-
Indian Journal of Otolaryngology and... Oct 2022Displacement of foreign bodies into the maxillary sinus shows an increasing tendency, especially in regard to raising amount of dental implant installation procedures....
Displacement of foreign bodies into the maxillary sinus shows an increasing tendency, especially in regard to raising amount of dental implant installation procedures. The purpose of our study was to compare the efficiency and the rate of late complications among the methods of removal of foreign bodies from maxillary sinus. We performed a systematic review following PRISMA Checklist, searching Pubmed and Google Scholar databases for studies investigating the methods of removal of foreign bodies from maxillary sinus. The inclusion criteria embraced the examined group of at least 10 cases and the follow up period of minimum 3 months. We qualified 7 papers from 531 identified in primary search. Among qualified studies functional endoscopic sinus surgery used in order to remove foreign body from maxillary sinus had no late complications, whereas they occurred in 0-5% cases of using replaceable or pedicled bone approaches and in 15-18% cases of Caldwell-Luc approach. FESS probably should become a gold standard in retrieving foreign bodies from maxillary sinus, however poor evidence requires further investigation, especially in prospective, randomized trials.
PubMed: 36452819
DOI: 10.1007/s12070-020-02153-9 -
International Journal of Oral and... Jan 2022The aim of this systematic review and meta-analysis was to critically evaluate the currently existing clinical evidence on the efficacy of graftless maxillary sinus... (Meta-Analysis)
Meta-Analysis Review
The aim of this systematic review and meta-analysis was to critically evaluate the currently existing clinical evidence on the efficacy of graftless maxillary sinus membrane elevation for implantation in the atrophic posterior maxilla. A search protocol without limitations to November 2020 was followed by two independent researchers. Randomized controlled trials using the lateral window approach for graftless sinus membrane elevation were included. Uncontrolled, retrospective, non-comparative studies, case reports, and experimental studies in animals or cadavers were excluded. The search identified 2777 studies. Critical selection by two independent researchers then led to the inclusion of a total of nine studies. A risk of bias assessment was applied using the revised Cochrane risk-of-bias tool for randomized trials. A meta-analysis was conducted for seven studies. Results showed a high overall implant survival rate in both the graftless and bone-grafted sinus lift groups (97.92% and 98.73%, respectively). The graftless sinus lift group showed a significantly lower vertical bone height gain, with a mean difference of -1.73mm (P=0.01), and a significantly lower bone density, with a mean difference of -94.7 HU (P<0.001). The implant stability quotient values did not differ significantly between the test and control groups (P=0.07).
Topics: Animals; Dental Implantation, Endosseous; Dental Implants; Dental Restoration Failure; Maxilla; Maxillary Sinus; Randomized Controlled Trials as Topic; Retrospective Studies; Sinus Floor Augmentation
PubMed: 33849784
DOI: 10.1016/j.ijom.2021.03.016 -
Journal of Indian Society of... 2023The aim of the present systematic review was to assess the effectiveness of simultaneous placement of implant in osteotome-mediated sinus floor elevation (OMSFE)... (Review)
Review
Efficacy of simultaneous placement of dental implants in osteotome-mediated sinus floor elevation with and without bone augmentation: A systematic review and meta-analysis.
BACKGROUND
The aim of the present systematic review was to assess the effectiveness of simultaneous placement of implant in osteotome-mediated sinus floor elevation (OMSFE) procedure with and without bone augmentation.
MATERIALS AND METHODS
An exploration of randomized clinical trials (RCTs) was systematically done in three databases comprising PubMed, Cochrane, and Google Scholar complemented by a thorough manual search of periodontology/implantology-related journals. A final inclusion of 6 RCTs (2010-2020) was done to investigate the efficiency of simultaneous implant placement with OMSFE in conjunction with bone augmentation. A meta-analysis was further conducted with comparable studies which assisted in attaining a final conclusion regarding the survival rate, endosinus bone gain (ESBG), and marginal bone loss (MBL).
RESULTS
Data synthesis was performed on the basis of 6 trials and further meta-analysis was performed to statistically validate the clinical and radiographic outcomes. Meta-analysis on the parameters indicated greater ESBG (mean difference [MD]: 0.82; [95% confidence interval [CI]: 0.72-0.91, 0.0001]), which was also associated with minimal MBL (MD: -1.11; [95% CI: -1.53-0.68, 0.0001)] in the bone augmentation group. However, the parameter of implant survival rate (risk ratio: 1.04; [95% CI: 0.83-1.31, = 0.6849)] failed to reveal significant difference between the two groups.
CONCLUSIONS
In the restoration of masticatory apparatus, simultaneous placement of implant in OMSFE with bone augmentation can be considered as successful and predictable treatment approach in deficient posterior maxillary ridges. It contributes toward bone neoformation resulting in greater ESBG as well as a substantial decrease in MBL.
PubMed: 36873969
DOI: 10.4103/jisp.jisp_196_21 -
Ear, Nose, & Throat Journal Dec 2022Implant dentistry has become a popularized means of replacing damaged or missing teeth. Although it has become common practice, there are accounts of implants displacing...
Implant dentistry has become a popularized means of replacing damaged or missing teeth. Although it has become common practice, there are accounts of implants displacing into surrounding structures, commonly the maxillary sinus. We present the case of a 54-year-old man who presented with chronic left sided pain and pressure found to be secondary to a displaced implant obstructing the left maxillary outflow sinus tract. A systematic review was conducted to assess the current management and treatment options for dental implants displaced into the maxillary sinus. Functional endoscopic sinus surgery (FESS) and the lateral window approach were both found to be safe techniques with minimal postoperative complications.
Topics: Humans; Male; Middle Aged; Maxillary Sinus; Dental Implants; Postoperative Complications
PubMed: 35968734
DOI: 10.1177/01455613221121043 -
European Journal of Oral Sciences Dec 2008Implant therapy in the atrophic posterior maxilla becomes challenging in the presence of reduced maxillary bone height. Sinus augmentation can be performed for resolving... (Review)
Review
Implant therapy in the atrophic posterior maxilla becomes challenging in the presence of reduced maxillary bone height. Sinus augmentation can be performed for resolving this condition prior to implant placement. The aim of this article was therefore to evaluate implant survival rates in the grafted sinus taking into account the influence of the implant surface, graft material, and implant placement timing. A systematic review of the literature was performed. Articles retrieved from electronic databases were screened using specific inclusion criteria, and data extracted were divided according to: graft material (autogenous, non-autogenous, composite graft), implant surface (machined or textured), and implant placement (simultaneous with grafting or delayed). Fifty-nine articles were included. Survival rates for implants placed in grafts made of bone substitutes alone and grafts of composite material were slightly better than the survival rates for implants placed in 100% autogenous grafts. Over 90% of implants associated with non-autogenous grafts had a textured surface. Textured surfaces achieved better outcomes compared with machined surfaces, and this was independent of the graft material. Simultaneous and delayed procedures had similar outcomes. It may be concluded that bone substitutes can be successfully used for sinus augmentation, reducing donor-site morbidity. Long-term studies are needed to confirm the performance of non-autogenous grafts. The use of implants with a textured surface may improve the outcome in any graft type.
Topics: Alveolar Ridge Augmentation; Bone Transplantation; Dental Implantation, Endosseous; Dental Implants; Dental Prosthesis Design; Dental Restoration Failure; Humans; Maxilla; Maxillary Sinus; Osseointegration; Survival Analysis; Treatment Outcome
PubMed: 19049518
DOI: 10.1111/j.1600-0722.2008.00571.x -
International Journal of Environmental... Jan 2021In bone regeneration, obtaining a vital bone as similar as possible to native bone is sought. This review aimed to evaluate the efficacy of stem cells in maxillary bone... (Meta-Analysis)
Meta-Analysis Review
In bone regeneration, obtaining a vital bone as similar as possible to native bone is sought. This review aimed to evaluate the efficacy of stem cells in maxillary bone regeneration for implant rehabilitation and to review the different techniques for obtaining and processing these cells. A systematic review and meta-analysis were performed using the Pubmed/Medline (NCBI), Cochrane, Scielo, and Scopus databases, without restriction on the publication date. The following Mesh terms were used, combined by the Boolean operator "AND": "dental implants" AND "stem cells" AND "bioengineering". Applying inclusion and exclusion criteria, five articles were obtained and three were added after manual search. The results from the meta-analysis (18 patients) did not provide significant differences despite the percentage of bone formed in the maxillary sinus, favoring the stem cell group, and the analysis of the percentage of residual Bio-Oss showed results favoring the control group. Stem cell regeneration usually shows positive vascular and viable bone formation. In conclusion, using mesenchymal stem cells in bone regeneration provides benefits in the quality of bone, similar or even superior to autologous bone, all this through a minimally invasive procedure.
Topics: Bone Regeneration; Bone Transplantation; Humans; Maxillary Sinus; Mesenchymal Stem Cells; Treatment Outcome
PubMed: 33494139
DOI: 10.3390/ijerph18030894 -
The Use of Tooth Derived Bone Graft Materials in Sinus Augmentation Procedures: a Systematic Review.Journal of Oral & Maxillofacial Research 2019The goal of this systematic review was to assess the current literature about sinus augmentation procedure using different types of tooth derived bone graft materials,... (Review)
Review
OBJECTIVES
The goal of this systematic review was to assess the current literature about sinus augmentation procedure using different types of tooth derived bone graft materials, thorough analysing the outcomes of sinus grafting with tooth grafts compared to sinus grafting with xenografts, allografts and alloplasts by radiography and histomorphometry.
MATERIAL AND METHODS
An electronic search in the MEDLINE (NCBI PubMed and PubMed Central) database was conducted to identify articles concerning application of tooth bone grafts in sinus augmentation. The search was restricted to English language articles published in the last 10 years (December 2009 to March 2019).
RESULTS
In total, 21 articles were found, out of which 7 met the inclusion criteria and were included in the final synthesis. According to the type of diagnostic tool, data about graft material outcome in sinus was extracted, and included the residual alveolar height, augmented graft height, resorption height as seen in panoramic radiography and histomorphometric analysis of new bone formation and residual graft material.
CONCLUSIONS
Within the limitations of our review, we suggest that tooth derived graft materials are as successful as xenografts, allografts and alloplasts in sinus augmentation procedures according to the radiographic and histomorphometric showings. Additional wider research should be conducted in order to determine whether tooth derived graft materials are superior to the currently used materials.
PubMed: 31402970
DOI: 10.5037/jomr.2019.10201 -
The Cochrane Database of Systematic... Mar 2010Insufficient bone volume is a common problem encountered in the rehabilitation of the edentulous posterior maxillae with implant-supported prostheses. Bone volume is... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Insufficient bone volume is a common problem encountered in the rehabilitation of the edentulous posterior maxillae with implant-supported prostheses. Bone volume is limited by the presence of the maxillary sinus together with loss of alveolar bone height. Sinus lift procedures increase bone volume by augmenting the sinus cavity with autogenous bone and/or commercially available biomaterials.
OBJECTIVES
To determine whether and when augmentation of the maxillary sinus are necessary and which are the most effective augmentation techniques for rehabilitating patients with implant-supported prostheses.
SEARCH STRATEGY
The Cochrane Oral Health Group's Trials Register, CENTRAL, MEDLINE and EMBASE were searched on 7th January 2010. Several dental journals were handsearched. The bibliographies of review articles were checked, and personal references were searched. More than 55 implant manufacturing companies were also contacted.
SELECTION CRITERIA
Randomised controlled trials (RCTs) of different techniques and materials for augmenting the maxillary sinus for rehabilitation with dental implants reporting the outcome of implant success/failure at least to abutment connection.
DATA COLLECTION AND ANALYSIS
Screening of eligible studies, assessment of the methodological quality of the trials and data extraction were conducted independently and in duplicate. Authors were contacted for any missing information. Results were expressed as random-effects models using mean differences for continuous outcomes and odds ratios for dichotomous outcomes with 95% confidence intervals. The statistical unit of the analysis was the patient.
MAIN RESULTS
Ten RCTs out of 29 met the inclusion criteria. One trial of 15 patients evaluated implants 5 mm long with 6 mm diameter as an alternative to sinus lift in bone with a residual height of 4 to 6 mm. Nine trials with 235 patients compared different sinus lift techniques; of these four trials (114 patients) evaluated the efficacy of platelet-rich plasma (PRP). Due to the variety of techniques evaluated, meta-analysis was only possible of use of PRP for implant failure (two trials) and complications (three trials). No statistically significant difference was observed.
AUTHORS' CONCLUSIONS
Conclusions are based on few small trials, with short follow-up, and judged to be at high risk of bias. Therefore conclusions should be viewed as preliminary and interpreted with great caution. It is still unclear when sinus lift procedures are needed. 5 mm short implants can be successfully loaded in maxillary bone with a residual height of 4 to 6 mm but their long-term prognosis is unknown. Elevating the sinus lining in presence of 1 to 5 mm of residual bone height without the addition of a bone graft may be sufficient to regenerate new bone to allow rehabilitation with implant-supported prostheses. Bone substitutes might be successfully used as replacements for autogenous bone. If the residual alveolar bone height is 3 to 6 mm a crestal approach to lift the sinus lining, to place 8 mm implants may lead to fewer complications than a lateral window approach, to place implants at least 10 mm long. There is no evidence that PRP treatment improves the clinical outcome of sinus lift procedures with autogenous bone or bone substitutes.
Topics: Alveolar Ridge Augmentation; Dental Implantation, Endosseous; Humans; Jaw, Edentulous, Partially; Maxillary Sinus; Randomized Controlled Trials as Topic
PubMed: 20238367
DOI: 10.1002/14651858.CD008397 -
Bioengineering (Basel, Switzerland) Oct 2022The objective of this systematic review is to assess the effect of the adjuvant use of platelet-rich plasma (PRP) and its type on new bone formation by anorganic bovine... (Review)
Review
BACKGROUND
The objective of this systematic review is to assess the effect of the adjuvant use of platelet-rich plasma (PRP) and its type on new bone formation by anorganic bovine bone during maxillary sinus floor augmentation procedure.
METHODS
PubMed, Cochrane Central Register of Controlled Trials, and Ovid databases were searched for relevant studies published up to 16 September 2021. Randomized clinical trials (RCTs) and non-randomized controlled clinical trials (CCTs) that reported data on the new bone formation (measured by histomorphometric analysis) were considered. Risk of bias and quality assessment of included studies were evaluated following the Cochrane Handbook for Systematic Reviews of Interventions and the Risk Of Bias In Non-randomised Studies of Interventions (ROBINS-I) tool. Strength of evidence was assessed following the approach of the Agency for Healthcare Research and Quality (AHRQ) through its evidence-based practice center (AHRQ EPC). The meta-analysis was based on the primary outcome of newly formed bone, for which the standard mean difference was calculated.
RESULTS
After the application of eligibility criteria, six clinical trials (three RCTs and three CCTs) covering 85 maxillary sinus floor elevation procedures were included. The pooled new bone formation value for PRP was 1.67 (95% CI: -0.15 to 3.49; I: 86%), indicating the absence of significant effect. Plasma rich in growth factors (PRGF) was the pure PRP tested in five of the included studies. When sub-group (type of PRP) meta-analysis was performed, significantly higher new bone formation was observed in the PRGF group [2.85 (95% CI: 0.07 to 5.64; I: 88%)] in comparison to the control group.
CONCLUSIONS
A beneficial effect on new bone formation after maxillary sinus floor elevation can be obtained when anorganic bovine bone is mixed with PRGF.
PubMed: 36290564
DOI: 10.3390/bioengineering9100597 -
Dento Maxillo Facial Radiology Jul 2023A systematic review was performed to evaluate the performance of panoramic radiography (PR) CT or cone beam CT (CBCT) in the diagnosis of pathological maxillary sinuses. (Meta-Analysis)
Meta-Analysis
Performance of panoramic radiography compared with computed tomography in the evaluation of pathological changes in the maxillary sinuses: a systematic review and meta-analysis.
OBJECTIVE
A systematic review was performed to evaluate the performance of panoramic radiography (PR) CT or cone beam CT (CBCT) in the diagnosis of pathological maxillary sinuses.
METHODS
This review was registered in the PROSPERO database under the number CRD42020211766. Observational studies that compared PR with CT/CBCT were used to evaluate pathological changes in the maxillary sinuses. A complete search of seven primary databases and gray literature was carried out. The risk of bias was assessed according to the Newcastle-Ottawa tool, and the GRADE tool was used to assess the quality of evidence. A binary meta-analysis was performed to assess the effectiveness of evaluating pathological alterations in the maxillary sinuses in PR and CT/CBCT.
RESULTS
Seven studies were included in our study, out of which four were included in a quantitative analysis. All studies were classified as low risk of bias. Five studies compared PR with CBCT and two studies compared PR to CT. The most common pathological alteration in maxillary sinuses reported was mucosal thickening. CT/CBCT was seen to be the most effective method for assessing pathological changes in the maxillary sinus when compared to PR (RR = 0.19, 95% confidence interval [CI] = 0.05 to 0.70, = 0.01).
CONCLUSION
CT/CBCT are the most appropriate imaging methods to evaluate pathological changes in the maxillary sinuses, while PR is still limited in the evaluation of these changes being considered only for initial diagnosis.
Topics: Humans; Maxillary Sinus; Radiography, Panoramic; Tomography, X-Ray Computed; Cone-Beam Computed Tomography
PubMed: 37192021
DOI: 10.1259/dmfr.20230067