OBJECTIVES: The purpose of this study was to evaluate the sinus bone graft resorption over 3 years after two-stage implant placement. MATERIALS AND METHODS: The subjects for this study included 30 patients whose maxillary posterior ridges were too atrophic for implants. Bone-added osteotome sinus floor elevation was used in 15 maxillary sinuses, while the bone graft by lateral approach technique was used in 25 maxillary sinuses. The height from the top of the fixture to the sinus floor was estimated immediately after implant placement and the follow-up period was over 3 years. The surgery was classified with two groups: sinus bone grafting with and without autogenous bone. All implants were placed simultaneously. RESULTS: The mean vertical bone loss was 3.15+/-2.95 mm. The survival rate of implants was 94.7%. CONCLUSION: The amount of bone resorption was not significantly associated with the surgical methods, the type of bone graft materials used, or sinus perforation during surgery.
Bone Resorption ; Bone Transplantation ; Dental Implants ; Follow-Up Studies ; Humans ; Maxillary Sinus* ; Sinus Floor Augmentation ; Survival Rate ; Transplants*

PURPOSE: Previous clinical investigations of sinus floor augmentation have demonstrated repneumatization of grafted sinus. The aim of this study is to evaluate and compare the height changes of sinus floor after grafting with deprotenized bovine bone mineral (DBBM) and beta tricalcium phosphate (TCP). MATERIALS AND METHODS: 34 sinuses in 28 patients were augmented with 100% DBBM or 100% TCP through lateral approaches. Sinusgraft height was measured before, immediately after, and 6 months after bone graft with panoramic radiography. RESULT: After 6 months, the decreases of graft heights were 14.53% for DBBM group and 15.15% for TCP group. There was no statistically significant difference. DISCUSSION AND CONCLUSION: Long-term stability of sinus-graft height represents an important factor for implant success. After the uses of DBBM and TCP for maxillary sinus floor augmentations, acceptable graft height maintenances were observed.
Bone Transplantation ; Calcium Phosphates ; Dental Implants ; Floors and Floorcoverings ; Humans ; Maxillary Sinus ; Radiography, Panoramic ; Retrospective Studies ; Sinus Floor Augmentation ; Transplants

OBJECTIVE: To investigate the change of endo-sinus bone height and bone volume in osteotome sinus floor elevation (OSFE) without bone graft but placing implants simultaneously by using cone beam computed tomography (CBCT) and three dimensional analysis, and to find the impacting factors on endo-sinus bone augmentation. METHODS: OSFE was performed in 38 edentulous patients with missing teeth at posterior maxillary region, and 44 implants were placed and referred for OSFE using no graft materials. CBCT was performed pre-surgery and 9－68 months post-surgery when the patients encountered another implant surgery. The gained bone height at mesial, distal, buccal and palatal sites around the implant in sinus were measured, volumetric measurements of the endo-sinus gained bone volume (ESGBV) in the elevated region were calculated by Mimics software. Univariate analysis and multiple linear regression were performed to investigate the impacting factors on the gained bone height and ESGBV. Marginal bone loss was recorded according to the periapical radiography after implant restoration. RESULTS: The mean residual bone height (RBH) pre-surgery was (3.41±1.23) mm, the mean protruded length (PL) into sinus of implant post-surgery was (3.41±1.28) mm, the mean endo-sinus gained bone height was (2.44±1.23) mm at distal sites, (2.88±1.20) mm at mesial sites, (2.83±1.22) mm at buccal sites and (2.96±1.16) mm at palatal sites, the mean endo-sinus gained bone height at distal sites was significantly lower than the other three sites (P < 0.05). The average endo-sinus gained bone height was (2.78±1.13) mm. The mean ESGBV was (122.15± 73.27) mm³. Univariate analysis showed the more RBH, the less bone height gained in sinus, which existed at buccal, lingual, mesial and distal sites (P < 0.001), and the more RBH, the smaller ESGBV gained (P=0.012). The ESGBV was significantly higher in the subjects whose bone generation period was more than 24 months than those whose bone generation period less than 24 months (P=0.034). The more PL, the more bone height and ESGBV gained (P=0.008). Multivariate analysis showed after adjusting factors of gender, age, smoking, width of sinus floor, thickness of sinus membrane pre-surgery, diameter and length of the implant, PL and bone generation period was positively correlated with mean endo-sinus gained bone height and ESGBV, while RBH negatively correlated with mean endo-sinus gained bone height. During the follow-up, the mean marginal bone loss was 0 (0－1.41) mm and all the implants loaded successfully. CONCLUSION OSFE without bone graft but with placed implant simultaneously can increase endo-sinus gained bone height and ESGBV. RBH, PL and bone generation period are the significant factors impacting endo-sinus bone augmentation.
Bone Transplantation ; Dental Implantation, Endosseous ; Dental Implants ; Humans ; Maxilla/surgery* ; Osteotomy ; Radiography ; Sinus Floor Augmentation ; Treatment Outcome

OBJECTIVETo introduce and evaluate the procedure and the effect of maxillary sinus lift with closed technique by Summers osteotome, bone grafting and simultaneous implant placement.

METHODS66 cases with severely resorbed alveolar bone in maxillary posterior region received sinus lift with Summers osteotome, simultaneously bone grafting and implants placement. The final restoration was finished at 6 months postoperatively.

RESULTSThe operation procedure were eventless in the 66 cases, the sinus floor were elevated by 2-5 mm, three-dimensional reconstruction of the CT scan pictures showed the smooth dome profile of the lifting sites and no signs of laceration on the membrane, and there were no maxillary antritis after operation. After 6 months, no significantly bone graft resorption and good osseointegration were noticed in X-ray imaging. The final restoration was finished at this time. 12-24 months after the restoration, all implants inserted were remain, the hard and soft tissue were healthy, prosthesis were stable and functioned. X-ray showed good osseointegration in the lifting sites, the vertical resorption around the implants were less than 1 mm.

CONCLUSIONWith properly use of Summers osteotome, scraps of the bone in the implant sockets can be pushed into the sinus, these autogenous bone scraps were in favor of the osseogenesis and the sinus floor can be easily elevated by the method with very infrequent complications. It enlarged indication of dental implants and avoided operation of harvesting autogenous bone in other site. The method is simple and valuable to clinical application.

Adult ; Alveolar Bone Loss ; Bone Transplantation ; Dental Implantation, Endosseous ; Dental Implants ; Humans ; Male ; Maxilla ; Maxillary Sinus ; Middle Aged ; Osseointegration ; Osteotomy ; Sinus Floor Augmentation

PURPOSE: This retrospective study compares the amount of bone resorption around implants between an autogenous tooth bone graft (AutoBT) and a synthetic bone graft after a bone-added crestally approached sinus lift with simultaneous implant placements. METHODS: In all, 37 patients participated in this study. Seventeen patients were grouped as group I and underwent an AutoBT-added sinus lift using the crestal approach. The remaining 20 patients were grouped as group II and underwent synthetic bone grafting. Both groups received the implant placements simultaneously. Of the 37 participating patients, only 22 patients were included in the final results: Eleven patients of group I and 11 patients of group II. Before the surgery, the distance from the alveolar crest to the sinus floor was measured using panoramic radiography. After the surgery, the distance was measured again from the neck of the implant thread to the most superior border of the added graft materials. Then, the amount of sinus lift was calculated by comparing the two panoramic radiographs. After a year, a panoramic radiograph was taken to calculate the resorption of the bone graft material from the radiograph that was taken after the surgery. The significance of the resorption amount between the two types of graft materials was statistically analyzed. RESULTS: The bone height was increased to an average of 4.89 mm in group I and 6.22 mm in group II. The analysis of panoramic radiographs 1 year after the surgery showed an average bone resorption of 0.76 mm and 0.53 mm, respectively. However, the degree of lifting (P=0.460) and the amount of bone-grafted material resorption (P=0.570) showed no statistically significant difference. CONCLUSIONS: Based on this limited study, AutoBT can be considered a good alternative bone graft to a synthetic bone graft in a bone-added sinus lift, when extraction is necessary prior to the surgery.
Bone Resorption* ; Bone Substitutes ; Bone Transplantation ; Dental Implants ; Humans ; Lifting* ; Neck ; Osseointegration ; Radiography, Panoramic ; Retrospective Studies* ; Sinus Floor Augmentation ; Tooth* ; Transplants*

OBJECTIVETo evaluate the effect of maxillary sinus elevation with gene-enhanced tissue engineering bone in dogs.

METHODSbone marrow stromal cells (BMSC) derived from dog marrow were cultured, and transduced with the adenovirus carrying bone morphogenetic protein-2 (BMP-2) gene (AdBMP-2), the adenovirus carrying green fluorescent protein (GFP) gene (AdGFP) in vitro. The bone formation ability of gene modified BMSC with scaffold was examined in nude mice and in elevated maxillary sinus of dog. Student's t-test was used for statistical analysis with SPSS 11.0 software package.

RESULTSGene transfection efficiency reached up to (83.95 ± 2.43)% as demonstrated by GFP expression. Ectopic bone formation was detected in nude mice. As for maxillary sinus floor elevation in a dog model, new bone formation area in the AdBMP-2 gene transduced BMSC with Bio-Oss group was significantly higher than in BMSC with Bio-Oss group at 120 d (P < 0.05).

CONCLUSIONSAdBMP-2 gene transduced BMSC can stimulate ectopic bone formation in nude mice, and promote bone formation and maturation in the dog maxillary sinus.

Adenoviridae ; genetics ; Animals ; Bone Matrix ; transplantation ; Bone Morphogenetic Protein 2 ; genetics ; metabolism ; Bone Transplantation ; methods ; Cells, Cultured ; Dogs ; Male ; Mesenchymal Stromal Cells ; cytology ; metabolism ; Mice ; Mice, Nude ; Minerals ; Osteogenesis ; Recombinant Proteins ; genetics ; metabolism ; Sinus Floor Augmentation ; methods ; Tissue Engineering ; methods ; Transfection

A method of transpedicular bone grafting using contrast impregnated bone to improve the visualization of bone graft on the image intensifier is reported. A - 36-year old man who had sustained traumatic burst fracture of T12 vertebra, with Load-Sharing Classification (LSC) score of 8, was treated with posterior short segment fusion from T11 to L1 with transpedicular bone graft of T12 vertebra. We were able to correct the kyphotic end plate angle (EPA) from 19º to 1.4º. Anterior bone graft augmentation was achieved with contrast enhaced transpedicular bone grafts. At six months follow up, CT scan showed good bony integration of the anterior column with EPA of 4.5º and two years later, radiographs showed EPA of 7.6 º.
Bone Transplantation

Bone graft is essential in various orthopaedic procedures. Among the many donor sites for harvesting autologous bone graft, the iliac crest has been the most commonly used. However, for foot and ankle procedures the proximal tibia has gained popularity as an alternative donor site due to its anatomic proximity to the primary surgical site. In this article we evaluated the possible complications associated with harvesting proximal tibia bone graft. Our study showed the low incidence of morbidity in harvesting proximal tibia bone graft, thereby providing a good alternative donor for foot and ankle procedures.
Bone Transplantation

OBJECTIVETo evaluate the long-term clinical outcome of delayed implant placements after maxillary sinus floor augmentation with autologous bone or Bio-Oss grafting.

METHODSEighteen patients underwent maxillary sinus floor augmentation and delayed implant placements from January, 2002 to December, 2008. Bone grafting and sinus floor augmentation were performed in 21 sides of maxilla and 46 implants were placed 6 - 8 months later. Residual bone height was less than 4 mm. The cases were divided to 2 groups and different materials (autologous bone + Bio-Oss and Bio-Oss alone) were grafted relatively. The bone resorption was assessed by panoramic X-ray and the stability of the implant was reviewed postoperatively.

RESULTSThe average follow-up time was 54 months. Only one implant was lost and the implant survival rate was 98%. X-ray showed that the bone resorption was observed in both groups. The absorption ratio of autologous bone + Bio-Oss group was 18.65% and that of the Bio-oss group was 1.93%. The difference was significantly different.

CONCLUSIONSThe result of maxillary sinus floor augmentation with bone grafting was predictable. More bone absorption occurred in the Bio-Oss than in autologous bone + Bio-Oss.

Adult ; Bone Substitutes ; therapeutic use ; Bone Transplantation ; methods ; Collagen ; therapeutic use ; Dental Implantation, Endosseous ; methods ; Female ; Follow-Up Studies ; Humans ; Jaw, Edentulous, Partially ; diagnostic imaging ; surgery ; Male ; Maxilla ; diagnostic imaging ; Middle Aged ; Minerals ; therapeutic use ; Radiography, Panoramic ; Sinus Floor Augmentation ; methods ; Young Adult

Grafting jawbone for the patient partical operating a section of bone is really essential. It is for restoring the function and esthetic for the patient. 2. The best material for grafting is natural bone auto graft which are taken from ribs or innomiate bone, because they are the same as jawbone. 3. Grafting bone is needed to follow closely clean system. 4. A treatment and nutrition are effected on result of surgery. 5. After 6 months, we can make denture on the grafter jawbone area
amelogen ; Bone and Bones ; Transplantation ; therapeutics ; Bone Transplantation