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Zhang W, Chen H, Zhao K, Gu X. Three-dimensional changes and influencing factors of tent space following osteotome sinus floor elevation without grafting: A 48-month retrospective radiographic study. Clin Oral Implants Res 2024; 35:1251-1261. [PMID: 38873850 DOI: 10.1111/clr.14312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 05/15/2024] [Accepted: 05/23/2024] [Indexed: 06/15/2024]
Abstract
OBJECTIVES To analyze the three-dimensional stability and morphologic changes of tent space after the osteotome sinus floor elevation (OSFE) procedures without bone grafts. MATERIALS AND METHODS Forty-six implants placed using the OSFE technique with simultaneous implant placement without bone grafts were included in this retrospective study. Cone-beam computed tomography (CBCT) scans of the augmented sinuses were obtained pre- and postoperatively up to 48 months of follow-up. The maxillary sinus cavity profiles were outlined using three-dimensional virtual reconstruction and superimposition of CBCT scans. The three-dimensional changes in the tent space were measured. A generalized estimating equation (GEE) was used to explore potential factors. RESULTS The implant survival rate was 97.8%. The mean volume of remaining tent space immediately after surgery was 96.8 ± 70.5 mm3, shrinking to 31.0 ± 24.9 mm3 after 48 months, while the mean percentage of remaining tent space volume decreased to 29.1 ± 20.7%. The tent space volume and the percentage of residual tent space volume only decreased significantly within 12 months after surgery (p = .008, .013). GEE results indicated positive correlations between the percentage of remaining tent space volume and implant protrusion length (p = .000) and apical height (p = .000), with a negative correlation between the sinus floor area immediately after surgery (p = .002) and the healing time (p = .022). CONCLUSIONS The volume of the tent space rapidly shrank after OSFE without bone grafts. Several factors might influence the tent space stability. Long-term clinical trials with larger sample sizes are necessary to further validate the results.
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Affiliation(s)
- Wen Zhang
- Department of Stomatology, Quzhou Hospital of Traditional Chinese Medicine, Quzhou, Zhejiang Province, China
| | - Haida Chen
- Department of Stomatology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Ke Zhao
- Department of Stomatology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Xinhua Gu
- Department of Stomatology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
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Liu M, Wang S, Chen H, Liu Y. A pilot study of a deep learning approach to detect marginal bone loss around implants. BMC Oral Health 2022; 22:11. [PMID: 35034611 PMCID: PMC8762847 DOI: 10.1186/s12903-021-02035-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 12/28/2021] [Indexed: 01/17/2023] Open
Abstract
Background Recently, there has been considerable innovation in artificial intelligence (AI) for healthcare. Convolutional neural networks (CNNs) show excellent object detection and classification performance. This study assessed the accuracy of an artificial intelligence (AI) application for the detection of marginal bone loss on periapical radiographs. Methods A Faster region-based convolutional neural network (R-CNN) was trained. Overall, 1670 periapical radiographic images were divided into training (n = 1370), validation (n = 150), and test (n = 150) datasets. The system was evaluated in terms of sensitivity, specificity, the mistake diagnostic rate, the omission diagnostic rate, and the positive predictive value. Kappa (κ) statistics were compared between the system and dental clinicians. Results Evaluation metrics of AI system is equal to resident dentist. The agreement between the AI system and expert is moderate to substantial (κ = 0.547 and 0.568 for bone loss sites and bone loss implants, respectively) for detecting marginal bone loss around dental implants. Conclusions This AI system based on Faster R-CNN analysis of periapical radiographs is a highly promising auxiliary diagnostic tool for peri-implant bone loss detection.
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Affiliation(s)
- Min Liu
- Department of Prosthodontics, Peking University School and Hospital of Stomatology and National Engineering Laboratory for Digital and Material Technology of Stomatology and Research Center of Engineering and Technology for Digital Dentistry of Ministry of Health and Beijing Key Laboratory of Digital Stomatology and National Clinical Research Center for Oral Diseases, 22 ZhongguancunNandajie, Haidian District, Beijing, 100081, China
| | - Shimin Wang
- Department of Prosthodontics, Peking University School and Hospital of Stomatology and National Engineering Laboratory for Digital and Material Technology of Stomatology and Research Center of Engineering and Technology for Digital Dentistry of Ministry of Health and Beijing Key Laboratory of Digital Stomatology and National Clinical Research Center for Oral Diseases, 22 ZhongguancunNandajie, Haidian District, Beijing, 100081, China
| | - Hu Chen
- Department of Prosthodontics, Peking University School and Hospital of Stomatology and National Engineering Laboratory for Digital and Material Technology of Stomatology and Research Center of Engineering and Technology for Digital Dentistry of Ministry of Health and Beijing Key Laboratory of Digital Stomatology and National Clinical Research Center for Oral Diseases, 22 ZhongguancunNandajie, Haidian District, Beijing, 100081, China.
| | - Yunsong Liu
- Department of Prosthodontics, Peking University School and Hospital of Stomatology and National Engineering Laboratory for Digital and Material Technology of Stomatology and Research Center of Engineering and Technology for Digital Dentistry of Ministry of Health and Beijing Key Laboratory of Digital Stomatology and National Clinical Research Center for Oral Diseases, 22 ZhongguancunNandajie, Haidian District, Beijing, 100081, China.
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3
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Peri-implant tissue conditions following transcrestal and lateral sinus floor elevation: 3-year results of a bi-center, randomized trial. Clin Oral Investig 2022; 26:3975-3986. [PMID: 35013782 PMCID: PMC9072487 DOI: 10.1007/s00784-021-04364-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 12/29/2021] [Indexed: 11/24/2022]
Abstract
Objectives The present study was performed to comparatively evaluate the peri-implant bone stability and conditions of marginal tissues at 3 years following transcrestal and lateral sinus floor elevation (tSFE and lSFE, respectively). Materials and methods Patients included in a parallel-arm randomized trial comparatively evaluating tSFE and lSFE were recalled at 3 years post-surgery. Twenty-one and 24 patients in tSFE and lSFE groups, respectively, participated in the follow-up visit. Peri-implant bone support was evaluated as the proportion of the entire implant surface in direct contact with the radiopaque area (totCON%) on 3-year periapical radiographs. The conditions of the marginal peri-implant tissues at 3-year visit were classified as peri-implant health, peri-implant mucositis, or peri-implantitis. Results At 3 years, both groups showed an implant survival rate of 100%. Median totCON% was stable at 3 years, being 100% in both groups (p = 0.124). Peri-implant health and mucositis were diagnosed in 10 (47.6%) and 11 (52.4%) patients, respectively, in the tSFE group, and in 8 (33.3%) and 16 (66.7%) subjects, respectively, in the lSFE group (p = 0.502). Conclusions At 3 years following surgery, implants placed concomitantly with tSFE and lSFE fully maintain peri-implant bone support. Peri-implant mucositis was the most prevalent condition, with a similar prevalence between groups. Clinical relevance. Based on 3-year data on peri-implant bone support and prevalence of peri-implant diseases, the study suggests that tSFE and lSFE represent two equally valid options for the rehabilitation of the posterior maxilla. ClinicalTrials.gov ID: NCT02415946.
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Lin ZZ, Xu DQ, Ye ZY, Wang GG, Ding X. Two-stage transcrestal sinus floor elevation-insight into replantation: Six case reports. World J Clin Cases 2021; 9:2386-2393. [PMID: 33869618 PMCID: PMC8026825 DOI: 10.12998/wjcc.v9.i10.2386] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 01/21/2021] [Accepted: 02/01/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Transcrestal sinus floor elevation (TSFE) has been widely used in the oral clinic when the residual bone height (RBH) exceeds 5 mm. However, when there is insufficient RBH in the posterior maxilla, two-stage TSFE may be an option.
CASE SUMMARY This article introduces the concept of two-stage TSFE. Six patients had osseointegration failure after TSFE. For the first-stage surgery, we restricted the vertical bone augmentation as much as possible. At the second-stage surgery, the increased RBH was 3.28 ± 1.55 mm, which was beneficial for surgery. Five implants functioned successfully on schedule, but one implant failed again during the healing period. A third surgery was performed, and the implant functioned successfully.
CONCLUSION When RBH was less than 5 mm, two or more procedures of TSFE might result in a higher RBH.
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Affiliation(s)
- Zhe-Zhen Lin
- Department of Stomatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
| | - Dong-Qian Xu
- Department of Stomatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
| | - Zhang-Yan Ye
- Department of Stomatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
| | - Ge-Ge Wang
- Department of Stomatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
| | - Xi Ding
- Department of Stomatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
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Andrés-García R, Ríos-Santos JV, Herrero-Climent M, Bullón P, Fernández-Farhall J, Gómez-Menchero A, Fernández-Palacín A, Ríos-Carrasco B. Sinus Floor Elevation via an Osteotome Technique without Biomaterials. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031103. [PMID: 33513756 PMCID: PMC7908564 DOI: 10.3390/ijerph18031103] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 01/20/2021] [Accepted: 01/24/2021] [Indexed: 11/16/2022]
Abstract
According to classic Hirschfeld studies, the first teeth to be lost are the first and second maxillary molars. After the teeth are extracted and the alveolar process is developed, the maxillary sinus is reabsorbed and pneumatized with a decrease in bone availability in the posterior sector of the maxilla. This process often creates the need to perform regeneration techniques for the placement of implants in this area due to the low availability of bone. The most frequently used and documented technique for the elevation of the sinus maxillary floor is elevation by the side window, as proposed by Tatum. In 1994, Summers proposed a technique that allowed the elevation of the sinus floor from a crestal access using an instrument called an osteotome, as well as the placement of the implant in the same surgical act. The aimed of the study was to evaluate the survival of 32 implants placed in posterior maxilla with bone availability less than 5 mm performing a sinus lift augmentation technique with osteotome without biomaterials. The results of this study show a survival rate of 100% for 32 implants placed in situations with an initial bone availability of 2 to 5 mm without the use of graft material. The infra-drilling technique used offers an increase in the primary stability of implants that allows adequate osteointegration Implants placed were charged at 12 weeks. In all cases, spontaneous bone formation was observed, even in cases where a positive Valsalva maneuver was observed. This proposed technique reduces treatment time and the need for more invasive maxillary sinus augmentation techniques.
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Affiliation(s)
- Rodrigo Andrés-García
- Department of Surgery, Faculty of Medicine, University of Salamanca, 37007 Salamanca, Spain;
| | - José Vicente Ríos-Santos
- Department of Periodontology, School of Dentistry, Universidad de Sevilla, 41009 Sevilla, Spain; (P.B.); (A.G.-M.); (B.R.-C.)
- Correspondence: ; Tel.: +34-954-481-121; Fax: +34-954-481-157
| | | | - Pedro Bullón
- Department of Periodontology, School of Dentistry, Universidad de Sevilla, 41009 Sevilla, Spain; (P.B.); (A.G.-M.); (B.R.-C.)
| | | | - Alberto Gómez-Menchero
- Department of Periodontology, School of Dentistry, Universidad de Sevilla, 41009 Sevilla, Spain; (P.B.); (A.G.-M.); (B.R.-C.)
| | - Ana Fernández-Palacín
- Department of Social and Health Sciences, Universidad de Sevilla, 41009 Sevilla, Spain;
| | - Blanca Ríos-Carrasco
- Department of Periodontology, School of Dentistry, Universidad de Sevilla, 41009 Sevilla, Spain; (P.B.); (A.G.-M.); (B.R.-C.)
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Shi JY, Qian SJ, Gu YX, Qiao SC, Tonetti MS, Lai HC. Long-term outcomes of osteotome sinus floor elevation without grafting in severely atrophic maxilla: A 10-year prospective study. J Clin Periodontol 2020; 47:1528-1535. [PMID: 32929768 DOI: 10.1111/jcpe.13365] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 08/27/2020] [Accepted: 09/04/2020] [Indexed: 12/30/2022]
Abstract
OBJECTIVE The aim of the present study was to report 10-year results of osteotome sinus floor elevation (OSFE) without grafting severely atrophic maxilla (residual bone height ≤4 mm). MATERIALS AND METHODS Patients undergoing OSFE without grafting and implant placement were included for 10-year examinations. Implant survival, complication-free survival, modified bleeding index (mBI), modified plaque index (mPI), pocket probing depth (PPD), peri-implant marginal bone loss (MBL), endo-sinus bone gain (ESBG) and mean cost of recurrence were evaluated. RESULTS Overall, 23 patients with 35 implants attended 10-year examination. Cemented implant crowns or implant-supported fixed dental prostheses were delivered to the patients. Kaplan-Meier implant survival was 89.2% at implant level and 84.1% at patient level. Complication-free survival was 26.0% at patient level and 37.0% at implant level. The average complication-free survival time was 74.6 months (95% CI: 63.2-86.0 months) at implant level and 69.1 months (95% CI: 54.8-83.4 months) at patient level. The mBI, mPI, PPD, MBL and ESBG at 10-year follow-up were 0.91 ± 0.58, 0.48 ± 0.51, 2.94 ± 0.79 mm, 1.63 ± 0.83 mm and 2.72 ± 0.51 mm, respectively. The cost of managing recurrence was 43.6% of the initial cost of treatment. CONCLUSION The results of the present study indicate that OSFE without grafting is a reliable treatment option in severely atrophic maxilla. Acceptable survival rate, stable MBL and ESBG could be achieved within 10 years. Low complication-free survival and high costs of recurrence management need to be considered.
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Affiliation(s)
- Jun-Yu Shi
- Department of Oral and Maxillo-facial Implantology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.,European Research Group on Periodontology, Berne, Switzerland
| | - Shu-Jiao Qian
- Department of Oral and Maxillo-facial Implantology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.,European Research Group on Periodontology, Berne, Switzerland
| | - Ying-Xin Gu
- Department of Oral and Maxillo-facial Implantology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.,European Research Group on Periodontology, Berne, Switzerland
| | - Shi-Chong Qiao
- Department of Oral and Maxillo-facial Implantology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.,European Research Group on Periodontology, Berne, Switzerland
| | - Maurizio S Tonetti
- Department of Oral and Maxillo-facial Implantology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.,European Research Group on Periodontology, Berne, Switzerland
| | - Hong-Chang Lai
- Department of Oral and Maxillo-facial Implantology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.,European Research Group on Periodontology, Berne, Switzerland
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Franceschetti G, Farina R, Minenna L, Riccardi O, Stacchi C, Di Raimondo R, Maietti E, Trombelli L. The impact of graft remodeling on peri-implant bone support at implants placed concomitantly with transcrestal sinus floor elevation: A multicenter, retrospective case series. Clin Oral Implants Res 2019; 31:105-120. [PMID: 31532857 DOI: 10.1111/clr.13541] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 08/08/2019] [Accepted: 09/03/2019] [Indexed: 12/16/2022]
Abstract
OBJECTIVES To evaluate the impact on peri-implant bone support (as assessed on periapical radiographs) of the remodeling dynamics of varying graft biomaterials used for transcrestal sinus floor elevation (tSFE). METHODS The study is a multicenter, retrospective series of cases undergone tSFE (performed according to the Smart Lift technique) and concomitant implant placement. At operator's discretion, tSFE was performed with bone core (BC) alone or supplemented by deproteinized bovine or porcine bone mineral (DBBM and DPBM, respectively), synthetic hydroxyapatite in a collagen matrix (S-HA), or ß-tricalcium phosphate (ß-TCP). Immediately after surgery, at 6-12 months post-surgery, and at later (≥24 months) follow-up intervals, the percentage proportion of the implant surface in direct contact with the radiopaque area was calculated for the entire implant surface (totCON%). Also, the height of the graft apical to the implant apex (aGH) was assessed. RESULTS At 6-12 months following tSFE, median totCON% was 100%, with a median aGH of 1.4 mm. A tendency of aGH to decrease in height was observed at later follow-up intervals for sites treated with all grafting procedures. In all treatment groups, the majority of the implant surface was still surrounded by the radiopaque area at the longest follow-up visits. CONCLUSIONS Although the height of the peri-implant radiopaque area apical to the implant apex tends to reduce overtime at sites which have received tSFE, the peri-implant bone support seems to be maintained long term irrespective of the graft material used.
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Affiliation(s)
- Giovanni Franceschetti
- Research Centre for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Ferrara, Italy
| | - Roberto Farina
- Research Centre for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Ferrara, Italy.,Operative Unit of Dentistry, University-Hospital of Ferrara, Ferrara, Italy
| | - Luigi Minenna
- Research Centre for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Ferrara, Italy
| | - Orio Riccardi
- Research Centre for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Ferrara, Italy.,Private practice, Rimini, Italy
| | | | | | - Elisa Maietti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy.,Center of Clinical Epidemiology, University of Ferrara, Italy
| | - Leonardo Trombelli
- Research Centre for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Ferrara, Italy.,Operative Unit of Dentistry, University-Hospital of Ferrara, Ferrara, Italy
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