Impact of human maxillary sinus volume on grafts dimensional changes used in maxillary sinus augmentation: a multislice tomographic study

Favato, Mario; Vidigal, Bruno César Ladeira; Cosso, Mauricio; Manzi, Flávio Ricardo; Shibli, Jamil Awad; Zenóbio, Élton Gonçalves

doi:10.1111/clr.12488

Cited by 28 publications

(35 citation statements)

References 25 publications

(58 reference statements)

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“…Several factors can lead to failure, resulting in a great volumetric reduction of the graft (4,11,12), making rehabilitation impossible. There are some evidences suggesting that dimensions of maxillary sinus cavity may affect healing by formation of granulation tissue (1), but this correlation is not yet completely accepted (13). On the other hand, in this study was assessed only the surgeons' performance to determine the amount of graft material required for the maxillary sinus floor augmentation.…”

Section: Discussionmentioning

confidence: 97%

Surgeons’ Performance Determining the Amount of Graft Material for Sinus Floor Augmentation Using Tomography

et al. 2017

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This study aimed to assess the performance of surgeons in determining the amount of graft material required for maxillary sinus floor augmentation in a preoperative analysis using cone-beam computed tomography images. A convenience sample of 10 retrospective CBCT exams (i-CAT®) was selected. Scans of the posterior maxilla area with an absence of at least one tooth and residual alveolar bone with an up to 5 mm height were used. Templates (n=20) contained images of representative cross-sections in multiplanar view. Ten expert surgeons voluntarily participated as appraisers of the templates for grafting surgical planning of a 10 mm long implant. Appraisers could choose a better amount of graft material using scores: 0) when considered grafting unnecessary, 1) for 0.25 g in graft material, 2) for 0.50 g, 3) for 1.00 g and 4) for 1.50 g or more. Reliability of the response pattern was analyzed using Cronbach's α. Wilcoxon and Mann-Whitney tests were performed to compare scores. Regression analysis was performed to evaluate whether the volume of sinuses (mm 3 ) influenced the choose of scores. In the reliability analysis, all values were low and the score distribution was independent of the volume of the maxillary sinuses (p>0.05), which did not influence choosing the amount of graft material. Surgeons were unreliable to determine the best amount of graft material for the maxillary sinus floor augmentation using only CBCT images. Surgeons require auxiliary diagnostic tools to measure the volume associated to CBCT exams in order to perform better.

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Section: Discussionmentioning

confidence: 97%

Surgeons’ Performance Determining the Amount of Graft Material for Sinus Floor Augmentation Using Tomography

et al. 2017

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“…Nevertheless, there is still only sparse information from the clinic on the possible beneficial effect of adding EMD on a bone substitute material in terms of enhancing bone tissue regeneration in non-periodontal sites. In particular, a single study has previously evaluated the BC + EMD combination vs. BC in sinus lift, but due to the fact that only radiographic analysis was performed, the results were unclear [14]; thus, the present study, including histological evaluation, was performed. After 6 months of healing, about 43% of the evaluated part of the biopsy consisted of newly formed mineralized bone and about 35% consisted of grafting material; no differences between the groups were observed also in regard to bone tissue organization and maturation, as revealed by analysis of birefringence.…”

Section: Discussionmentioning

confidence: 99%

“…In fact, in an in vitro study, published after the clinical procedures of the present study were concluded, it was shown that best adsorption of EMD on bone substitute particles is achieved when particles are dry and EMD is allowed to adsorb for at least 5 min. Further, in that study it was shown that inadequate adsorption of EMD on the bone substitute particles had negative influences in osteoblast proliferation and differentiation [14, 15, 18]. …”

Section: Discussionmentioning

confidence: 99%

“…Although the few available preclinical studies have not shown any clear benefit when EMD was used for bone regeneration, emerging evidence shows that EMD upregulates the expression of several chemokines and growth factors relevant for bone wound healing [13]. In this context, clinical testing on the possible potential of EMD to enhance bone formation in other types of bone defects (i.e., non-periodontal) is sparse and the results are unclear [14]. …”

Section: Introductionmentioning

confidence: 99%

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β-TCP/HA with or without enamel matrix proteins for maxillary sinus floor augmentation: a histomorphometric analysis of human biopsies

et al. 2017

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BackgroundIt is still unclear whether enamel matrix proteins (EMD) as adjunct to bone grafting enhance bone healing. This study compared histomorphometrically maxillary sinus floor augmentation (MSFA) with β-TCP/HA in combination with or without EMD in humans.MethodsIn ten systemically healthy patients needing bilateral MSFA, one side was randomly treated using β-TCP/HA mixed with EMD (BC + EMD) and the other side using only β-TCP/HA (BC). After 6 months, biopsies were harvested from grafted areas during implant installation, being histologically and histomorphometrically analyzed. Differences between the groups considering new bone formation, soft tissues, and remaining BC were statistically evaluated.ResultsAll patients showed uneventful healing after MSFA, and dental implant installation was possible in all patients after 6 months. Histological analysis showed newly formed bone that was primarily woven in nature; it was organized in thin trabeculae, and it was occasionally in contact with residual bone substitute particles, which appeared in various forms and sizes and in advanced stage of degradation. Mean bone area was 43.4% (CI95 38.9; 47.8) for the BC group and 43.0% (CI95 36.6; 49.5) for the BC + EMD group. Mean soft tissue area was 21.3% (CI95 16.5; 26.2) for BC group and 21.5% (CI95 17.7; 25.3) for BC + EMD group, while the remaining biomaterial was 35.3% (CI95 36.6; 49.5) and 35.5% (CI95 29.6; 41.3) for BC and BC + EMD group, respectively.ConclusionsMSFA with BC resulted in adequate amounts of new bone formation allowing successful implant installation; adding EMD did not have a significant effect.

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“…For this reason, clinical understanding of drugs and their therapeutic application is essential for the predictable management of maxillary sinus elevation (Misch ; Favato et al. ). Jousimies‐Somer et al.…”

mentioning

confidence: 99%

Bacterial influence on consolidation of bone grafts in maxillary sinus elevation

Carreño

González-Jaranay

Aguilar‐Salvatierra

et al. 2016

Clinical Oral Implants Res

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Impact of human maxillary sinus volume on grafts dimensional changes used in maxillary sinus augmentation: a multislice tomographic study

Abstract: This study demonstrated that there is no sufficient evidence to support the thesis that the volume of the maxillary sinus influences the contraction of the grafts, at least on sample or the biomaterials evaluated in this cohort study.

Cited by 28 publications

References 25 publications

Surgeons’ Performance Determining the Amount of Graft Material for Sinus Floor Augmentation Using Tomography

Surgeons’ Performance Determining the Amount of Graft Material for Sinus Floor Augmentation Using Tomography

β-TCP/HA with or without enamel matrix proteins for maxillary sinus floor augmentation: a histomorphometric analysis of human biopsies

Bacterial influence on consolidation of bone grafts in maxillary sinus elevation

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