Accuracy of Schneiderian membrane thickness: a cone‐beam computed tomography analysis with histological validation

Ínsua, Ángel; Monje, Alberto; Chan, Hsun‐Liang; Zimmo, Nouf; Shaikh, Lujain; Wang, Hom Lay

doi:10.1111/clr.12856

Cited by 34 publications

(24 citation statements)

References 55 publications

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“…The mean SMT was 0.64 ± 0.2 mm in our study, which correlates to the findings of Wen et al (2015) and Insua, Monje, Urban, et al (2017)). However, the CBCT assessment was 2.6-fold higher than the histological examination (Insua, Monje, Chan, et al, 2017). In our study, no correlation was found between the membrane thickness and the IoP, which is contrary to the findings reported by Wen and coworkers (Wen et al, 2015) who observed a higher perforation rate in thicker membranes (≥3 mm) or thinner membranes (<0.5 mm).…”

Section: Discussioncontrasting

confidence: 99%

Microscope and micro‐camera assessment of Schneiderian membrane perforation via transcrestal sinus floor elevation: A randomized ex vivo study

Gargallo‐Albiol

Sinjab

Barootchi

et al. 2019

Clinical Oral Implants Res

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Objective We sought to assess the effectiveness of using a microscope and non‐invasive camera for assessing sinus membrane perforations during transcrestal sinus floor elevation (TSFE). Materials and methods Five fresh human cadaver heads corresponding to eight maxillary sinuses (six bilateral and two unilateral) underwent 4 TSFEs per sinus (a total of 32 single site elevations). Each elevation was randomly assigned to receive a three or six mm membrane elevation height (MEH). A microscope and micro‐camera were used to assess the sinus membrane perforation. Afterwards, radiological and clinical membrane perforation assessments were performed. The statistical analysis results are expressed using the means, standard deviations, range values of the residual ridge height (RRH), residual ridge width (RRW), sinus membrane thickness (SMT) and incidence of perforation (IoP). Generalized linear methods were used to test for the correlation of RRH and MEH to the microscope and micro‐camera perforation assessments and the correlation of microscope and micro‐camera assessments with the post‐operative CBCT and crestal liquid evaluation. Results The cumulative percentage of IoP was 40.62%, (23.07% with 3 mm MEH, and 76.92% with 6 mm MEH, p < 0.05). The perforation assessed using either the microscope or micro‐camera coincided with the post‐operative CBCT and crestal liquid assessment in 87.55% sites. No significant correlation was found between the microscope or micro‐camera assessments with RRH or MEH. Conclusion Application of a microscope and micro‐camera during transcrestal sinus floor elevation may allow the detection of the integrity of the Schneiderian membrane with greater than 85% accuracy in this ex vivo model.

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Section: Discussioncontrasting

confidence: 99%

Microscope and micro‐camera assessment of Schneiderian membrane perforation via transcrestal sinus floor elevation: A randomized ex vivo study

Gargallo‐Albiol

Sinjab

Barootchi

et al. 2019

Clinical Oral Implants Res

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“…Temmerman et al. reported that both SCA, lateral sinus lift and intra‐lift techniques caused a temporary thickening of the membrane, with a statistically significant change in membrane volume for the lateral sinus lift versus SCA . In this situation, the very limited trauma caused by surgery in our study with a progressive de‐attachment of the membrane may explain that only some membranes suffered with inflammatory thickening and most, even with shrinkage.…”

Section: Discussionmentioning

confidence: 48%

“…Temmerman et al reported that both SCA, lateral sinus lift and intra-lift techniques caused a temporary thickening of the membrane, with a statistically significant change in membrane volume for the lateral sinus lift versus SCA. 17 In this situation, the very limited trauma caused by surgery in our study with a progressive de-attachment of the membrane may explain that only some membranes suffered with inflammatory thickening and most, even with shrinkage. Nonetheless, it should be noted that higher accuracy than 0.5 mm cannot be expected with a clinical use of CBCT 18 and that CBCT measurement might overestimate the histologic real thickness of the membrane 19 ; therefore, measurement of thinner structures like SM might not be totally precise and should be taken cautiously.…”

Section: Discussionmentioning

confidence: 68%

Effect of staged crestal maxillary sinus augmentation: A case series

Sonoda¹,

Yamamichi²,

Harada³

et al. 2019

Journal of Periodontology

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Background In sinus augmentation, when remaining bone height is ≤5 mm, a lateral window approach is often the preferred choice; nonetheless, patients prefer to have a less invasive approach such as crestal sinus augmentation (CSA). Prior case reports have described the use of various staged approaches of a CSA technique in cases of limited bone height. The aim of this report was to describe the results of a case series in which a two‐stage CSA technique was used in patients with 4 to 6 mm of bone height. Methods Nineteen subjects with 28 sinuses of initial vertical bone height of 4 to 6 mm were included in which a two‐stage CSA technique was used in place of a lateral window approach. In the first surgery, 0.3 mL graft material was inserted into all sites. In the second surgery, 13 sites were filled with 0.2 mL graft material and remaining 15 sites were filled with 0.4 mL. Results No damage was observed in the maxillary sinus floor membrane after first 0.2 mL filling; however, one case had Schneiderian membrane perforation after filling 0.4 mL. The average elevation height (EH) after first surgery was 5.81 ± 0.7 mm, 5.15 ± 0.91 mm before second surgery, 6.69 ± 0.89 mm with 0.2 mL filling (total 0.5 mL) and 8.11 ± 1.24 mm with 0.4 mL filling (total 0.7 mL). The thickness of maxillary sinus membrane before first surgery was 2.6 ± 2.59 mm; however, it has become 0.97 ± 1.59 mm before second surgery, with a decrease of 1.6 mm estimate. Conclusion This case series that assessed outcomes of staged crestal maxillary sinus augmentation was an effective approach to elevating 6 or 8 mm alveolar bone height without causing major membrane perforation. However, the two‐stage approach was used in the limited residual bone height (4 to 6 mm) and required two separate surgical procedures.

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“…38,39 The abutment connection on the endosseous portion of the implant leaves a gap in a range of 10-50 lm. 38 A pumping effect of the fluid contained in the implant cavities might shift inwards to the peri-implant compartment due to the cyclical loading of the implant/abutment interface 38,40 and facilitate the colonization of the gap by putative pathogens. These organic fluids with bacteria products and endotoxins could upregulate the expression of proinflammatory cytokines in the peri-implant tissues and stimulate the chemotaxis of active osteoclasts.…”

Section: Bone Remodeling Processmentioning

confidence: 99%

Basis of bone metabolism around dental implants during osseointegration and peri‐implant bone loss

Ínsua

Monje

Wang

et al. 2017

J Biomedical Materials Res

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195

188

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Despite the growing number of publications in the field of implant dentistry, there are limited studies to date investigating the biology and metabolism of bone healing around dental implants and their implications in peri-implant marginal bone loss. The aim of this review article is to provide a thorough understanding of the biological events taking place during osseointegration and the subsequent early and late phases of bone remodeling around dental implants. An update on the coupling mechanism occurring during bone resorption-bone remodeling is provided, focused on the relevance of the osteocytes, bone lining cells and immune cells during bone maintenance. An electronic and manual literature search was conducted by three independent reviewers in several databases, including MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Cochrane Oral Health Group Trials Register databases for articles up to September 2016 with no language restriction. Local bone metabolism is subject to signals from systemic calcium-phosphate homeostasis and bone remodeling. Three areas of interest were reviewed due to recent reported compromises in bone healing including the putative effects of (1) cholesterol, (2) hyperlipidemia, and (3) low vitamin D intake. Moreover, the prominent influence of osteocytes and immune cells is discussed as being key regulators during dental implant osseointegration and maintenance. These cells are of crucial importance in the presence of biofilm accumulation and their associated byproducts that leads to hard and soft tissue breakdown; the so called peri-implantitis. Factors that could negatively impact osteoclastogenesis or osteal macrophage activation should be monitored in future research including implant placement/torque protocols, bone characteristics, as well as meticulous maintenance programs to favor osseointegration and future long-term stability and success of dental implants. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 2075-2089, 2017.

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Accuracy of Schneiderian membrane thickness: a cone‐beam computed tomography analysis with histological validation

Abstract: Within the limitation of this study, the median histological Schneiderian membrane thickness was 0.30 mm. Cone-beam computed tomography assessment was 2.6 times higher than the histological examination.

Cited by 34 publications

References 55 publications

Microscope and micro‐camera assessment of Schneiderian membrane perforation via transcrestal sinus floor elevation: A randomized ex vivo study

Microscope and micro‐camera assessment of Schneiderian membrane perforation via transcrestal sinus floor elevation: A randomized ex vivo study

Effect of staged crestal maxillary sinus augmentation: A case series

Basis of bone metabolism around dental implants during osseointegration and peri‐implant bone loss

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