• Journal of Periodontal and Implant Science
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• 제44권2호
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• pp.50-56
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• 2014

Purpose: The aims of this study were to measure the distance of the intraosseous vascular anastomosis in the anterolateral wall of the maxillary sinus from different reference points, and to correlate the location of the intraosseous vascular anastomosis with the tooth position and the residual bone height of the maxilla. Methods: Computed tomography (CT) images were taken from 283 patients undergoing dental implants placement in the posterior maxilla. Three horizontal lines were drawn at the ridge crest, maxillary sinus floor, and the position of the anastomosis. A vertical second line at the center of each tooth was drawn perpendicular to the horizontal lines. The distance from the ridge crest to the maxillary sinus floor and the distance from the maxillary sinus floor to the bony canal were measured from the intersections of the horizontal and vertical lines. The residual alveolar bone height was used to categorize three groups: group 1,<4 mm; group 2, between 4 and 8 mm; and group 3, >8 mm. Results: The residual bone height values of different tooth positions were significantly different (P=0.0002). The distance from the maxillary sinus floor to the intraosseous vascular anastomosis was significantly different between groups 1 and 3 (P=0.0039). At the molar sites, a moderate negative correlation was found between the residual bone height and the distance from the maxillary sinus floor to the intraosseous anastomosis. The distances of the alveolar ridge crest and the maxillary sinus from the intraosseous vascular anastomosis were not significantly different between sexes. Conclusions: Within the limitations of this study, sites with a higher residual bone height in the molar regions were at a relatively high risk of artery damage during window osteotomy preparation; therefore, we recommend taking more precautions when using a lateral approach for sinus elevation.

• Journal of Periodontal and Implant Science
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• 제42권6호
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• pp.204-211
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• 2012

Purpose: This study was performed to establish an experimental rabbit model for single-stage maxillary sinus augmentation with simultaneous implant placement. Methods: Twelve mature New Zealand white rabbits were used for the experiments. The rabbit maxillary sinuses were divided into 3 groups according to sinus augmentation materials: blood clot (BC), autogenous bone (AB), and bovine-derived hydroxyapatite (BHA). Small titanium implants were simultaneously placed in the animals during the sinus augmentation procedure. The rabbits were sacrificed 4 and 8 weeks after surgery and were observed histologically. Histomorphometric analyses using image analysis software were also performed to evaluate the parameters related to bone regeneration and implant-bone integration. Results: The BC group showed an evident collapse of the sinus membrane and limited new bone formation around the original sinus floor at 4 and 8 weeks. In the AB group, the sinus membrane was well retained above the implant apex, and new bone formation was significant at both examination periods. The BHA group also showed retention of the elevated sinus membrane above the screw apex and evident new bone formation at both points in time. The total area of the mineral component (TMA) in the area of interest and the bone-to-implant contact did not show any significant differences among all the groups. In the AB group, the TMA had significantly decreased from 4 to 8 weeks. Conclusions: Within the limits of this study, the rabbit sinus model showed satisfactory results in the comparison of different grafting conditions in single-stage sinus floor elevation with simultaneous implant placement. We found that the rabbit model was useful for maxillary sinus augmentation with simultaneous implant placement.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제37권4호
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• pp.278-286
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• 2011

Introduction: This study examined the predictability of new bone formation in the pneumatized maxillary sinus using only fibrin-rich blocks with concentrated growth factors as an alternative to bone grafts. Materials and Methods: Maxillary sinus augmentation was performed in thirty-three patients with a deficient alveolar bone height (mean 3.9 mm). All patients were treated consecutively with sinus membrane elevation via the lateral window approach and panoramic radiograms and cone-beam computed tomograms were taken to evaluate the remaining bone height and the new bone formation in the maxillary sinus, before and after surgery. Four biopsy specimens were taken at the time of implant consolidation (after an average of five months healing) and were stained by H & E and Trichrome staining. Results: None of the patients had postoperative complications during implant consolidation. After an average of 5 months since sinus augmentation, newly formed bone was observed in all cases by a radiographic evaluation. In 4 biopsy samples, newly formed bone was observed along the floor of the replaced bony window. The osteoblast lining and well distinguished Osteocytes in the lacunas were observed in the newly formed bone. Of the 74 implants (4 different surfaced implants - resorbable blast media-surfaced (RBM), Hydroxyapatite (HA) coated, acid-etched, sintered porous-surfaced implant) placed, one RBM implant failed. The success rate was 98.6% after a mean of 15 months. Discussion: These results suggest that maxillary sinus augmentation using fibrin rich block with concentrated growth factors is a successful and predictable technique.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제41권1호
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• pp.30-36
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• 2015

Objectives: The aim of this study is to determine the incidence, location, and orientation of maxillary sinus septa in formalin embalmed cadavers. Materials and Methods: The study was conducted on 210 cadaveric heads available in our department. After taking the mid-sagittal section the specimens were opened from the medial aspect and the sinus sinus septa, their anatomical plane, location and dimensions. Results: The mean linear distance between maxillary sinus floor and its anatomical ostium was $26.76{\pm}5.21mm$ and $26.91{\pm}4.96mm$ on right and left side, respectively. A total of 59 maxillary sinus septa (28.1%) were observed in 210 maxillary specimens. Septae were most common, 33 septa (55.9%), in the middle region (between first and second molar tooth) of the sinus cavity. The maxillary sinus membrane (Schneiderian membrane) adhered tightly to the maxillary sinus and over the septae. Significantly more maxillary sinus septa were observed in edentulous maxillae in comparison to the dentate upper jaw. Conclusion: Knowledge of location of maxillary sinus ostium is mandatory for the rhinologist for drainage of secretions in maxillary sinusitis. The morphological details of maxillary sinus septa, particularly their location and anatomical planes, will guide dentists in performance of safe implant surgeries. The maxillary antrum septa of category I and II may complicate the procedure of inversion of bone plate and elevation of sinus membrane during maxillary augmentation surgeries. The category III septa observed in the sagittal plane were embedded by one of the branches of the infraorbital nerve in it, and if accidentally cut will lead to infraorbital nerve palsy in maxillary sinus surgeries.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제43권4호
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• pp.214-220
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• 2017

Maxillary sinus lift for dental implant installation is a well-known and versatile technique; new techniques are presented based on the physiology of intrasinus bone repair. The aim of this review was to determine the status of graftless maxillary sinus lift and analyze its foundations and results. A search was conducted of the literature between 1995 and 2015 in the Medline, ScienceDirect, and SciELO databases using the keywords "maxillary sinus lift," "blood clot," "graftless maxillary sinus augmentation," and "dental implant placement." Ten articles were selected for our analysis of this technique and its results. Despite the limited information, cases that were followed for at least six months and up to four years had a 90% success rate. Published techniques included a lateral window, elevation of the sinus membrane, drilling and dental implant installation, descent of the membrane with variations in the installation of the lateral wall access and suturing. The physiology behind this new bone formation response and the results of the present research were also discussed. We concluded that this is a promising and viable technique under certain inclusion criteria.

• Imaging Science in Dentistry
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• 제46권2호
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• pp.109-115
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• 2016

Purpose: Sinus elevation procedures have become a routine and reliable way to gain bone volume in the edentulous maxilla for dental implant placement. Presence of bony septations and pathology in the maxillary sinus often cause complications leading to graft or implant failure or both. The aim of this study was to retrospectively evaluate the prevalence of pathology, direction of the septa, and sinus width measured at 2 mm, 5 mm, and 10 mm from the sinus floor in maxillary sinuses using cone-beam computed tomography (CBCT). Materials and Methods: Seventy-two sinuses from 36 random preoperative CBCT scans referred for implant therapy were retrospectively evaluated for the number, prevalence, and direction of bony septations and presence of pathology. Width of the sinus was also measured at 2 mm, 5 mm, and 10 mm from the sinus floor to account for the amount of bone available for implant placement. Results: Maxillary sinus septa were found in 59.7%. Presence of a single septum was noted in 20 sinuses (27.7%), followed by two septa in 17 sinuses. The most common direction of the septum was the transverse direction. Retention pseudocyst and mucosal thickening were the most commonly seen abnormality/pathology. Conclusion: Based on the high prevalence of septa and sinus pathology in this sample, a preoperative CBCT scan might be helpful in minimizing complications during sinus augmentation procedures for dental implant therapy.

• Journal of Korean Dental Science
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• 제17권1호
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• pp.45-52
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• 2024

Purpose: To investigate the 5-year outcome of dental implants placed in a grafted maxillary sinus using recombinant human bone morphogenetic protein-2 (rhBMP-2). Materials and Methods: We retrospectively analyzed 27 implants after maxillary sinus floor augmentation (MSFA) using rhBMP-2 in 16 patients between January 2016 and March 2017. The study evaluated two outcome variables: (1) 5-year cumulative survival and success rate of the implant after functional loading and (2) marginal bone loss (MBL) for implant failure. Results: The average residual bone height was 4.78±1.53 mm. The healing period before loading was 8.35±2.34 months. The crown-to-implant ratio was 1.31±0.26. The 5-year cumulative survival and success rate after functional loading were 100% and 96.3%, respectively. The 5-year average MLB was 0.89±0.82 mm. Conclusion: Placing dental implants with MSFA using rhBMP-2 is a reliable procedure with favorable long-term survival and success rates.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제40권3호
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• pp.117-122
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• 2014

Objectives: The purpose of this study was to evaluate the sinus bone graft resorption over 3 years after two-stage implant placement. Materials and Methods: The subjects for this study included 30 patients whose maxillary posterior ridges were too atrophic for implants. Bone-added osteotome sinus floor elevation was used in 15 maxillary sinuses, while the bone graft by lateral approach technique was used in 25 maxillary sinuses. The height from the top of the fixture to the sinus floor was estimated immediately after implant placement and the follow-up period was over 3 years. The surgery was classified with two groups: sinus bone grafting with and without autogenous bone. All implants were placed simultaneously. Results: The mean vertical bone loss was $3.15{\pm}2.95mm$. The survival rate of implants was 94.7%. Conclusion: The amount of bone resorption was not significantly associated with the surgical methods, the type of bone graft materials used, or sinus perforation during surgery.

• 대한치과보철학회지
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• 제47권2호
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• pp.240-246
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• 2009

연구목적: 이 연구는 측방접근법을 통해 상악동 골이식을 시행한 후 임플란트를 식립하였을 때, 누적 생존률 및 성별, 연령별, 이식재, 자가골의 공여부, 술전 잔존골 양, 무치악 형태, 식립 시기, 임플란트 종류, 직경과 길이에 따른 임플란트의 생존률 및 변연골의 방사선학적 결과의 차이를 분석하고자 시행되었다. 연구 재료 및 방법: 상악 구치에 측방접근법을 통해 상악동 골이식술 후 임플란트 보철치료를 시행한 71명을 대상으로 하였으며 표면 처리된 나사모양의 임플란트를 사용하였다. Osseotite(BIOMET 3i, Warsaw, USA), Neoplant(Neobiotec, Seoul, Korea), $Br\ddot{a}nemark$(Nobel Biocare, Goteberg, Sweden)과 SSII(Osstem, Busan, Korea)를 사용하였다. 최소 6개월 이상의 기간 관찰 누적 생존률은 Kaplan-Meier 분석법을 이용하였으며 다른 요소에 따른 임플란트의 생존률의 유의성은 Chi-square test로 검정하였다. 결과: 상악동골 이식술이 시행된 모든 증례에서 임플란트 식립이 가능한 골 양이 얻어졌으며 92%의 생존률을 보였다. 결론: 상악동 골이식술을 시행한 후 임플란트 보철 수복은 자가골 단독 사용시에 자가골과 골대체 물질이 혼합된 것보다 우수한 생존률을 보였다. 지연 식립하는 경우가 임플란트와 동시에 식립하는 경우보다 생존률이 높았다.

• Imaging Science in Dentistry
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• 제51권3호
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• pp.243-250
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• 2021

Purpose: The objective of this study was to evaluate the amount of height available for a maxillary sinus augmentation procedure without blocking the ostium and jeopardizing the drainage of the ostiomeatal complex using cone-beam computed tomography (CBCT) imaging. Materials and Methods: A total of 200 sinonasal complexes comprising 100 dentate and 100 edentulous scans were retrospectively assessed using CBCT. Invivo 5.0, a CBCT reconstruction program, was used for image evaluation. The coronal section demonstrating the ostiomeatal complex was selected as a reference view to perform measurements of the sinus. The measurements were done by 2 evaluators in separate sessions. Comparative analyses of measurements were performed between dentate and edentulous patients and between male and female patients. Results: The safe height to which the sinus can be elevated without compromising the integrity of the ostiomeatal complex was calculated for each sinus. In the presence of significant mucosal thickening, the height available for augmentation was calculated by subtracting the height of mucosal thickening from the sinus floor to the location of the ostium. In this study, the available height was approximately 27.05 mm for dentate and 23.40 mm for edentulous patients. The inter-operator reliability was excellent for all the parameters evaluated. Conclusion: This retrospective study with a limited number of patients from a single university-based site shows that CBCT is valuable in evaluating the location and patency of the ostium for planning sinus augmentation procedures for dental implant placement.