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The International Journal of Oral &... Nov 2023The clinical use of bioactive substances, such as growth factors, have significantly increased, however, potential regenerative effects derived from the addition of...
Do recombinant, purified or concentrated growth factors enhance the regenerative potential of particulate bone graft substitutes in maxillary sinus floor augmentation? A systematic review and meta-analysis.
BACKGROUND
The clinical use of bioactive substances, such as growth factors, have significantly increased, however, potential regenerative effects derived from the addition of different growth factors to bone substitutes on maxillary sinus floor augmentation (MSA) procedures is still controversial. This systematic review (SR) aimed at answering the following question: "Do recombinant, purified and concentrated growth factors enhance the regenerative potential of particulate bone graft substitutes in maxillary sinus floor augmentation?".
METHODS
Human studies comparing histomorphometric data of the outcomes of interest new bone formation, residual graft material, and fibrous tissue ratio following MSA procedures employing particulate bone grafts/substitutes in combination or not with growth factors were retrieved from PubMed/MEDLINE, Web of Science, Cochrane and Scopus online databases and complemented with a hand search. Controlled studies published in English up to December 2022 and reporting on histomorphometric data expressed as percent volume of the outcomes of interest were considered. Risk of bias was assessed, and a meta-analysis (MA) was performed to investigate the effects of supplementary growth factors on new bone formation, remaining graft particles and fibrous tissue ratio.
RESULTS
Data of 613 samples from 477 patients reported in 22 publications were included. MA showed PRP or PRF resulted in 49% more new bone formation than in areas in control groups (P=0.004), and those areas supplemented with growth factors presented 57% less residual graft particles after healing (P<0.0001). A significant (P=0.03) 1.85-fold increase in connective tissue formation was noted in areas treated with rhBMP after healing.
CONCLUSION
The MA provided evidence that selective supplementary growth factors may enhance new bone formation and accelerate particulate graft turnover, while rhBMP may significantly increase connective tissue formation in MSA procedures in humans.
PubMed: 37939238
DOI: 10.11607/jomi.10553 -
Oral Diseases Oct 2023Surgical ciliated cysts occur mainly in the maxillae after radical maxillary sinus surgery; they rarely develop in the mandible. This study aims to gather information on... (Review)
Review
BACKGROUND
Surgical ciliated cysts occur mainly in the maxillae after radical maxillary sinus surgery; they rarely develop in the mandible. This study aims to gather information on all the characteristics of patients suffering from mandibular surgical ciliated cysts. This article also reports two new cases.
METHODS
PubMed, Google Scholar and the International Clinical Trials Registry Platform were explored until 13 December 2022 for articles regarding mandibular surgical ciliated cysts. Maxillary ciliated cysts were excluded.
RESULTS
Fourteen original articles were included in a total of 16 cases. Maxillofacial surgeries are the first aetiology (94.4%). Surgical ciliated cysts of the mandibular region show a 1.25:1 male-to-female ratio with a protracted time to diagnosis (range: 2-56 years). Most patients are symptomatic (77.8%). Typically, radiology shows a radiolucency lesion (88.9%) and histology describes pseudostratified ciliated columnar epithelium. Enucleation has always been described as the treatment.
DISCUSSION
All results were case reports, thus a low level of evidence studies. Mandibular surgical ciliated cysts should be considered in patients presenting a mandibular swelling or radiolucency lesion with a maxillofacial surgery history. Meticulous surgical techniques can aid in the prevention of this lesion.
PubMed: 37884395
DOI: 10.1111/odi.14795 -
Clinical Otolaryngology : Official... Jan 2024Sinonasal undifferentiated carcinoma (SNUC) is a rare but aggressive tumour with very poor prognosis. There are currently no well-established clinical trials to guide... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
Sinonasal undifferentiated carcinoma (SNUC) is a rare but aggressive tumour with very poor prognosis. There are currently no well-established clinical trials to guide therapy and the impact of various treatment modalities on survival is not well defined. We aim to provide an updated systematic review on current treatment modalities on survival outcomes.
DESIGN AND SETTING
Individual patient data were extracted, and survival data pooled in a one-stage meta-analysis. Descriptive statistics were analysed using the Kaplan-Meier method. Patient-level comparisons stratified by treatment modalities, adjusted for demographics, were conducted using shared-frailty Cox regression.
PARTICIPANTS AND MAIN OUTCOME MEASURES
Participants include all patients diagnosed with SNUC based on histological evidence. We looked at the overall cumulative survival outcome for different treatment modalities and overall survival by treatment modality in low versus high stage SNUC patients.
RESULTS AND CONCLUSION
Seventeen studies were identified, comprising 208 patients from 1993 to 2020. There was no significant difference in cumulative overall survival in low versus high stage patients, and no significant difference in outcomes by treatment modality. The overall cumulative survival of SNUC is 30% at 95 months. Among patients treated with various combinations of treatment modalities, patients with chemoradiotherapy had the highest cumulative survival of 42% at 40 months. Definitive chemoradiotherapy was associated with improved disease survival rate. Regardless of tumour stage, patients should be treated early and aggressively, with no superiority of one treatment regimen over another. Trimodality treatment does not confer survival advantage over bimodality treatment.
Topics: Humans; Maxillary Sinus Neoplasms; Carcinoma; Combined Modality Therapy; Prognosis; Retrospective Studies
PubMed: 37859617
DOI: 10.1111/coa.14100 -
Head & Neck Jan 2024Sinonasal NUT carcinoma is an extremely rare, lethal malignancy with limited literature.
BACKGROUND
Sinonasal NUT carcinoma is an extremely rare, lethal malignancy with limited literature.
METHODS
A case series was conduction of all patients with sinonasal NUT carcinoma at a single institution between 2010 and 2022. Survival and associated were evaluated. A systematic review of the literature was performed.
RESULTS
In 12 patients, followed for a median of 1.5 years, the median overall survival (OS) and disease-specific survival (DSS) were both 14.6 months. Patients with maxillary sinus tumors were 91% more likely to survive (hazard ratio [HR]: 0.094, 95% confidence interval [CI]: 0.011-0.78, p = 0.011). Patients with higher-stage disease stage had worse OS (stage IVb-c vs. III-IVa, p = 0.05). All three patients who were alive with no evidence of disease received induction chemotherapy.
CONCLUSION
For patients with sinonasal NUT carcinoma, the median survival was 15 months but better with lower-stage and maxillary tumors. Induction chemotherapy may be beneficial.
Topics: Humans; Carcinoma; Maxillary Sinus Neoplasms; Proportional Hazards Models; Retrospective Studies
PubMed: 37853958
DOI: 10.1002/hed.27553 -
The International Journal of Oral &... Oct 2023To assess the survival rate (SR) and probability of postoperative complications at both the implant and patient level for each of the four surgical techniques for... (Meta-Analysis)
Meta-Analysis
PURPOSE
To assess the survival rate (SR) and probability of postoperative complications at both the implant and patient level for each of the four surgical techniques for zygomatic implant (ZI) placement: Brånemark, sinus slot, extrasinus, and extramaxillary.
MATERIALS AND METHODS
A systematic literature review and meta-analysis of clinical studies that reported the survival rate and postoperative ZI complications for the rehabilitation of atrophic edentulous maxillae was conducted based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) recommendations. Two independent reviewers consulted four databases during the literature search: MEDLINE (PubMed), Google Scholar, Clinicaltrials.gov, and LILACS. Duplicate articles were eliminated.
RESULTS
A total of 35 studies were included in the meta-analysis. Subgroup analysis showed that study design (prospective vs retrospective) had no significant impact (P = .10) on the outcomes. The SR was highest for the Brånemark and extrasinus techniques (100%) and lowest for the sinus slot technique (94%; 95% CI = 86% to 102%). The extramaxillary (38%; 95% CI = 1% to 3%) and the Brånemark (29%; 95% CI = 15% to 44%) techniques resulted in the highest occurrence of patient-level complications. Moreover, the extramaxillary technique showed the highest percentage of prothesis-related complications (44%; 95% CI = 27% to 62%).
CONCLUSIONS
ZI placement was demonstrated to be a reliable technique for the rehabilitation of severely atrophic maxillae, irrespective of the surgical technique evaluated. Accurate case and surgical protocol selection is of paramount importance to reduce technique-related postoperative complications.
Topics: Humans; Dental Implants; Retrospective Studies; Prospective Studies; Survival Rate; Dental Implantation, Endosseous; Postoperative Complications; Zygoma; Maxilla; Dental Prosthesis, Implant-Supported; Jaw, Edentulous; Follow-Up Studies
PubMed: 37847828
DOI: 10.11607/jomi.10330 -
Imaging Science in Dentistry Sep 2023This systematic review examined the detection of the posterior superior alveolar artery, along with various anatomic characteristics, on cone-beam computed tomography...
PURPOSE
This systematic review examined the detection of the posterior superior alveolar artery, along with various anatomic characteristics, on cone-beam computed tomography images.
MATERIALS AND METHODS
Studies were identified electronically through the Web of Science, MEDLINE, Scopus, and Embase databases. The quality of the included studies was evaluated using a 5-item binary scale. The detection rate, location, and classified diameter of the posterior superior alveolar artery were estimated as prevalence values. The diameter of this artery, as well as the distances from the artery to the alveolar crest and sinus floor, were estimated as means with associated 95% confidence intervals.
RESULTS
Thirty-seven studies were enrolled, with 34 of these included in the meta-analysis. The mean detection rate was 79% (range: 72%-84%), and the mean diameter was 1.06±0.05 mm (range: 0.96-1.16 mm). The posterior superior alveolar artery was located intraosseously in 64% of cases. The mean distance of the artery from the alveolar crest was 16.71±0.49 mm (range: 15.75-17.68 mm), while the mean distance from the artery to the sinus floor was 8.85±0.4 mm (range: 8.05-9.64 mm).
CONCLUSION
According to the findings of this meta-analysis regarding various anatomic characteristics of the posterior superior alveolar artery, severe hemorrhage after damage to this artery during sinus augmentation procedures is not a substantial clinical problem.
PubMed: 37799745
DOI: 10.5624/isd.20230009 -
International Journal of Implant... Oct 2023The main purpose of this study was to evaluate whether large granular bovine bone can be as effective as small granular bovine bone in maxillary sinus floor elevation. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
The main purpose of this study was to evaluate whether large granular bovine bone can be as effective as small granular bovine bone in maxillary sinus floor elevation.
METHODS
A comprehensive online search of eligible articles was conducted using PubMed, EMBASE, Cochrane Library, Scopus, and Web of Science, and a systematic review and meta-analysis was performed from establishment to February, 2023. The outcome indicators were the percentage of connective tissue, the percentage of newly formed bone and the percentage of residual xenograft respectively. The meta-analysis was conducted by using the Stata 15.1 (Stata Conpernarn, USA) and Review Manager software5.4.1.
RESULTS
After careful screening and review, a total of 4 studies were included for systematic review and meta-analysis. The data were extracted to compare the histological performance of bovine bones with different particle sizes after maxillary sinus elevation. No significant differences were found in the percentage of connective tissue, the percentage of newly formed bone, and the percentage of residual xenograft.
CONCLUSION
In this study, a systematically review of the previous literature showed that similar histological results were obtained for both large-particle bovine bone and small-particle bovine bone. Therefore, the large granular bovine bone and the small granular bovine bone were equally effective in maxillary sinus elevation. It is difficult to make conclusion from limited evidence from four studies. More clinical evidence was needed.
Topics: Humans; Animals; Cattle; Sinus Floor Augmentation; Bone Transplantation; Dental Implantation, Endosseous; Particle Size; Bone Substitutes
PubMed: 37782429
DOI: 10.1186/s40729-023-00502-1 -
Turkish Journal of Orthodontics Sep 2023This systematic review was intended to evaluate the maxillary sinus dimensions in vertical and sagittal craniofacial patterns and to assess if there was a difference...
This systematic review was intended to evaluate the maxillary sinus dimensions in vertical and sagittal craniofacial patterns and to assess if there was a difference among the craniofacial patterns. A systematic search was performed in seven databases till February 2021. The risk of bias was performed with modified Newcastle Ottawa scale. Meta-analysis was performed using random effects model. Twelve studies were included in the review and 8 in the meta-analysis. Compared to Class I malocclusion, the maxillary sinus area is greater in Class II and lesser in Class III malocclusion. On comparing normo-divergent growth pattern, the maxillary sinus area is lesser in hypo-divergent and greater in hyper-divergent individuals. Most of the studies were graded as satisfactory. The measurements are greater in hyper-divergent Class II malocclusion and in males.
PubMed: 37782024
DOI: 10.4274/TurkJOrthod.2022.2022.4 -
Biomedicines Aug 2023There is no unequivocal scientific consensus for the temporary anchorage device (TAD) positioning in the infrazygomatic crest area (IZC). The two principal aims of this... (Review)
Review
There is no unequivocal scientific consensus for the temporary anchorage device (TAD) positioning in the infrazygomatic crest area (IZC). The two principal aims of this systematic review were to assess bone availability in the IZC and to establish both the target site and the need for cone-beam computed tomography (CBCT) prior to miniscrew placement. The study was performed following PRISMA guidelines (PROSPERO: CRD42023411650). The inclusion criteria were: at least 10 patients, three-dimensional radiological examination, and IZC assessment for the TAD placement. ROBINS-I tool and Newcastle-Ottawa Scale were used for quality evaluation. No funding was obtained. The study was based on the information coming from: PubMed, Google Scholar, Web of Science Core Collection, MDPI, Wiley, and Cochrane Libraries. The last search was carried out on 1 August 2023. Fourteen studies were identified for analysis. A narrative synthesis was performed to synthesize the findings of the different studies. Unfortunately, it is not possible to establish the generally recommended target site for IZC TAD placement. The reasons for this are the following: heterogeneity of available studies, inconsistent results, and significant risk of bias. The high variability of bone measurements and the lack of reliable predictors of bone availability justify the use of CBCT for TAD trajectory planning. There is a need for more high-quality studies aiming three-dimensional bone analysis of the IZC.
PubMed: 37760830
DOI: 10.3390/biomedicines11092389 -
Medicine Sep 2023The objective of this review is to investigate and analyze the anatomical variations present in the maxillary sinus (MS), through the examination of the prevalence of... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
The objective of this review is to investigate and analyze the anatomical variations present in the maxillary sinus (MS), through the examination of the prevalence of these variations, as well as the corresponding prevalence of clinically significant pathologies and complications associated with them.
METHODS
The search process was carried out in the following databases; MEDLINE, SCIELO, WOS, CINHAL, SCOPUS, and GOOGLE SCHOLAR, using as search terms; "Maxillary bone," "Maxillary sinus," "Paranasal sinus," "Anatomical variations," "Sinusitis" and "Clinical anatomy."
RESULTS
A total of 26 articles and 12969 samples were included, from which 12,594 subjects had their sex recorded giving a total of 5802 males and 6792 females. The variants reported by the included were Haller cells, Concha Bullosa, Number of septa, Hypoplastic sinus, Agger Nasi, Thickening of the MS mucosa, Deviation of the nasal septum, Accessory ostium, and Onodi cells. Among the mentioned, the ones that presented the greatest number of studies (between 8 and 10 studies included) were: the Haller Cells, the Concha Bullosa, and the Number of septa, where prevalence was 0.30, 0.36, 0.39 respectively. These variations can lead to sinusitis, cause some types of tumors, or affect neighboring structures that could be compromised by this variation.
CONCLUSION
As a result, it is certainly complex to distinguish the presence of anatomical variations from pathological abnormalities. Therefore, knowledge of the different variations and their clinical relationships could be a useful asset for clinicians dedicated to this region.
Topics: Female; Male; Humans; Nose Diseases; Databases, Factual; Knowledge; MEDLINE; Maxillary Sinus
PubMed: 37747000
DOI: 10.1097/MD.0000000000034510