• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제35권5호
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• pp.346-352
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• 2009

There have been reports of successful bone formation with sinus floor elevation by simply elevating the maxillary sinus membrane and filling the sinus cavity below the lifted sinus membrane with a blood clot. But, in a review of the current literature, we found no animal study that substantiated blood clot's ability in this respect. The aim of this study was to investigate the effect of the method of maxillary sinus floor augmentation using the patient's own venous blood in conjunction with a sinus membrane elevation procedure. An implant was placed bilaterally in the maxillary sinus of six adult mongrel dogs so that it protruded 8 mm into the maxillary sinus after sinus membrane elevation. On one side of the maxillary sinus, the resultant space between the membrane and the sinus floor was filled with autologous venous blood retrieved from the dog. On the opposite side, the maxillary sinus was left untreated as a control. The implants were left in place for six months. The mean height of the newly formed bone in the sinus was 3.7 mm on the side without venous blood and 3.5 mm on the side with venous blood (p>0.05). There was no difference between the two sides regarding new bone height in the sinus. Our results indicate that filling the space between the lifted sinus membrane and the sinus floor with venous blood has no effect on bone formation around implants placed in the maxillary sinus cavity.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제29권3호
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• pp.241-249
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• 2007

An augmentation of the maxillary sinus floor facilitates placement of dental implants in the posterior atrophic maxilla. However, a maxillary sinus augmentation has potential complications that can lead to early failure and loss of the bone graft. One specific complication is sinus membrane perforation. Especially, large perforations may cause loss of the graft materials into the sinus and infection, so, early failure of the sinus lift. Attempts at managing sinus membrane perforations are difficult because of the limited access to them and friability of the thin Schneiderian membrane. Repair of sinus membrane perforations intraoperatively may be performed using a variety of techniques and materials, including sutures, collagen membranes, fibrin glue. Inspite of various repair technique, as has been reported extensively in the literature, large perforations represent an absolute contraindication to the continuation of surgery. But, we obtained clinically favorable results in cases that show repair of the perforated sinus membrane with a micro-suture technique by 4X Loupe ($Surgitel^{(R)}$ Loupe, General Scientific Corporation) in large perforation. The objective of this presentation is to report of several cases of repair of the perforated sinus membrane with micro-suture technique using 7.0 or 8.0 suture materials, to make a brief review of the literature about various technique managing perforated sinus membrane.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제47권6호
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• pp.411-426
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• 2021

Combining different procedures to reduce the number of surgical sessions and patient discomfort in implant placement and sinus floor elevation has been recommended, and evidence supports good outcomes. The aim of this study was to review the results of clinical studies on sinus floor elevation through extraction sockets and simultaneous immediate posterior implant placement. An electronic search was carried out in PubMed, Scopus, and Web of Science to find English articles published in or before August 2020. A manual search was also performed. Titles, abstracts, and the full-text of the retrieved articles were studied. Thirteen studies met our eligibility criteria: 6 retrospective case series, 3 case reports, 2 prospective cohort case-series, 1 prospective case series, and 1 randomized controlled trial. Overall, 306 implants were placed; 2 studies reported implant survival rates of 91.7% and 98.57%. The others either did not report the survival rate or reported 100% survival. Sinus floor elevation through a fresh extraction socket and simultaneous immediate implant placement appears to be a predictable modality with a high success rate. However, proper case selection and the expertise of the clinician play fundamental roles in the success of such complex procedures.

• Journal of Korean Dental Science
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• 제3권1호
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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.

• Journal of Periodontal and Implant Science
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• 제49권4호
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• pp.237-247
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• 2019

Purpose: To analyze the maxillary sinus anatomy over edentulous ridges in the bilateral posterior maxillary area in Taiwanese patients using cone-beam computed tomography (CBCT). Methods: In total, 101 anatomical sites from 61 patients, including 32 premolar and 69 molar regions, were analyzed using CBCT. Measurements were made of the width and height of edentulous ridges, the thickness of the lateral wall of the maxillary sinus, and the presence of a sinus septum and the posterior superior alveolar artery (PSAA). A statistical analysis of the measurements was performed, and correlations among the measurements were assessed. Results: The average ridge width was $10.26{\pm}3.16mm$, with a significantly greater ridge width in the second molar region than in the premolar region. The mean residual ridge height was $8.55{\pm}4.09mm$, and ridge height showed an opposite trend from ridge width for the premolar and molar regions. A sinus septum was present at 5.9% of the sites, and the PSAA was observed in 24.5%. The average thickness of the lateral wall of the maxillary sinus was $2.08{\pm}0.94mm$, with no significant difference between the tooth position and lateral wall thickness. Conclusions: This study presents the anatomical features of the maxillary sinus, which should be considered in sinus lift procedures for implant placement, in the Taiwanese population. The use of CBCT is recommended to avoid intraoperative complications.

• Journal of Periodontal and Implant Science
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• 제40권6호
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• pp.271-275
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• 2010

Purpose: Many techniques have been described for achieving vertical augmentation of the maxillary sinus. The aim of this study is to evaluate the effect of low-intensity pulsed ultrasound (LIPUS) to enhance bone regeneration after sinus floor elevation. Methods: The sinus lifting technique was performed through a lateral approach on 8 different sites of 5 patients (3 males and 2 females) and their mean age was 45.7 years old. The sites were randomly assigned to the control or test groups. The control group had 4 sites that received lateral sinus lifting procedure only, while the test group had 4 sites that received LIPUS application after the lateral sinus lifting procedure. 24-32 weeks (an average of 29 weeks) postoperatively, new bone formation in the augmented sinus sites was evaluated through histologic and histomorphometric analyses of the biopsy specimens obtained during implant placement. Results: In the test group, the mean percentage of newly formed bone was $19.0{\pm}2.8$%. In the control group, the mean percentage of newly formed bone was $15.2{\pm}3.1$%. The percentage of newly formed bone was approximately 4% higher in those cases where the sinus was treated by LIPUS than the percentage in those cases where it was not used. The difference was statistically significant. Conclusions: Within the scope of this study, low-intensity pulsed ultrasound application after sinus lifting appeared to have a significant effect on the development of new bone formation.

• Imaging Science in Dentistry
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• 제50권2호
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• pp.93-98
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• 2020

Purpose: Little is known regarding the accuracy of clinical magnetic resonance imaging (MRI) protocols with acceptable scan times in sinus graft assessment. The aim of this study was to evaluate the correlations between MRI and cone-beam computed tomographic (CBCT) measurements of maxillary sinus grafts using 2 different clinical MRI imaging protocols. Materials and Methods: A total of 15 patients who underwent unilateral sinus lift surgery with biphasic calcium phosphate were included in this study. CBCT, T1-weighted MRI, and T2-weighted MRI scans were taken 6 months after sinus lift surgery. Linear measurements of the maximum height and buccolingual width in coronal images, as well as the maximum anteroposterior depth in sagittal images, were performed by 2 trained observers using CBCT and MRI Digital Imaging and Communication in Medicine files. Micro-computed tomography (micro-CT) was also performed to confirm the presence of bone tissue in the grafted area. Correlations between MRI and CBCT measurements were assessed with the Pearson test. Results: Significant correlations between CBCT and MRI were found for sinus graft height (T1-weighted, r=0.711 and P<0.05; T2-weighted, r=0.713 and P<0.05), buccolingual width (T1-weighted, r=0.892 and P<0.05; T2-weighted, r=0.956 and P<0.05), and anteroposterior depth (T1-weighted, r=0.731 and P<0.05; T2-weighted, r=0.873 and P<0.05). The presence of bone tissue in the grafted areas was confirmed via micro-CT. Conclusion: Both MRI pulse sequences tested can be used for sinus graft measurements, as strong correlations with CBCT were found. However, correlations between T2-weighted MRI and CBCT were slightly higher than those between T1-weighted MRI and CBCT.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제35권6호
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• pp.442-450
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• 2009

Purpose: Simultaneous implantation has been traditionally limited to patients with at least 5 mm of residual bone to ensure that the implant is completely stabilized. This is considered to be one of the most critical factors for primary implant stability and parallelism and, subsequently osseointegration. Recently, improved initial implant stability is provided by advancement of surgical techniques, implant designs and surface treatments. This has led surgeons to extending simultaneous treatment option to patients with below 4 mm of residual bone height, despite the lack of much data. The purpose of this study was to retrospectively evaluate and compare the status of implants which are installed by delayed and simultaneous methods. Material and methods: The subjects were patients(121 patients, 278 implants) who had been operated with sinus lifting from 2003 to 2007 in Sun Dental Hospital. Lateral window approach with autograft and xenograft(1:1 ratio) were carried out for all sinus lifting. 4 types of implant were used. The mean follow up period was 26.3 months(19 - 58 months) in delayed group, and 22.8 months(18 - 43 months) in simultaneous group. Results: The survival rate of implant restoration of this study was 98.2% in delayed group and 91.7% in simultaneous group. In simultaneous group, wide-platform type implants showed 100% survival rate. The total average of marginal bone loss in radiographs was $0.96\;{\pm}\;0.29\;mm$ in delayed group and $1.02\;{\pm}\;0.31\;mm$ in simultaneous group. Conclusion: Simultaneous implantation with sinus lifting(below 4mm of residual bone height) could be predictable treatment.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제33권3호
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• pp.281-285
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• 2011

Sinus floor elevation is a predictable and standard procedure for the treatment of the posterior maxilla before insertion of dental implants. Although overall complication rates are low, complications can occur including sinus membrane perforation, infection of sinus, swelling and hemorrhage. The most common complication is membrane perforation. Recently, various techniques and materials for repair of perforation to the sinus membrane have been proposed. The purpose of this article is to report on various techniques and materials that can be used for repair of perforations to the sinus membrane. The search protocol used was the following electronic database: Pubmed, with a time limit from 1998 to 2009. The key words such as 'sinus lift', 'sinus augmentation', 'sinus floor elevation', 'sinus graft', 'sinus perforation', 'repair of sinus perforation' and 'repair of sinus membrane' were used, alone and in combination, when searching the database. Various techniques have been proposed to manage of perforation of sinus membranes. These include that the use of collagen membranes, demineralized freeze-dried human lamellar bone sheets, processed human allografts, lamella bone, buccal fat pads and suturing. Implant success rate ranges from 69.9% to 98.9%.

• Journal of Mechanical Science and Technology
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• 제18권8호
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• pp.1435-1450
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• 2004

Experimental data are presented which describe the effects of a combustor-level high free-stream turbulence on the near-wall flow structure and heat/mass transfer on the endwall of a linear high-turning turbine rotor cascade. The end wall flow structure is visualized by employing the partial- and total-coverage oil-film technique, and heat/mass transfer rate is measured by the naphthalene sublimation method. A turbulence generator is designed to provide a highly-turbulent flow which has free-stream turbulence intensity and integral length scale of 14.7% and 80mm, respectively, at the cascade entrance. The surface flow visualizations show that the high free-stream turbulence has little effect on the attachment line, but alters the separation line noticeably. Under high free-stream turbulence, the incoming near-wall flow upstream of the adjacent separation lines collides more obliquely with the suction surface. A weaker lift-up force arising from this more oblique collision results in the narrower suction-side corner vortex area in the high turbulence case. The high free-stream turbulence enhances the heat/mass transfer in the central area of the turbine passage, but only a slight augmentation is found in the end wall regions adjacent to the leading and trailing edges. Therefore, the high free-stream turbulence makes the end wall heat load more uniform. It is also observed that the heat/mass transfers along the locus of the pressure-side leg of the leading-edge horseshoe vortex and along the suction-side corner are influenced most strongly by the high free-stream turbulence. In this study, the end wall surface is classified into seven different regions based on the local heat/mass transfer distribution, and the effects of the high free-stream turbulence on the local heat/mass transfer in each region are discussed in detail.