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  • 1
    ISSN: 1434-3940
    Keywords: Keywords Endosseous implant ; Maxilla ; Bone grafting ; Sinus augmentation ; Oral rehabilitation ; Schlüsselwörter Enossales Implantat ; Oberkiefer ; Knochentransplantat ; Kieferhöhlenbodenaugmentation ; Orale Rehabilitation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Die Verankerung enossaler Implantate in den atrophierten Oberkiefer ist oft durch das Fehlen von unterstützendem Knochen begrenzt. Eine neue zuverlässige Behandlungsmethode scheint die Augmentation des Kieferhöhlenbodens mit autologen Knochentransplantaten zu sein. An 75 Patienten wurden nach Augmentation des Oberkieferhöhlenbodens die Morbidität und die Komplikationsrate untersucht. Zur Augmentation wurden Transplantate aus Beckenkamm (n = 65, 128 Sinus, 276 Implantate), mandibularer Symphyse (n = 8, 10 Sinus, 21 Implantate) oder maxillarer Tuberositas (n = 2, 2 Sinus, 2 Implantate) verwendet. Die Breite des Alveolarkamms mußte bei 52 Patienten rekonstruiert werden, während bei den anderen 23 Patienten die Augmentation und die Implantation simultan durchgeführt wurden. Die Sinusmembran wurde in 45 Fällen perforiert, was aber nicht zu einer Prädisposition für die Entstehung einer Sinusitis führte. Der Verlust von Knochenpartikeln und -sequestern wurde bei 1 (diabetischen) Patienten beobachtet, bei dem auch eine mukosale Dehiszenz auftrat. Eine 2. Augmentation war erfolgreich. Symptome einer transienten Sinusitis wurden bei 2 von 7 Patienten mit einer Sinusitisprädisposition beobachtet. Diese Symptome wurden erfolgreich mit Dekongestionsmitteln und Antibiotika behandelt. 1 Patient entwickelte eine purulente Sinusitis, die nach nasaler Antrostomie verschwand. In allen Fällen war das Knochenvolumen für die zu inserierenden Implantate ausreichend. 20 von 299 inserierten Brånemark-Implantaten (6,7%) wurden während der Nachbeobachtungszeit (durchschnittlich 32 Monate) verloren, es wurde keine Sinuspathologie beobachtet. Die Patienten erhielten Implantat-gestützte Gebisse (58 Patienten) oder feste Brücken (17 Patienten) und zeigten hinsichtlich der Knochentransplantate und der Implantate keine Beschwerden. Wir schließen hieraus, daß die Morbidität und die Komplikationsrate von autologen Knochentransplantaten des Kieferhöhlenbodens niedrig sind.
    Notes: Summary Placement of endosseous implants in the atrophic maxilla is often limited because of a lack of supporting bone. A technique to augment the floor of the maxillary sinus with autogenous bone graft seems to be a new reliable treatment modality. The morbidity and complication rate of augmentation of the maxillary sinus floor was studied in 75 patients. The sinus floor was augmented with iliac crest (n = 65, 128 sinuses, 276 implants), mandibular symphysis (n = 8, ten sinuses, 21 implants), or maxillary tuberosity grafts (n = 2, two sinuses, two implants). The width of the alveolar crest had to be reconstructed in 52 patients, while in the other 23 patients augmentation and implantation were performed simultaneously. Perforation of the sinus membrane occurred in 45 patients, but this did not predispose them to the development of sinusitis. Loss of bone particles and sequesters were observed in one (diabetic) patient only, in whom a mucosal dehiscence occurred. A second augmentation procedure was successful. Symptoms of transient sinusitis were observed in two of the seven patients with a predisposition for sinusitis. These symptoms were successfully treated with decongestants and antibiotics. One patient developed a purulent sinusitis which resolved after a nasal antrostomy. The bone volume was sufficient for insertion implants in all patients. Twenty of 299 patients (6.7%) in whom Brånemark implants had been inserted were lost to follow-up (mean, 32 months); no sinus pathology was observed. The patients received implant-supported overdentures (58 patients) or fixed bridges (17 patients) and experienced no complaints with regard to the grafts or implants. We conclude that the morbidity and complication rate of bone grafting of the floor of the maxillary sinus floor with autogenous bone is low.
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  • 2
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Between 1987 and 1990, 57 edentulous patients were treated with overdentures supported by 2 endosseous IMZ implants connected by a bar in the lower jaw. The condition of the peri-implant tissue was evaluated for a loading period ranging from 12 to 57 months (mean 30 months and median 24 months). The evaluation parameters included Plaque Index, Bleeding Index, Gingiva Index, pocket depth, dysesthesia of chin or lip, peri-implant bone loss and loss of implants. During the healing phase prior to the construction of an overdenture, 3 implants were lost. After a healing period of 6 months, these implants were successfully replaced. During the follow-up period, a Plaque Index ≤1 was observed in 45 patients and an abundance of plaque and calculus was observed in 1 patient. Heavy or profuse bleeding and severe gingival inflammation was observed in 3 patients. The mean pocket depth was 3.6±1.7 mm. None of the patients experienced lip or chin dysesthesia. Marginal bone loss was observed around 30 (26%) implants. From this study it is concluded that, once proper osseointegration is obtained, 2 IMZ implants connected with a bar in the lower jaw supply a proper base for the support of an overdenture; the condition of the peri-implant tissues is steady and independent of the follow-up time.
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