• Title/Summary/Keyword: Sinus graft

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Comparative histomorphologic study of regenerated bone for dental implant placement in the atrophied posterior maxilla

  • Kim, Se-Jung;Kim, Soung-Min;Kim, Ji-Hyuck;Park, Young-Wook
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.33 no.1
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    • pp.28-39
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    • 2007
  • The purpose of this study is to evaluate the regenerative capacity of reconstruction in the atrophied posterior maxilla by comparing bone graft procedures and alveolar distraction osteogenesis (ADO) techniques. We performed the autogenous iliac bone graft (AGB group, 5 specimens in 3 patients), and the combination (Mixed group, 3 specimens in 3 patients) of the autogenous and deproteinized bovine bone ($Bio-Oss^{(R)}$, Geistlich Co., Switzerland) as the ratio of 2:1 in the sinus floor elevation procedures. ADO procedures using $TRACK^{(R)}$ (KLS Martin Co., Germany) were also performed to augment vertical alveolar height in atrophied posterior maxilla (ADO group, 5 specimens in 4 patients). Newly generated bone tissues were obtained with the 2.0mm diameter trephine bur (3i Co., USA) during implant fixture installation after 5-7 months. Routine histolomorphological observation, immunodot blot assay for quantitative evaluation, and immunohistochemical staining with antibodies to MMP-1, -9, -10, TIMP-1, -2, and BMP-2, -4 were all carried out. Lamellar bone formation was well shown in all specimens and new bone formations of ADO group increased than those of other procedures. In immunohistochemical staining, the strong expression of BMP-2 was shown in all specimens, and immunodot blot assay showed that bone formation is accompanied by the good induction of factors associated with angiogenesis and appeared more increased amount of osteogenic and angiogenic factors in ADO group. ADO is the most effective technique for new bone formation compared to sinus floor elevation with autogenous or mixed bone graft in the atrophied posterior maxilla. In the quantitative immunodot blot assay, the regenerated bone after ADO showed more increased products of VEGF, BMP-2, PCNA and MMP-1 than those after the other procedures, and these findings were able to be confirmed by immunohistochemical stainings.

Maxillary Sinus Grafts for Endosseous Implant Placement: A Literature Review

  • Park, Seung-Byung;Kim, Su-Gwan;Baek, Sung-Moon;Ahn, Yu-Seok;Moon, Kyung-Nam;Jeon, Woo-Jin;Oh, Ji-Su;Lee, Jeong-Hoon;Im, Jae-Hyung;Yoo, Kyung-Hwan;Kim, Jin-Ha
    • Journal of Korean Dental Science
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    • v.3 no.1
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    • pp.25-31
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    • 2010
  • This study sought to evaluate the effect of the type of grafts used in sinus lifting. A review of literature through MEDLINE search covering the period 1980 ~ 2006 was performed. After screening, this study was narrowed down to 2,452 patients receiving sinus lift grafts wherein 7,151 implants were placed. In this study, the types of grafts used in sinus augmentation were autogenous bone, allogenic bone, corticocancellous block bone, and various alloplastic materials. The success rate varied from 69% to 100% depending on the graft material type. The highest success rate was reported for the autogenous bone, with high success rates recorded for the most part in most studies.

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Maxillary Sinus Augmentation Using Macroporous Biphasic Calcium Phosphate ($MBCP^{TM}$) : Three Case Report With Histologic Evaluation (합성골 이식재인 Macroporous biphasic calcium phosphate를 이용한 사람의 상악동 거상술-증례 보고)

  • Lee, Ji-Hyun;Jung, Ui-Won;Kim, Chang-Sung;Choi, Seong-Ho;Cho, Kyoo-Sung
    • Journal of Periodontal and Implant Science
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    • v.36 no.2
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    • pp.567-577
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    • 2006
  • Background Several bone grafting materials have been used in sinus augmentation procedures. Macroporous Biphasic Calcium Phosphate($MBCP^{TM}$) consists of the mixture of 60% HA and 40% ${\beta}-TCP$. Therefore, it can provide good scaffold for the new bone to grow owing to HA, in the other hand, it can have bioactivity for bone remodeling owing to ${\beta}-TCP$. The purpose of this study was to evaluate bone formation following maxillary sinus augmentation using $MBCP^{TM}$ by means of histologic analysis. Material and Method $MBCP^{TM}$ was placed as a primary bone substitute for maxillary sinus augmentation. Three patients were selected after evalaution of their medical dental examination. $MBCP^{TM}$ only, $MBCP^{TM}$ combined with Irradicated cancellous bone and $MBCP^{TM}$ combined with autogenous bone were used for each patient. After about eight months, bone biopsies were harvested for histologic evaluation and fixtures installed. Results Eight months after surgery we observed new vital bone surrounding $MBCP^{TM}$ particle and the amount of new bone was about 30% even though there were discrepancies between specimens. This case report documents that $MBCP^{TM}$ when used as a grafting material for sinus floor augmentation whether combined other bone graft material or not, may lead to the predictable results for dental implants on posterior maxillary area with insufficient vertical height for fixture installation.

STABILITY OF SIMULTANEOUS IMPLANTATION WITH AUTOGENOUS ILIAC BONE GRAFT IN THE SEVERELY ATROPHIC MAXILLA (심하게 흡수된 상악골에서 자가 장골 이식술과 동시에 시행한 임프란트 치료의 안정성에 대한 연구)

  • Byun, June-Ho;Park, Bong-Wook;Jeong, Hee-Chan;Kim, Jong-Ryoul
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.28 no.6
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    • pp.570-578
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    • 2006
  • A severely atrophic maxilla may disturb the proper implant placement. The various bone graft techniques are required for simultaneous or delayed implantation in the cases of atrophic alveolar ridges. We present 11 consecutive patients treated with simultaneous implantation using the autogenous inlay and/or onlay bone grafts from iliac crest to the floor of the maxillary sinus and the alveolar crest. In the cases of atrophic maxilla, a total 69 implants were simultaneously placed with autogenous iliac bone graft. 40 fixtures were inserted in the sinus floor simultaneously with subantral block bone graft, the other 29 fixtures were placed in the anterior or premolar areas with block or particulate bone graft. The vertical alveolar bone height was measured with Dental CT at the preoperation and 6 months postoperation. Moreover, the implant stability quotients (ISQ) were measured by $Osstell^{TM}$ during second implant surgery at 6 months later of first implantation. All implants were obtained successful osseointegration with the grafted bone. The mean vertical increases were 3.9mm in the anterior ridges and 12.8mm in the posterior ridges. During the second implant surgery, mean ISQ were 62.95 in the anterior ridge and 61.32 in the posterior ridge. We concluded that the simultaneous implantation with autogenous iliac bone graft were stable and available methods for severely atrophic maxilla.

THE EFFECTS OF UNDIFFERENTIATED MESENCHYMAL STEM CELLS ON SINUS BONE GRAFTING IN RABBIT (가토의 상악동 골이식술시 미분화 간엽 줄기세포의 골형성 효과)

  • Oh, Sung-Hwan;Choi, Young-Won;Kim, Bum-Soo;Yeo, In-Bum;Jo, Pil-Kwy
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.28 no.6
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    • pp.520-530
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    • 2006
  • Undifferentiated mesencymal stem cells(UMSCs) have been thought to be multipotent cells that can replicate as undifferentiated cells and that have the potential to differentiate into lineages of mesenchymal tissue including the bone, cartilage, fat, tendon, muscle, and marrow stroma. It can be used to sinus lifting, Guided bone regeneration, other bone graft in dental part. The purpose of this study is to evaluate the effect of mesencymal stem cells on sinus augmentation with autogenous bone, fibrin glue mixture in a rabbit model. 8 New Zealand white rabbits were divided randomly into 4 groups based on their time of sacrifice(1, 2, 4 and 8 weeks). First, undifferentiated mesenchymal stem cells were isolated from iliac crest marrow of rabbits and expanded in vitro. cell culture was performed in accordance with the technique described by Tsutsumi et al. In the present study, The animals were sacrificed at 1, 2, 4 and 8 weeks after transplantation, and the bone formation ability of each sides was evaluated clinically, radiologically, histologically and histomorphologically. According to the histological observations, Stem cell group showed integrated graft bone with host bone from sinus wall. At 2 and 4weeks, It showed active newly formed bone and neovascularization. At 8 weeks, lamella bone was observed in sinus graft material area. Radiologically, autobone with stem cell showed more radiopaque than autobone without stemcell. there were significant differences in bone volume between 2 and 4 weeks (p<0.05). In summary, the autobone with stem cells had well-formed, newly formed bone and neovasculization, compared with the autobone without stem cells (esp. 2 weeks and 4 weeks) The findings of this experimental study indicate that the use of a mixture of mesenchymal stem cell yielded good results in osteogenesis and bone volume comparable with that achieved by autogenous bone. Therefore, this application of this promising new sinus floor elevation method for implants with tissue engineering technology deserves further study.

A review of complications of maxillary sinus augmentation and available treatment methods

  • Kim, Joongmin;Jang, Hyonseok
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.45 no.4
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    • pp.220-224
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    • 2019
  • Maxillary sinus grafting is a dependable procedure that has been in use for a long time. However, clinical complications often arise. To prevent complications of maxillary sinus grafting, it is necessary to know the contra-indications, both for general implantation and for maxillary bone grafting. In addition, presence of various complications requires careful consideration of treatment method; therefore, dentists should be familiar with the treatment protocols. Complications can be divided into postoperative, immediate postoperative, and delayed postoperative complications. Particularly for the outpatient, it is necessary to quickly distinguish between treatable cases and cases for which transfer is required. The purpose of this review is to discuss the contra-indications, complications, and treatment options for complications of maxillary sinus graft.

The retrospective study of survival rate of implants with maxillary sinus floor elevation (상악동 거상술을 동반한 상악구치부에 식립된 임플란트 생존율에 대한 후향적 연구)

  • Kim, Beom-Jin;Lee, Jae-Hoon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.36 no.2
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    • pp.108-118
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    • 2010
  • Introduction: Maxillary posterior region, compared to the mandible or maxillary anterior region, has a thin cortical bone layer and is largely composed of cancellous bone, and therefore, it is often difficult to achieve primary stability. In such cases, sinus elevation with bone graft is necessary. Materials and Methods: In this research, 121 patients who had implant placement after bone graft were subjected to a follow-up study of 5 years from the moment of the initial surgery. The total survival rate, 5-year cumulative survival rate and the influence of the following factors on implant survival were evaluated; the condition of the patient (sex, age, general body condition), the site of implant placement, diameter and length of the implant, sinus elevation technique, closure method for osseous window, type of prosthesis and opposing teeth. Results: 1. The 5-year cumulative survival rate of total implants was 90.5%, there was no significant difference between sex, age, the site of implant placement, diameter and length of the implant, sinus elevation technique, and the type of opposing teeth. 2. Patients with diabetes mellitus < osteoporosis and smooth-surfaced machined group < hydroxyapatite (HA)-treated group and homogenous demineralized freeze dried allogenic bone (DFDB) bone graft only group had significantly lower survival rate. 3. With less than 4 mm of residual alveolar ridge height, lateral approach without closing the osseous window resulted in a significantly lower survival rate. 4. Restoration of a single implant showed a significantly lower survival rate, compared to cases where the superstructure was joined with several implants in the area. Conclusion: Patients with diabetes or osteoporosis need longer period of time for osseointegration compared to the normal, and the dentists must be prudent when choosing a surface treatment type and the bone graft material. Also, as the vertical dimension of the residual alveolar ridge can influence the result, staged implant placement should be considered when it seems difficult for the implant to gain primary stability from the residual bone with less than 4 mm of vertical dimension. It is recommended to obdurate the bone window and that the superstructure be connected with several impants in the peripheral area.

Sinusitis Managment Associated with Maxillary Sinus Augmentation: Case Report (상악동 증대술과 관련된 상악동염의 처치: 증례보고)

  • Hong, Su-Ryeon;Lee, Yong-Wuk;Yoon, Kyung-Sung;Choe, Ji-Hye;Ha, Ju-Hyo;Kim, In-Ho;Jung, Su-Jin;Lee, Hyun-Su;Yang, Soo-Nam
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.32 no.6
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    • pp.558-562
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    • 2010
  • Sinusitis has been reported as a complication of sinus lift surgery. Obstruction of the sinus outflow tract by mucosal edema and particulate graft material may result in sinusitis. Two main surgical procedures have been proposed for the treatment of associated infectious complications; inferior meatal antrostomy and functional endoscopic sinus surgery through transnasal approach. We performed superior lateral wall antrostomy through introral approach in patient suffering from the sinusitis after sinus floor augmentation and implant installation. This procedure permitted easier access to the maxillary sinus for treat sinusitis caused by sinus lifting.