To overcome the intra and post-operative complications that might arise during the use of the conventional instruments for cutting the bony window and elevation of maxillary sinus membrane, the application of ultrasonic device (piezosurgery) has been introduced.
Aim of the study:To evaluate the efficiency and safety of the piezosurgery during direct sinus lifting procedure in comparison to the conventional rotary instruments.
Patients and methods:A randomized controlled clinical trial was performed, in which forty patients (17 females and 23 males) with bone height of less than 3 mm in the posterior maxilla, who required implant placement to replace the missing teeth, were selected. The sinus lift surgeries were done either by the piezosurgery or the conventional bur technique. The rate of perforation, time of the operation, healing, postoperative edema, and pain were evaluated. Six months later, implants were placed within the augmented sites.
Results:A lower percentage of membrane perforation has been encountered in the piezosurgery group (5% one patient), when compared to the conventional group (15%, three patients).The pain and swelling were significantly less in the piezosurgery group but the mean time was longer in the piezosurgery group .
Conclusion:The piezosurgery is an effective device that is safer in performing the lateral maxillary sinus lift surgery than the conventional rotary method, but unfortunately it takes longer operation time.
Statement of the problem: Endosseous implants are being increasingly used for the retention of mandibular restorations in recent years. It has been suggested that there is a risk of maxillary bone resorption under complete dentures in patients wearing mandibular implant-retained overdentures as well as mandibular all-on-four hybrid prosthesis. However, there was little evidence-based information about the effect of these 2 treatment modalities on the maxillary bone changes. Patients and methods: This is a prospective parallel randomized controlled clinical study, in which forty eight implants were placed in mandibles of 12 completely edentulous male patients. Patients were randomly allocated into one of the two groups: group A, where 6 patients received 4 parallel implants with implant retained overdenture and group B, where 6 patients received 4 implants in the anterior part of the mandible, 2 axial implants in the center and 2 tilted implants at the distal ends with all-on four hybrid prosthesis. All patients received maxillary removable complete dentures. Radiographic evaluation was made using the CBCT to asses bone height changes that occur in the anterior and posterior maxillary areas 6 months and 12 months following denture insertion and functional loading in comparison to time of loading. Collected data were tabulated and statistically analyzed. Results: Comparison of radiographic bone changes under complete maxillary denture at the anterior and posterior maxilla, between group A and group B, showed no significant differences between the two groups at any time interval. However, pair-wise comparison of bone height changes over time for each group showed significant difference between immediate time point and 12-month post-loading time point in group A, both in anterior and posterior maxilla, where the P value was <0.05. On the other hand there was no significant difference between the same time points in group B, both in anterior and posterior maxilla.
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