Sinus Floor Augmentation

窦底增强
  • 文章类型: Journal Article
    自体牙本质基质(ADM),从病人拔下的牙齿中提取出来,可以在重建牙科中用作自体移植材料。提取的牙齿为ADM提供了来源,以其低拒绝率而著称,骨诱导能力和易于制备。因此,它提供了一个可行的替代自体骨。动物研究证实了其有效的骨诱导特性,虽然其临床应用包括提取后部位保存,上颌窦底增强术,并引导骨组织再生。然而,ADM应用于骨再生的长期疗效仍未得到充分开发,并且在制备过程中缺乏标准化。本文全面探讨了作文,骨诱导性的潜在机制,制备方法,和ADM的临床应用,目的是为该主题的未来研究建立基本参考。
    Autogenous dentin matrix (ADM), derived from a patient\'s extracted tooth, can be repurposed as an autologous grafting material in reconstructive dentistry. Extracted teeth provide a source for ADM, which distinguishes itself with its low rejection rate, osteoinductive capabilities and ease of preparation. Consequently, it presents a viable alternative to autogenous bone. Animal studies have substantiated its effective osteoinductive properties, while its clinical applications encompass post-extraction site preservation, maxillary sinus floor augmentation, and guided bone tissue regeneration. Nevertheless, the long-term efficacy of ADM applied in bone regeneration remains underexplored and there is a lack of standardization in the preparation processes. This paper comprehensively explores the composition, mechanisms underlying osteoinductivity, preparation methods, and clinical applications of ADM with the aim of establishing a fundamental reference for future studies on this subject.
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  • 文章类型: Journal Article
    这项系统综述和荟萃分析旨在提供详细的见解,以了解与骨增强同时放置的较短和较长的牙科植入物的临床表现。
    在MEDLINE(PubMed)上进行了文献搜索,ScienceDirect和Cochrane图书馆数据库,遵守特定的选择标准和系统审查和荟萃分析(PRISMA)指南的首选报告项目。只有2014年至2024年之间以英文发表的文章才被考虑用于数据收集。主要结果是生存率(SR),边缘骨丢失(MBL)和并发症。临床结果如下:探查出血(BOP),牙周袋深度(PPD),和植入物稳定性商(ISQ)。通过JoannaBriggs研究所开发的随机对照试验的关键评估清单工具评估偏倚评估的质量和风险。
    共筛选了14678篇文章,9符合纳入标准,并被用于本系统综述和荟萃分析。共有495名患者使用984个植入物(491个短植入物和493个较长植入物),短植入物的SR为93.91%,较长植入物的SR为91.83%。荟萃分析显示,同时放置牙槽骨增强的短植入物和长植入物与MBL之间存在统计学上的显着差异(-0.513mm,95%CI=-0.93至-0.096;P=0.02),和PPD(-0.247,95%CI=-0.515至0.022;P=0.07)。
    当比较短和更长的牙科植入物结合牙槽骨增强的治疗结果时,短植入物在存活率参数方面显示出更好的临床结果,边缘骨丢失和并发症。
    UNASSIGNED: This systematic review and meta-analysis aim to provide detailed insights into the clinical performance of short and longer dental implants placed simultaneously with bone augmentation.
    UNASSIGNED: The search for literature was performed across MEDLINE (PubMed), ScienceDirect and the Cochrane Library databases, adhering to specific selection criteria and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Only articles published in English between 2014 and 2024 were considered for data collection. Primary outcomes were survival rate (SR), marginal bone loss (MBL) and complications. Clinical outcomes were as follows: bleeding on probing (BOP), periodontal pocket depth (PPD), and implant stability quotient (ISQ). Quality and risk of bias assessment were evaluated by the Critical Appraisal Checklist tool for randomized controlled trials developed by the Joanna Briggs Institute.
    UNASSIGNED: A total of 14678 articles were screened, with 9 meeting the inclusion criteria and being utilized for this systematic review and meta-analysis. A total of 495 patients with 984 implants (491 short and 493 longer implants) showing a SR of 93.91% for the short implants and 91.83% for the longer implants. Meta-analysis revealed statistically significant difference between short implants and longer implants simultaneously placed with alveolar bone augmentation in relation to MBL (-0.513 mm, 95% CI = -0.93 to -0.096; P = 0.02), and in PPD (-0.247, 95% CI = -0.515 to 0.022; P = 0.07).
    UNASSIGNED: When comparing the results of treatment with short and longer dental implants combined with alveolar bone augmentation, short implants showed better clinical results regarding the parameters of survival rate, marginal bone loss and complications.
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  • 文章类型: Journal Article
    目的:鼻窦膜穿孔是隆窦手术的常见并发症。这篇综述旨在研究解剖因素,如隔膜的存在和侧壁厚度,是否会影响膜穿孔的风险。
    方法:本研究注册于PROSPERO(CRD42023488259)。PubMed,Embase,搜索了截至2024年6月26日发表的相关研究。感兴趣的结果是基于隔片和侧壁厚度的穿孔风险。使用二元数据进行随机效应荟萃分析,以使用ReviewManager获得穿孔的比值比(OR)。
    结果:纳入了10项研究,其中1865例患者接受了2168个“外侧”鼻窦提升手术。Schneiderian膜穿孔的总发生率为19%(405例)。有鼻窦隔片169/425例(39.76%),无隔片184/1492例(12.33%)存在Schneider膜穿孔。Meta分析显示,隔片与穿孔风险增加显著相关(OR:4.0395%CI:1.77,9.19),异质性高(I2=87%)。证据的确定性很低。关于侧壁厚度和穿孔风险的数据在荟萃分析中过于异质。研究报告了基于侧壁厚度的穿孔风险的混合结果。
    结论:我们的结果表明,质量很低的证据,在上颌窦提升手术中,隔膜的存在显着增加了穿孔的风险。关于鼻窦提升手术中侧壁厚度与穿孔风险之间的关联的证据是相互矛盾的,现阶段还不能得出明确的结论。
    OBJECTIVE: Sinus membrane perforation is a common complication of sinus lift surgery. This review aimed to examine if anatomical factors such as the presence of septa and lateral wall thickness influence the risk of membrane perforation.
    METHODS: This study was registered on PROSPERO (CRD42023488259). PubMed, Embase, and Web of Science were searched for relevant studies published up to 26th June 2024. The outcome of interest was the risk of perforation based on presence of septa and lateral wall thickness. Random-effects meta-analysis was conducted with dichotomous data to obtain the odds ratio (OR) of perforation using Review Manager.
    RESULTS: Ten studies with 1865 patients undergoing 2168 \"lateral\" sinus lift procedures were included. The total incidence of Schneiderian membrane perforations was 19% (405 cases). Schneiderian membrane perforation was present in 169/425 cases (39.76%) with sinus septa and 184/1492 cases (12.33%) without septa. Meta-analysis showed that septa were significantly associated with an increased risk of perforation (OR: 4.03 95% CI: 1.77, 9.19) with high heterogeneity (I2 = 87%). The certainty of the evidence was very low. Data on lateral wall thickness and risk of perforation was too heterogeneous for a meta-analysis. Studies reported mixed results on the risk of perforation based on lateral wall thickness.
    CONCLUSIONS: Our results show, with very low-quality evidence, that the presence of septa significantly increases the risk of perforations during maxillary sinus lift surgery. Evidence on the association between lateral wall thickness and a risk of perforations during sinus lift surgery is conflicting, and no clear conclusions can be derived at this stage.
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  • 文章类型: Journal Article
    这项系统评价和荟萃分析评估了在经胰窦抬起过程中或之后插入植入物的临床结果。研究方案在PROSPERO(CRD42024504513)上前瞻性注册。PubMed,WebofScience,Embase,和Scopus数据库在2024年2月21日之前进行了检索,并纳入了使用经颌窦解除的随机临床试验.进行了定性和定量综合。使用随机效应模型来汇集使用手骨器而不进行移植的经骨窦提升器放置的植入物的存活率,以及荟萃回归和亚组分析。漏斗图和Egger线性回归用于探索可能的发表偏倚。小于0.05的概率被认为是显著的。最初搜索后,总共确定了1807条记录。纳入了17项研究,其中10项考虑进行荟萃分析。研究使用手骨器,压电和手骨器的组合,钻头,和鼻窦抬高的智能升降机。只有使用手骨器的研究报告了患者随后的眩晕和头晕。荟萃分析显示,使用手骨切开术进行移植和非移植的经颌骨窦提升均具有100%(95%CI:99%至100%)的存活率。Meta回归显示,随访时间对植入物的生存率没有显著影响。亚组分析显示,骨水平和组织水平植入物与一阶段或两阶段植入物之间没有显着差异。考虑到这项研究的局限性,可以得出结论,闭合性上颌窦抬高可以被认为是一种相对安全的技术,具有较高的生存率。然而,由于窦壁穿孔和报告患者眩晕的发生率较高,因此使用手骨凿时应谨慎。
    This systematic review and meta-analysis assesses the clinical outcomes of implants inserted during or following transcrestal sinus lifts. The study protocol was prospectively registered on PROSPERO (CRD42024504513). PubMed, Web of Science, Embase, and Scopus databases were searched up to 21 February 2024, and randomised clinical trials utilising transcrestal sinus lifts were included. Qualitative and quantitative syntheses were conducted. A random effects model was used to pool the survival rate of implants placed with transcrestal sinus lifts using hand osteotomes without grafting, along with meta-regression and subgroup analyses. Funnel plots and Egger\'s linear regression were used to explore possible publication bias. Probabilities of less than 0.05 were considered significant. A total of 1807 records were identified after the initial search. Seventeen studies were included with 10 of them considered for meta-analysis. Studies used hand osteotomes, a combination of piezoelectric and hand osteotomes, drills, and smart lifts for sinus elevation. Only studies that used hand osteotomes reported subsequent vertigo and dizziness in patients. The meta-analysis showed a 100% (95% CI: 99% to 100%) survival rate for both grafted and non-grafted transcrestal sinus lifts using hand osteotomes. Meta-regression showed that follow-up time did not significantly affect the implants\' survival. Subgroup analyses showed no significant difference between bone-level and tissue-level implants and one-stage or two-stage implants. On considering the limitations of this study it can be concluded that closed maxillary sinus elevation can be considered a relatively safe technique that is associated with a high survival rate. However, caution should be taken when using hand osteotomes because of a higher rate of sinus lining perforation and reported patient vertigo.
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  • 文章类型: Journal Article
    背景:上颌窦提升术是一种有据可查且公认的后上颌骨康复技术。施耐德膜穿孔是最常见的并发症,可能发生在7%至56%的病例中。已经描述了不同的材料和技术来实现穿孔的修复。这项研究的目的是确定与未穿孔的情况相比,上颌窦提升手术中施耐德膜的穿孔及其修复是否会导致较低的植入物存活率。材料和方法:对评估使用外侧窗方法放置在再生窦中的植入物的存活率的研究进行系统回顾和荟萃分析,施耐德膜穿孔发生的地方,进行了。使用开放式荟萃分析师进行统计分析,计算置入穿孔鼻窦和非穿孔鼻窦的植入物的比值比。结果:共纳入10篇文献进行定性分析,7篇文献进行定量分析或荟萃分析。共进行了1224例上颌窦增强手术,未发生Schneiderian膜穿孔,并放置了2725个植入物;随访期间有62个植入物失败,总生存率为97.7%。在480个穿孔鼻窦中,放置了1044个植入物,其中30例失败;总生存率为97.1%。两组种植体生存率差异无统计学意义(OR=0.78;CI=0.49-2.23;p=0.28,I2异质性:0%,p=0.44)。结论:Schneiderian膜穿孔,只要修好了,似乎不会对植入物的存活率产生负面影响。膜穿孔不应被视为中止手术的原因或植入物放置的绝对禁忌症。
    Background: Maxillary sinus lift is a well-documented and accepted technique in the rehabilitation of the posterior maxilla. Schneiderian membrane perforation is the most common complication and may occur in between 7% and 56% of cases. Different materials and techniques have been described to achieve reparation of the perforation. The aim of this study was to establish whether the perforation of the Schneiderian membrane and its repair during maxillary sinus lift surgery results in a lower implant survival rate compared to those cases where the membrane has not been perforated. Materials and methods: A systematic review and meta-analysis of studies assessing the survival rate of implants placed in regenerated sinus using the lateral window approach, where the perforation of the Schneiderian membrane occur, was carried out. Statistical analysis was performed with Open Meta-Analyst, calculating the odds ratio of implants placed in perforated sinuses and non-perforated sinuses. Results: Ten articles were included in the qualitative analysis and seven articles in the quantitative analysis or meta-analysis. A total of 1224 maxillary sinus augmentation surgeries were performed without perforation of the Schneiderian membrane and 2725 implants were placed; 62 implants failed during the follow-up period with an overall survival rate of 97.7%. In 480 perforated sinuses, 1044 implants were placed, of which 30 failed; the overall survival rate was 97.1%. There were no significant differences between the implant survival rate of the implants in the two groups (OR = 0.78; CI = 0.49-2.23; p = 0.28 and I2 heterogeneity: 0%, p = 0.44). Conclusions: Schneiderian membrane perforation, as long as it is repaired, does not appear to negatively influence implant survival rate. Membrane perforation should not be considered a reason to abort the procedure or an absolute contraindication to implant placement.
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  • 文章类型: Journal Article
    背景:我们回顾了文献,以检查窦膜的厚度是否是侧窦提升术中穿孔的危险因素。
    方法:我们搜索了Embase,PubMed,和WebofScience数据库,直到2023年12月4日,用于研究不同窦膜厚度的穿孔风险。还包括报告穿孔和非穿孔病例的窦膜厚度的研究。
    结果:11项研究合格。所有研究均使用锥形束计算机断层扫描来测量窦膜厚度。荟萃分析表明,与非穿孔病例相比,穿孔病例的窦膜厚度显着降低(MD:-0.9195%CI:-1.48,-0.33I2=94%)。四项研究使用2mm作为界限来定义厚和薄的窦膜。汇总分析未能证明穿孔率存在显着差异(OR:0.9795%CI:0.44,2.17I2=56%)。使用1.5mm(OR:0.6695%CI:0.29,1.48I2=72%)和1mm截止值(OR:0.9395%CI:0.34,2.56)的研究的荟萃分析也显示出类似的无意义结果。
    结论:我们的研究表明,与没有穿孔的患者相比,有穿孔的患者的窦膜明显更薄。然而,一项基于不同膜厚度截止值的荟萃分析未能证明较薄的窦膜与较高的穿孔风险之间存在关系.需要进一步研究检查窦膜厚度对穿孔率的作用。
    BACKGROUND: We reviewed the literature to examine if the thickness of the sinus membrane is a risk factor for perforation during lateral sinus lift surgery.
    METHODS: We searched Embase, PubMed, and Web of Science databases till 4th December 2023 for studies examining the risk of perforation with different sinus membrane thicknesses. Studies reporting sinus membrane thickness in perforation and non-perforation cases were also included.
    RESULTS: Eleven studies were eligible. All studies used cone beam computed tomography for measuring sinus membrane thickness. Meta-analysis showed that sinus membrane thickness was significantly lower in perforation cases as compared to non-perforation cases (MD: -0.91 95% CI: -1.48, -0.33 I2=94%). Four studies used 2mm as the cut-off to define thick and thin sinus membranes. Pooled analysis failed to demonstrate any significant difference in perforation rates (OR: 0.97 95% CI: 0.44, 2.17 I2=56%). Meta-analysis of studies using 1.5mm (OR: 0.66 95% CI: 0.29, 1.48 I2=72%) and 1mm cut-off (OR: 0.93 95% CI: 0.34, 2.56) also demonstrated similar non-significant results.
    CONCLUSIONS: Our study shows that the sinus membrane is significantly thinner in cases with perforations as compared to those with no perforations. However, a meta-analysis based on different membrane thickness cut-offs failed to demonstrate a relationship between thinner sinus membranes and a higher risk of perforation. There is a need for further studies examining the role of sinus membrane thickness on perforation rates.
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  • 文章类型: Journal Article
    目的:本系统综述的目的是评估与植入物周围新骨形成相关的组织学和影像学结果,与鼻窦增大同时插入,比较不同类型的移植物。
    方法:系统审查是在系统审查和荟萃分析(PRISMA)的首选报告项目之后进行的,和《科克伦干预措施系统审查手册》。LILACS/BVS,Medline/PubMed,Cochrane图书馆和Embase数据库,包括灰色文献和人工调查,进行了搜索,以确定报告植入物周围骨形成的人体组织学和影像学数据的临床试验,在抬高和增加手术的同一时刻插入上颌窦,使用几种材料。研究选择,偏见风险(Rob2.0或ROBINSI),证据质量(等级),数据收集由两名独立评审员进行.
    结果:在1101篇可能符合条件的文章中,44人被找回,12项被评估为合格性,5项被纳入本系统评价(4项随机和1项对照临床试验)。因此,103例患者的130个移植鼻窦和179个安装植入物,年龄在24至79岁之间,随访6至15个月,进行了分析。研究之间的异质性不允许将数据进行荟萃分析。所有移植材料都被证明是干预的可行选择。BCP的使用与更高的骨与植入物接触有关。
    结论:所有评估的移植物都是所解决的干预措施的可行选择。某些材料的使用是合理的,以保持窦体积,并允许在窦膜下植入物的顶端部位形成骨。选择自体骨时,应考虑更长的椅子时间和供体部位的发病率。由于当与DBB相比时%BIC的较高值,因此可以选择合成双相材料用于这种干预。
    OBJECTIVE: To assess histologic and imaging outcomes related to new bone formation around implants, inserted simultaneously with sinus augmentation, and compare different types of grafts.
    METHODS: This systematic review (SR) was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and the Cochrane Handbook for Systematic Reviews of Interventions. LILACS/BVS, MEDLINE/PubMed, Cochrane Library, and Embase databases, including gray literature and manual investigations, were searched to identify clinical trials reporting specific requirements. The present study needed human histologic and imaging data of bone formation around implants inserted into the maxillary sinus simultaneously with elevation and augmentation procedures. Study selection, risk of bias (Rob 2.0 or ROBINS-I), quality of evidence (GRADE), and data collection were performed by two independent reviewers.
    RESULTS: Of the 1,101 potentially eligible articles, 44 were retrieved, 12 were assessed for eligibility, and 5 were included (4 randomized and 1 controlled clinical trial). As a result, 130 grafted sinuses with 179 placed implants in 103 patients were analyzed. The patients were aged between 24 and 79 years and followed up between 6 and 15 months. The heterogeneity between studies did not allow the data to be combined for meta-analysis. All graft materials proved to be viable options for the intervention. The use of biphasic calcium phosphate was related to higher bone-to-implant contact.
    CONCLUSIONS: All of the assessed grafts are viable options for the addressed intervention. The use of some material is justified to maintain the sinus volume and allow bone formation in the apical implant site under the sinus membrane. Longer chair time and donor site morbidity should be considered when choosing autogenous bone. Synthetic biphasic materials can be selected for this intervention due to superior bone-to-implant contact compared to deproteinized bovine bone.
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  • DOI:
    文章类型: English Abstract
    目的:分析基于椎间盘上窦铰刀(DSR)的内窦底抬高植入后10年植入物周围的骨重建,并探讨不同因素对植入物固位的影响。
    方法:从口腔种植科收集基于DSR的窦底抬高同时植入的患者的临床和影像学资料,青岛大学附属医院2008年1月至2011年12月。采用全景胶片和CBCT测量不同时期种植体周围骨量的变化。采用Kaplan-Meier和Log-rank检验,利用SPSS26.0软件包分析不同因素对种植体固位的影响。
    结果:该研究包括98名患者,总共128个植入物。在0-168个月的随访中,7个植入物失败,剩下的形成了良好的骨整合和功能,10年累计留存率为94.53%。75个植入部位的骨形成高度在顶部为(0.29±0.15)mm,在鼻窦为(2.74±0.66)mm,术后十年获得了完整的影像学数据。Kaplan-Meier和Log-rank检验显示,包括初始骨高度在内的8个因素,骨高度升高,粘膜穿孔,植入物长度,植入物扭转,糖尿病,吸烟和牙周炎对种植体固位有显著影响。
    结论:基于DSR的内窦底抬高结合植入是治疗上颌骨后区垂直骨缺损的一种可靠、稳定的增骨手术。10年累计留存率不低于94%。初始骨高度,骨高度升高,粘膜穿孔,植入物长度,植入物扭转,糖尿病,吸烟和牙周炎是影响种植体长期保留率的重要因素。
    OBJECTIVE: To analyze the bone remodeling around the implant 10 years after disk-up sinus reamer(DSR)-based internal sinus floor elevation with implantation and to investigate the influence of different factors on implant retention.
    METHODS: The clinical and imaging data of patients undergoing DSR-based sinus floor elevation with simultaneous implantation were collected from the Department of Dental Implantology, Affiliated Hospital of Qingdao University from January 2008 to December 2011. Panoramic film and CBCT were used to measure the changes of bone mass around implant in different periods. Kaplan-Meier and Log-rank tests were used to analyze the effects of different factors on implant retention with SPSS 26.0 software package.
    RESULTS: The study included 98 patients with a total of 128 implants. During the follow-up of 0-168 months, 7 implants failed, and the remaining formed good osseointegration and functioned, with a 10-year cumulative retention rate of 94.53%. The height of bone formation was (0.29±0.15) mm at the top and (2.74±0.66) mm in the sinus of 75 implant sites with complete imaging data obtained ten years after surgery. Kaplan-Meier and Log-rank tests showed that 8 factors including initial bone height, elevated bone height, mucosal perforation, implant length, implant torsion, diabetes, smoking and periodontitis had significant effects on implant retention.
    CONCLUSIONS: The DSR-based internal sinus floor elevation with implantation is a reliable and stable bone augmentation operation for vertical bone defect in maxillary posterior region, with a 10-year cumulative retention rate of no less than 94%. Initial bone height, elevated bone height, mucosal perforation, implant length, implant torsion, diabetes, smoking and periodontitis are the important factors affecting the long-term retention rate of implants.
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  • 文章类型: Systematic Review
    背景和目的:本系统评价的目的是评估使用同种异体移植物进行鼻窦提升的效率。材料和方法:本系统评价是根据系统评价和荟萃分析的首选报告项目(PRISMA)指南和Cochrane干预措施系统评价手册的建议编写的。三个电子数据库进行了筛选,直到2023年10月。根据加强流行病学观察性研究报告(STROBE)指南评估偏倚风险。对中位骨体积和植入物存活率进行统计学分析。结果:从检索到的321篇文章中,这篇综述包括7篇文章。冻干同种异体骨(FDBA)和脱蛋白牛骨(DBB)之间的平均骨体积比较表明加权平均差(WMD)为-0.17[-0.69,0.36](95%置信区间(CI)),p=0.53。对于植入物的存活率,在FDBA和自体骨之间进行比较,表明风险比(RR)为1.00[0.96,1.05](95%CI),p=1.00。结论:现有证据表明,同种异体骨可用于鼻窦提升手术。获得的结果不足以与其他类型的植骨进行比较,需要更长的随访时间。为了评估使用同种异体骨的优势,需要未来的临床试验。
    Background and Objectives: The aim of this systematic review was to assess the efficiency of using allografts for sinus lift. Materials and Methods: This systematic review was written under the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and recommendation of the Cochrane Handbook for Systematic Reviews of Interventions. Three electronic databases were screened until October 2023. The risk of bias was assessed according to the Strengthening the Reporting of Observational studies in Epidemiology (STROBE) guidelines. Statistical analysis was performed for median bone volume and implant survival rate. Results: From 321 articles retrieved, 7 articles were included in this review. A comparison between freeze-dried bone allograft (FDBA) and deproteinized bovine bone (DBB) for mean bone volume indicated a weighted mean difference (WMD) of -0.17 [-0.69, 0.36] (95% confidence interval (CI)), p = 0.53. For implant survival rate, a comparison was made between FDBA and autogenous bone indicating a risk ratio (RR) of 1.00 [0.96, 1.05] (95% CI), p = 1.00. Conclusions: The available evidence suggested that allograft bone can be used in sinus lift procedures. The results obtained are insufficient to compare with other types of bone graft, requiring a longer follow-up time. Future clinical trials are needed in order to evaluate the advantages of using allograft bone.
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  • 文章类型: Journal Article
    在美容区更换缺失或无望的牙齿是牙科最关键的挑战之一。在过去,需要多种外科手术来重建受损的提取部位。手术与长愈合时间和发病率增加有关,所有患者都在使用固定或可移动的临时修复体。本文确定的程序将外科手术时间降至最低,愈合时间,以及通过在一次访问中结合多个外科手术来获得最终修复的延迟。程序是技术敏感的。该特定患者术后1年随访临床照片和CBCT扫描。取得了优异的临床效果。还确定了程序的好处和局限性。
    Replacement of missing or hopeless teeth in the esthetic zone is one of dentistry\'s most critical challenges. In the past, multiple surgical procedures have been needed to reconstruct compromised extraction sites. The surgeries have been associated with long healing times and increased morbidity, all the while patients are using either fixed or removable interim restorations. The procedures identified in this paper minimize surgical operating times, healing times, and delays in obtaining definitive restorations by combining multiple surgical procedures in one visit. The procedures are technique sensitive. This particular patient has been followed for 1 year post-operatively with clinical photographs and CBCT scans. Excellent clinical results were obtained. Benefits and limitations of the procedures have also been identified.
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