Background
The overlying maxillary sinus frequently restrains the height of the posterior maxillary bones.
Purpose
Evaluating the effect of downsizing the antrostomy side‐window on the stability of the installed implants and vertical bone gain, after employing a graftless antral membrane balloon elevation (AMBE).
Materials and methods
The study is a randomized controlled clinical trial conducted on 20 patients with 30 deficient maxillary alveolar ridges underwent graftless (AMBE) after being allocated into a (5 mm) entry antrostomy group (the test group) and a (10 mm) entry antrostomy group (the control group) implementing a radiographic linear bone height and implant stability quotations (ISQ) comparison among both groups immediately after the placement of 38 Implants and 6 months after.
Results
Radiographic bone gain of the test group (5.55 ± 0.93 mm) was significantly higher than the control group (2.86 ± 0.60 mm) (p <0.001). There was no significant difference in primary stability between the test (65 ± 5.32) and control groups (62.67 ± 4.46) (p = 0.202); while the test group (73.43 ± 4.39) showed significantly higher secondary stability than the control group (64.83 ± 6.05) (p <0.001). ISQ values recorded at 6 months were significantly higher than those recorded at insertion in the test group (p <0.001), while they were insignificant in the control group (p = 0.148).
Conclusion
Undersizing the antrostomy window deemed beneficial concerning the vertical bone gain and the simultaneously placed root form dental implants' secondary stability.
Purpose: This study aims to evaluate the efficiency of computer-aided design and computer-aided manufacturing (CAD/CAM), mirror-imaged Polyetheretherketone (PEEK) assembly that aimed to duplicate both of the exact anatomic position and the configuration of the resected mandibular condyle, post segmental proximal tumor resection. Methods: Five patients were included in the study; diagnosed for mandibular ramus locally aggressive tumors, involving or markedly jeopardizing the mandibular condyles. All of the patients were subjected to a fully guided reconstructive protocol that implements guided resection, guided alignment of a pre-bent reconstruction plate, secured to a (CAD/CAM) fabricated, mirror-imaged (PEEK), looking forward to duplicating both of the anatomic location and the configuration of the amputated mandibular ramus and condyle. Results: Clinical evaluation revealed acceptable recovery of the maximal mouth opening and limited postoperative malocclusion and mandibular deviation. The computed radiographic superimposition between the virtual plane and the oneweek postoperative C.T. revealed decreased linear condyle displacement in both the mediolateral and anteroposterior directions versus an increased linear vertical displacement and decreased axial angular rotation versus increased sagittal angular rotation. The replication between the virtually planned condylar location and that surgically duplicated was judged as good to excellent among all the cases.
Conclusion:The novel simulation and allocation of the customized (PEEK) assembly represents a simple and efficient modality to reconstruct both of the lost condylar position and configuration. However, the anterior extension of the resected proximal mandibular segment deemed determinant to the success of the identical surgical execution of the virtual preplanned arrangement.
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