Objectives
To compare clinical and radiographic outcomes between transcrestal sinus floor elevation (TSFE) and lateral sinus floor elevation (LSFE) approaches of simultaneous implant placement in atrophic maxilla.
Materials and Methods
Patients with a residual bone height (RBH) ≤6 mm were enrolled and randomly assigned to TSFE and LSFE groups. Patients in both groups simultaneously underwent sinus floor elevation with bovine‐derived xenograft and implant placement. Clinical and radiographic results were evaluated immediately after surgery and after 6, 12, 18, and 24 months. The endo‐sinus bone gain (ESBG), apical implant bone height (ABH), endo‐sinus bone–implant contact rate (EBICR), and crestal bone level (CBL) were assessed using panoramic radiographs.
Results
Forty‐one implants (TSFE: 21, LSFE: 20) were placed in cases with a mean RBH of 3.77 ± 1.16 mm. All implants obtained clinical success and satisfactory ESBG at 24 months. No significant differences were found in ESBG and ABH between two groups immediately after surgery, but LSFE group showed significantly higher values than TSFE group thereafter. Grafts in TSFE group reached stability 6 months earlier than that in LSFE group. In both groups, EBICR was almost 100%, and CBL showed no detectable changes.
Conclusions
LSFE can achieve higher ESBG 2 years after surgery. Otherwise, TSFE could be an alternative to LSFE, when the access for lateral window preparation is limited. Both approaches were highly predictable for RBH ≤6 mm during 24‐month observation period for the implants placed simultaneously.
Protection of glandular acinar cells from autoimmune-induced damage would be of significant clinical benefit to Sjogren's syndrome (SS) patients. EGCG (the most abundant green tea polyphenol) possesses anti-apoptotic, anti-inflammatory, and autoantigen-inhibitory properties. To investigate if EGCG can protect against certain autoimmune-induced pathological changes in the salivary glands of the non-obese diabetic (NOD) mouse model for SS-like symptoms, animals were provided with either water or water containing 0.2% EGCG. At the age of 8, 16 and 22 weeks, samples were collected for pathological and serological analysis. Massive lymphocyte infiltration was observed in the salivary glands of the water-fed group at the age of 16 weeks, while the EGCG group showed significantly reduced lymphocyte infiltration. By 22 weeks of age, animals fed with water demonstrated elevated levels of apoptotic activity within the lymphocytic infiltrates, and high levels of serum total anti-nuclear antibody, in comparison with the animals fed with EGCG. Remarkably, proliferating cell nuclear antigen (PCNA) and Ki-67 levels in the salivary glands of NOD animals fed with water were significantly elevated in comparison to BALB/c control mice; in contrast, PCNA and Ki-67 levels in EGCG-fed NOD animals were similar to BALB/c controls. These results indicate that EGCG is able to protect the NOD mouse submandibular glands from autoimmune-induced inflammation, and reduces serum autoantibody levels. Abnormal proliferation, rather than apoptosis, appears to be a characteristic of the NOD mouse gland that is normalized by EGCG. The evidence suggests that EGCG could ultimately be used to delay or manage SS-like autoimmune disorders.
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