of randomized control studies in English identified in MEDLINE (PubMed) and Cochrane online databases, published between 2007.09.01 and 2017.09.01. Surgeries had to be performed in vivo, for patients over 18 years old. A study had to have at least 10 sinus lifting procedures, had to detail how the bony window was used and had to report the number of Schneiderian membrane perforations.
RESULTS
922 publications were found, out of which 68 were selected for qualitative assessment. 29 of them were selected for quantitative assessment. 4 distinct uses for bony window were found: bony window is elevated into the sinus cavity under the membrane; removed and discarded; repositioned to its original position after the surgery; used as a graft material for sinus lift.
CONCLUSIONS
there is a statistically significant difference of sinus membrane perforations between different uses of the lateral bony window of an open sinus lift procedure. However, due to the lack of publications that investigate the effects of different bony window usage methods, clinical recommendations cannot be drawn from current data.
Topics: Humans; Maxilla; Maxillary Sinus; Osteotomy; Sinus Floor Augmentation
PubMed: 29806654
DOI: No ID Found -
Cureus Jan 2021The anatomy of the nasal cavities and paranasal sinuses is one of the most varied in the human body. The aim of this study is to review the prevalence of anatomical... (Review)
Review
The anatomy of the nasal cavities and paranasal sinuses is one of the most varied in the human body. The aim of this study is to review the prevalence of anatomical variations in the sinonasal area. This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. We performed on PubMed a literature search from October 2004 until May 2020. The search strategy included the following keywords: ('paranasal sinus' OR 'frontal sinus' OR 'maxillary sinus' AND ('anatomical variants' OR 'anomalies')). Fifty studies were eligible and included in the analysis. Overall, the studies encompassed a total of 18,118 patients included in this review. Most common anatomical variations include agger nasi cells, nasal septum deviation and concha bullosa. Other variations seen in this region are uncinate process variations, paradoxical middle turbinate, Haller, Onodi and supraorbital ethmoid cells, accessory ostia of maxillary sinus. Less common variations include any sinus aplasia, crista galli pneumatization and dehiscence of the optic or maxillary nerve, internal carotid artery and lamina papyracea. Anatomical variations of this region also differ among ethnic groups. This study highlights the amount, variability and significance of most anatomical variants reported in the literature in the last years. It is essential for the sinus surgeon to have a broad spectrum of knowledge not only of "the typical" anatomy but also all the possible anatomical variations. With modern imaging modalities, anatomical variations can be detected, and uneventful pitfalls might be prevented.
PubMed: 33614330
DOI: 10.7759/cureus.12727 -
Clinical Implant Dentistry and Related... Jan 2015The aim of this systematic review was to evaluate clinical and safety data for recombinant human bone morphogenetic protein-2 (rhBMP-2) in an absorbable collagen sponge... (Review)
Review
PURPOSE
The aim of this systematic review was to evaluate clinical and safety data for recombinant human bone morphogenetic protein-2 (rhBMP-2) in an absorbable collagen sponge (ACS) carrier when used for alveolar ridge/maxillary sinus augmentation in humans.
MATERIALS AND METHODS
Clinical studies/case series published 1980 through June 2012 using rhBMP-2/ACS were searched. Studies meeting the following criteria were considered eligible for inclusion: >10 subjects at baseline and maxillary sinus or alveolar ridge augmentation not concomitant with implant placement.
RESULTS
Seven of 69 publications were eligible for review. rhBMP-2/ACS yielded clinically meaningful bone formation for maxillary sinus augmentation that would allow placement of regular dental implants without consistent differences between rhBMP-2 concentrations. Nevertheless, the statistical analysis showed that sinus augmentation following autogenous bone graft was significantly greater (mean bone height: 1.6 mm, 95% CI: 0.5-2.7 mm) than for rhBMP-2/ACS (rhBMP-2 at 1.5 mg/mL). In extraction sockets, rhBMP-2/ACS maintained alveolar ridge height while enhancing alveolar ridge width. Safety reports did not represent concerns for the proposed indications.
CONCLUSIONS
rhBMP-2/ACS appears a promising alternative to autogenous bone grafts for alveolar ridge/maxillary sinus augmentation; dose and carrier optimization may expand its efficacy, use, and clinical application.
Topics: Absorbable Implants; Alveolar Ridge Augmentation; Bone Morphogenetic Protein 2; Collagen; Humans; Osteogenesis; Recombinant Proteins; Sinus Floor Augmentation; Transforming Growth Factor beta
PubMed: 24102703
DOI: 10.1111/cid.12156 -
Journal of Periodontology Jun 2017This systematic review and meta-analysis aims to investigate survival rates of dental implants placed simultaneously with graft-free maxillary sinus floor elevation... (Meta-Analysis)
Meta-Analysis
BACKGROUND
This systematic review and meta-analysis aims to investigate survival rates of dental implants placed simultaneously with graft-free maxillary sinus floor elevation (GFSFE). Factors influencing amount of vertical bone gain (VBG), protruded implant length (PIL) in sinus at follow-up (PILf), and peri-implant marginal bone loss (MBL) are also evaluated.
METHODS
Electronic and manual searches for human clinical studies on simultaneous implant placement and GFSFE using the lateral window or transcrestal approach, published in the English language from January 1976 to March 2016, were conducted. The random-effects model and mixed-effect meta-regression were used to analyze weighted mean values of clinical parameters and evaluate factors that influenced amount of VBG.
RESULTS
Of 740 studies, 22 clinical studies were included in this systematic review. A total of 864 implants were placed simultaneously with GFSFE at edentulous sites having mean residual bone height of 5.7 ± 1.7 mm. Mean implant survival rate (ISR) was 97.9% ± 0.02% (range: 93.5% to 100%). Weighted mean MBL was 0.91 ± 0.11 mm, and it was significantly associated with the postoperative follow-up period (r = 0.02; R = 43.75%). Weighted mean VBG was 3.8 ± 0.34 mm, and this parameter was affected significantly by surgical approach, implant length, and PIL immediately after surgery (PILi) (r = 2.82, 0.57, 0.80; R = 19.10%, 39.27%, 83.92%, respectively). Weighted mean PILf was 1.26 ± 0.33 mm (range: 0.3 to 2.1 mm).
CONCLUSION
Within limitations of the present systematic review, GFSFE with simultaneous implant placement can achieve satisfactory mean ISR of 97.9% ± 0.02%.
Topics: Humans; Alveolar Bone Loss; Databases, Factual; Dental Implantation, Endosseous; Dental Implants; Dental Restoration Failure; Maxilla; Maxillary Sinus; Michigan; Sinus Floor Augmentation
PubMed: 28168901
DOI: 10.1902/jop.2017.160665 -
Journal of Indian Prosthodontic Society 2022The aim of this systematic review is to evaluate the survival rate of dental implant placed using different maxillary sinus floor elevation techniques. (Meta-Analysis)
Meta-Analysis
AIM
The aim of this systematic review is to evaluate the survival rate of dental implant placed using different maxillary sinus floor elevation techniques.
SETTING AND DESIGN
PRISMA guidelines were used for this systematic review and meta-analysis.
MATERIALS AND METHODS
Relevant articles were searched from Medline, PubMed, Google Scholar, ScienceDirect, and Cochrane trials. Articles published in English language were selected. Hand search was further conducted. For risk of bias, two tools were used, i.e., Cochrane tool for randomized controlled trials (RCTs) and new castle Ottawa quality assessment tool for non-RCTs.
STATISTICAL ANALYSIS
For statistical meta-analysis RevMan 5.4 software was used.
RESULTS
Seventeen studies were finalized. All studies were included in the meta-analysis to check the implant survival rate. There is no statistical difference between direct and indirect techniques, and forest plot was derived for direct approach (P = 0.688, 95% confidence interval [CI] 0.9691) and for indirect approach (P = 0.686 and 95% CI 0.970).
CONCLUSION
There is no statistically significant difference in the survival rate of implant placed using direct or indirect sinus lift approach procedures. Hence, the technique is selected as per the indications given for each direct and indirect procedure.
Topics: Maxillary Sinus; Sinus Floor Augmentation; Dental Implants; Dental Implantation, Endosseous; Dental Restoration Failure; Survival Rate
PubMed: 36511050
DOI: 10.4103/jips.jips_283_22