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Radiological findings in the post sinus-lift maxillary sinus: A C.T. follow-up
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025C - Maxillofacial reconstruction
4. Radiological Findings in the Post Sinus-Lift Maxillary Sinus: A C.T. Follow-Up
Gavriel, (2.1, Peleg, M. 1, Mazor, Z. 1, Bakoon, M. 2, Taicher, S. 1 Department of Oral and Maxillofacial Surgery, 1 Department of Diagnostic Imaging, 2The Chaim Sheba Medical Center, Tel Hashomer, Israel
The purpose of this presentation is to describe the pre and postoperative radiological findings of a short term (8 months) CT follow up, in 21 patients (24 sinuses) undergoing sinus elevation procedures, with simultaneous implant (57) placement. In 28 implants (50%) all aspects were completely covered with bone. In 20 implants bone fully covered the implants and extended beyond the apex range. In 9 implants there was lack of full bone coverage. All the implants support a fixed ceramo-metal prosthesis and no implant failure was recorded up to the end of this study (3 y followup). In 8 sinuses cortication of the buccal window was completed. In the rest of the sinuses bone consolidation on the buccal aspect was evident without cortication. All the sinuses healed without complications and without any clinical signs of sinusitis. The highest values of membrane thickness were recorded for different areas. In 13 sinuses, no changes in membrane sinus thickness were noted, in 11 sinuses membrane thickness decreased postoperatively in one case there was membrane thickening. It can be concluded: 1. CT scan follow up of patients following sinus lift procedures is highly recommended. 2. Bone consolidation at 8 months postoperatively occurs predictably in all three dimensions. 3. Lack of bone coverage over minimal apical implant areas does not hamper the final result. 4. Membrane thickness does not increase following sinus lift procedures.
5. The Use of Lyodura for Bone Augmentation of Osseous Defects Around Dental Implants
Peleg, M., Chaushu, G., Taicher, S.
Department of Oral and Maxillofacial Surgery, The Chaim Sheba Medical Center, Tel Hashomer, Israel
The purpose of this paper is to describe the use of lyodura as a resorbable barrier in order to promote bone formation in osseous defects around dental implants. The study group consisted of 22 patients. The mean age was 32. A total of 44 (27 maxilla, 17 mandible) implants were placed. In extraction sites (27) the bony vertical defects were measured on the buccal, lingual, mesial and distal sites of the implant. In cases of either immediate or late implan-
tation (17), when a dehiscence was apparent, its vertical length from the alveolar crest was measured. All bony defects were grafted with autogenous bone graft harvested from the tuberosity. Each site was covered with lyodura. All the measurements were redone at exposure (3-6 month after stage I surgery). Healing was uneventful and no soft tissue dehiscence, inflammation or infection was noticed. New bone formation completely filling the defect was observed in all the extraction sites and 76% of the dehiscence defects. In the remaining dehiscence sites a mean vertical bone gain of 2.5 mm was obtained. The mean vertical bone gain was 2.6 mm in extraction sites and 2.79 mm in dehiscence sites. Our clinical experience with the lyodura has shown that its mechanical properties (thickness and memory) maintain a secluded space without collapse and a well defined constant shape of the alveolus beneath the membrane, throughout the entire healing period. It can be concluded that lyodura can be used safely and efficiently for GBR in extraction sites and dehiscence defects.
6. Wide Diameter Implants: A Prospective Three Year In-Function Follow-up Study
Zosky, J. Toronto, Ontario, Canada
Theoretically, a wide-bodied dental implant would have better load bearing capabilities than the standard 3.75 mm diameter implant. This would be especially true of the posterior maxilla and mandible where the volume of bone is greater to accept the wider implant and where the loading forces are greater daring mastication. This is a prospective three year in-function follow-up study on five and six millimeter diameter implants. Steri-Oss | (Yorba Linda, California) threaded, hydroxylapatite-coated and titanium plasma spray-coated implants placed in the posterior maxilla and mandible were used. Prosthetic applications were either single tooth restorations or abutment support for fixed partial dentures. There was specific inclusion and exclusion criteria. There were specific diagnostic aids used in pre-surgical planning. Evaluation centered on achieving osseointegration and maintaining osseointegration in function. Crestal bone levels and soft tissue health indices were evaluated along with integrity of the final prosthesis and patient satisfaction. 192 (99 mandibular and 93 maxillary) consecutively placed implants were evaluated in 126 patients. There was one implant failure. There was an average of less than 1.5 mm of crestal bone loss after two years in-function. Soft tissue health remained excellent except in one patient who was a heavy smoker and noncompliant in his oral hygiene (smokers were not excluded in this study although they were encouraged to stop). This prospective study would indicate wide-bodied implants are very effective in posterior ridges when the available bone quantity allows for their insertion. A controlled, randomized, comparative study would be desirable in further studies.
025C - Maxillofacial reconstruction
4. Radiological Findings in the Post Sinus-Lift Maxillary Sinus: A C.T. Follow-Up
Gavriel, (2.1, Peleg, M. 1, Mazor, Z. 1, Bakoon, M. 2, Taicher, S. 1 Department of Oral and Maxillofacial Surgery, 1 Department of Diagnostic Imaging, 2The Chaim Sheba Medical Center, Tel Hashomer, Israel
The purpose of this presentation is to describe the pre and postoperative radiological findings of a short term (8 months) CT follow up, in 21 patients (24 sinuses) undergoing sinus elevation procedures, with simultaneous implant (57) placement. In 28 implants (50%) all aspects were completely covered with bone. In 20 implants bone fully covered the implants and extended beyond the apex range. In 9 implants there was lack of full bone coverage. All the implants support a fixed ceramo-metal prosthesis and no implant failure was recorded up to the end of this study (3 y followup). In 8 sinuses cortication of the buccal window was completed. In the rest of the sinuses bone consolidation on the buccal aspect was evident without cortication. All the sinuses healed without complications and without any clinical signs of sinusitis. The highest values of membrane thickness were recorded for different areas. In 13 sinuses, no changes in membrane sinus thickness were noted, in 11 sinuses membrane thickness decreased postoperatively in one case there was membrane thickening. It can be concluded: 1. CT scan follow up of patients following sinus lift procedures is highly recommended. 2. Bone consolidation at 8 months postoperatively occurs predictably in all three dimensions. 3. Lack of bone coverage over minimal apical implant areas does not hamper the final result. 4. Membrane thickness does not increase following sinus lift procedures.
5. The Use of Lyodura for Bone Augmentation of Osseous Defects Around Dental Implants
Peleg, M., Chaushu, G., Taicher, S.
Department of Oral and Maxillofacial Surgery, The Chaim Sheba Medical Center, Tel Hashomer, Israel
The purpose of this paper is to describe the use of lyodura as a resorbable barrier in order to promote bone formation in osseous defects around dental implants. The study group consisted of 22 patients. The mean age was 32. A total of 44 (27 maxilla, 17 mandible) implants were placed. In extraction sites (27) the bony vertical defects were measured on the buccal, lingual, mesial and distal sites of the implant. In cases of either immediate or late implan-
tation (17), when a dehiscence was apparent, its vertical length from the alveolar crest was measured. All bony defects were grafted with autogenous bone graft harvested from the tuberosity. Each site was covered with lyodura. All the measurements were redone at exposure (3-6 month after stage I surgery). Healing was uneventful and no soft tissue dehiscence, inflammation or infection was noticed. New bone formation completely filling the defect was observed in all the extraction sites and 76% of the dehiscence defects. In the remaining dehiscence sites a mean vertical bone gain of 2.5 mm was obtained. The mean vertical bone gain was 2.6 mm in extraction sites and 2.79 mm in dehiscence sites. Our clinical experience with the lyodura has shown that its mechanical properties (thickness and memory) maintain a secluded space without collapse and a well defined constant shape of the alveolus beneath the membrane, throughout the entire healing period. It can be concluded that lyodura can be used safely and efficiently for GBR in extraction sites and dehiscence defects.
6. Wide Diameter Implants: A Prospective Three Year In-Function Follow-up Study
Zosky, J. Toronto, Ontario, Canada
Theoretically, a wide-bodied dental implant would have better load bearing capabilities than the standard 3.75 mm diameter implant. This would be especially true of the posterior maxilla and mandible where the volume of bone is greater to accept the wider implant and where the loading forces are greater daring mastication. This is a prospective three year in-function follow-up study on five and six millimeter diameter implants. Steri-Oss | (Yorba Linda, California) threaded, hydroxylapatite-coated and titanium plasma spray-coated implants placed in the posterior maxilla and mandible were used. Prosthetic applications were either single tooth restorations or abutment support for fixed partial dentures. There was specific inclusion and exclusion criteria. There were specific diagnostic aids used in pre-surgical planning. Evaluation centered on achieving osseointegration and maintaining osseointegration in function. Crestal bone levels and soft tissue health indices were evaluated along with integrity of the final prosthesis and patient satisfaction. 192 (99 mandibular and 93 maxillary) consecutively placed implants were evaluated in 126 patients. There was one implant failure. There was an average of less than 1.5 mm of crestal bone loss after two years in-function. Soft tissue health remained excellent except in one patient who was a heavy smoker and noncompliant in his oral hygiene (smokers were not excluded in this study although they were encouraged to stop). This prospective study would indicate wide-bodied implants are very effective in posterior ridges when the available bone quantity allows for their insertion. A controlled, randomized, comparative study would be desirable in further studies.