Residual ridge dimensions at edentulous maxillary first molar sites and periodontal bone loss among two ethnic cohorts seeking tooth replacement

Acharya, Aneesha; Hao, Jia; Mattheos, Nikos; Chau, Anson C.M.; Shirke, Prashant; Lang, Niklaus P.

doi:10.1111/clr.12292

Cited by 22 publications

(20 citation statements)

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“…Although residual alveolar ridge height has been associated with sinus mucosal thickening [36], our study did not find a significant association between these two parameters. Acharya et al [36] reported that lower available bone height in the subsinus region was related to thickened sinus membranes within an Asian-Indian and Hong Kong-based Chinese population.…”

Section: Discussioncontrasting

confidence: 92%

“…Acharya et al [36] reported that lower available bone height in the subsinus region was related to thickened sinus membranes within an Asian-Indian and Hong Kong-based Chinese population. Differences in the ethnic composition and geographic location of this population might explain the different findings compared to our study, which was primarily comprised of a Caucasian cohort in North America.…”

Section: Discussionmentioning

confidence: 99%

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Dental implants and grafting success remain high despite large variations in maxillary sinus mucosal thickening

et al. 2017

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BackgroundAlthough mucosal thickening is the most common radiographic finding observed regarding sinus pathology, the knowledge regarding its clinical significance on the outcomes of dental implants and grafting in the maxillary sinuses is still limited. We hypothesized that mucosal thickening would not alter the predictability for sinus floor augmentation and dental implant placement. The purpose of this retrospective study was to evaluate the outcomes of dental implant placement in sinus-augmented areas with preexisting sinus mucosal thickening.MethodsThis study involved the review of cone-beam computed tomographic (CBCT) scans taken on patients that underwent both maxillary sinus elevation with grafting and implant placement at the University of Michigan School of Dentistry from 2004 to 2014. Cases with documented radiographic and clinical follow-up were included. The data analyses revealed the following.ResultsA total of 29 CBCT scans met the inclusion criteria for evaluation, and 93.1% of them had maxillary sinus mucosal/tissue thickening. Specifically, 6.9% of cases exhibited no thickening, 6.9% had minimal thickening (1–2 mm), 20.7% of cases had moderate thickening (2–5 mm), and 65.5% had severe thickening (>5 mm). We propose these categorical measurements of tissue thickening as a new “mucosal thickening index.” The tissue thickening did not vary based on gender, age, or smoking status, nor did it relate to the underlying alveolar ridge height. However, patients with a history of periodontal diseases demonstrated a significant association with mucosal thickening (p = 0.0043). These data indicate that there is high implant and grafting success rate (100%) in the maxillary sinus despite large and varied physiologic sinus mucosal/tissue thickening.ConclusionsBased on study findings, this research will help guide dental practitioners regarding cases that exhibit mucosal thickening. These data support the concept that physiologic mucosal thickening in varied ranges is not associated with implant or grafting failure in the maxillary sinus.

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Section: Discussioncontrasting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Dental implants and grafting success remain high despite large variations in maxillary sinus mucosal thickening

et al. 2017

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“…It was demonstrated that the available bone height in the subsinus region was affected by ethnicity, gender, and sinus membrane thickening, while the residual ridge width was related to age and the presence of adjacent teeth (Acharya et al. ). Furthermore, the vertical bone height alone is not the only decisive measure for the assessment of the type of surgery required for sinus floor elevation.…”

Section: Discussionmentioning

confidence: 99%

Is furcation involvement in maxillary molars a predictor for subsequent bone augmentation prior to implant placement? A pilot study

Walter

Dagassan-Berndt

Kühl

et al. 2013

Clinical Oral Implants Res

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AIM: The aim of this pilot study was to analyze the interfurcal bone height in relation to the possible need for subsequent sinus floor elevation in patients with advanced periodontitis and furcation involvement of first and/or second maxillary molars. MATERIAL AND METHODS: Seventeen dentate patients, who received cone beam computed tomography (CBCT) for detailed preoperative diagnosis and planning of surgical interventions at periodontally involved maxillary molars (17 first and 15 second molars), were consecutively recruited for the study. The minimal bone height in the interfurcal region was measured from CBCT and related to furcation involvement, residual bone above the root tips, and the clinical probing pocket depth (PPD). RESULTS: The minimal interfurcal bone height measured 4.1 ± 2.6 mm on average with 75% of maxillary molars having 6 mm and almost 60% having only 4 mm bone height left below the sinus floor. A higher risk for reduced interfurcal bone height of 4 mm was given when residual PPD of 6 mm was remaining at two or more tooth sites (OR 0.10; 0.11). CONCLUSIONS: The majority of periodontally involved maxillary molars had a substantially reduced interfurcal bone height, particularly with at least two sites with residual PPD 6 mm. This was a predictor for a subsequent need for sinus floor elevation when tooth replacement with a dental implant is desired. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 Material and methods: 17 dentate patients, who received CBCT for detailed preoperative diagnosis and planning of surgical interventions at periodontally involved maxillary molars (17 first and 15 second molars), were consecutively recruited for the study. The minimal bone height in the interfurcal region was measured from CBCT and related to furcation involvement, residual bone above the root tips and to the clinical probing pocket depth (PPD). Results:The minimal interfurcal bone height measured 4.1 ± 2.6 mm on average with 75% of maxillary molars having ≤6 mm and almost 60% having only ≤4 mm bone height left below the sinus floor. A higher risk for reduced interfurcal bone height of ≤4mm was given when residual PPD of ≥6 mm were remaining at 2 or more tooth sites. Conclusions:The majority of periodontally involved maxillary molars had a significantly substantially reduced interfurcal bone height, particularly with at least 2 sites with residual PPD ≥6 mm. This was a predictor for a subsequent need for sinus floor elevation when tooth replacement with a dental implant is desired.

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“…The use of dental implants is considered a predictable therapeutic option for the rehabilitation of partially or fully edentulous patients providing long‐term function and esthetics . Tissue deficiencies at implant sites are common clinical findings . Their presence may lead to an increase in marginal bone loss, soft‐tissue inflammation, and soft‐tissue recession .…”

Section: Introductionmentioning

confidence: 99%

The etiology of hard‐ and soft‐tissue deficiencies at dental implants: A narrative review

Hämmerle

Tarnow

2018

J Clinic Periodontology

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Hard- and soft-tissue deficiencies at implant sites may result from a multitude of factors. They encompass natural resorption processes following tooth extraction, trauma, infectious diseases such as periodontitis, peri-implantitis, endodontic infections, growth and development, expansion of the sinus floor, anatomical preconditions, mechanical overload, thin soft tissues, lack of keratinized mucosa, malpositioning of implants, migration of teeth, lifelong growth, and systemic diseases. When more than one factor leading to hard and/or soft-tissue deficiencies appear together, the severity of the resulting condition may increase. Efforts should be made to better identify the relative importance of these etiological factors, and to develop strategies to counteract their negative effects on our patient's wellbeing.

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Residual ridge dimensions at edentulous maxillary first molar sites and periodontal bone loss among two ethnic cohorts seeking tooth replacement

Cited by 22 publications

References 50 publications

Dental implants and grafting success remain high despite large variations in maxillary sinus mucosal thickening

Dental implants and grafting success remain high despite large variations in maxillary sinus mucosal thickening

Is furcation involvement in maxillary molars a predictor for subsequent bone augmentation prior to implant placement? A pilot study

The etiology of hard‐ and soft‐tissue deficiencies at dental implants: A narrative review

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