K. Deniz

Early Implant Survival in Posterior Maxilla With or Without β-Tricalcium Phosphate Sinus Floor Graft

PURPOSE The sinus lift procedure provides a way to increase the amount of available bone and the placement of longer implants. The aim of this study was to evaluate and compare the survival rates of implants inserted in the posterior maxilla (without sinus lift) to simultaneous implant insertion with sinus lift. PATIENTS AND METHODS Seventy maxillary sinuses in 62 patients were augmented by beta-tricalcium phosphate and 121 implants were inserted into these augmented sinuses (study group) and 136 implants were inserted in the posterior maxilla in 65 patients (control group). Follow-up times were 29.8 and 32.3 months for the study and control groups, respectively. RESULTS One implant in the study group and 1 implant in the control group failed. All other implants in both groups were functioning well without any significant clinical finding. Implant survivals were 99.17% in the study group and 99.26% in the control group. CONCLUSION Simultaneous implant insertion and sinus lift with beta-tricalcium phosphate is a safe surgical procedure, and survival rates of implants inserted in the augmented sinus were similar to those of implants inserted in the posterior maxilla without sinus lift.

Survival rates of implants inserted in the maxillary sinus area by internal or external approach.

Objective:There are 2 surgical techniques to elevate the sinus floor: sinus lift with crestal approach (internal sinus lift [ISL]) and sinus lift with lateral wall approach (external sinus lift [ESL]). The aim of this study was to evaluate and compare the survival rates of implants placed in the posterior maxilla with ESL or ISL. Patients and Methods:Ninety sinus lifts with lateral wall approach were performed in 82 patients, and 147 implants were inserted in these augmented sinuses in ESL group. Forty-five implants were inserted in maxilla in 33 patients with sinus lift with crestal approach in ISL group. The follow-up time was 33.8 and 15.6months for ESL and ISL groups, respectively. Results:One implant failure was observed in ESL group, and there was no implant failure in ISL group. All other implants were functioning well without any significant clinical finding. Implant survival was 99.2% in ESL group and 100% in ISL group. Conclusion:The sinus lift with lateral wall approach and crestal approach were reliable methods for implant insertion in the posterior maxilla. Survival rates of the ISL were slightly higher than ESL group. However, follow-up time of the ISL was shorter.

Is auditory function affected after Le Fort I osteotomy

The aim of this study was to evaluate changes to the Eustachian tube and middle ear function and hearing level in individuals undergoing Le Fort I osteotomy. 20 consecutive patients underwent Le Fort I maxillary osteotomy with advancement, impaction or a combination of both. All individuals underwent hearing sensitivity tests, including pure tone audiometry and acoustic impedance measurements (middle ear pressure and compliance), which were carried out by an audiologist 1 week before surgery (t(0)), and then again 1 week (t(1)) and 4 weeks (t(2)) after surgery. Regarding pure tone audiometry, the differences between t(0) and t(2) at a frequency of 125Hz (P=.002), between t(0) and t(1) and between t(0) and t(2) at a frequency of 250Hz, and between t(0) and t(1) at a frequency of 1000Hz (P=.006) were statistically significant. There was no statistically significant difference at any other frequency. Regarding middle ear pressure, no statistically significant difference was observed between t(0) and t(1), and t(0) and t(2). Following Le Fort I osteotomy, mild changes in hearing sensitivity and middle ear pressure are possible, but these changes were clinically insignificant.

A Simple Technique for Increasing the Length of the Distracted Area: Technical Note

D Intraoral distraction osteogenesis is a relatively new procedure for lengthening of the jaws and alveolar bone. In this procedure the newly formed bone is maintained in a more physiologic way. Alveolar distraction osteogenesis (ADO) shows various advantages in rehabilitation of alveolar bone defects resulting from congenital or acquired bone deficiencies. There are some reports evaluating the risks and complications of ADO. However, none of these reports mentioned the inadequacy of the distractor length. Because intraoral distractors are miniaturized devices, the amount of distraction is limited with the length of the distractor rod. The length of the rods of the alveolar distractors available on the market is about 1.5 cm, and this mount of lengthening is less than sufficient in most ases. Sagittal (anterior-posterior) distraction of the lveolus is a recently applied version of this crest engthening procedure, and the desired amount of agittal lengthening is longer than vertical lengthenng. Distractors longer than 1.5 cm can hardly be used intraorally because they are intolerable and unesthetic. In addition, rods longer than 1.5 cm may not be rigid and steady. More rigid distractors may be manufactured by increasing the diameter of the rod, but bulky distractors cannot be used intraorally.

Evaluation of benign paroxysmal positional vertigo following Le Fort I osteotomy

The Le Fort I osteotomy is widely used to correct dentofacial deformities. Benign paroxysmal positional vertigo (BPPV) is a common vestibular end organ disorder characterized by short, often recurrent episodes of vertigo. Head trauma is one of the known causes of BPPV. During pterygoid osteotomy, the surgical trauma induced by percussion with the surgical mallet and osteotomes can displace otoliths into the semicircular canal, resulting in BPPV. The aim of this study was to evaluate the potential risk of occurrence of BPPV in individuals undergoing Le Fort I osteotomy. Twenty-three patients were included in this study. The Dix-Hallpike manoeuvre, positional tests using electronystagmography, and vestibular evoked myogenic potential (VEMP) tests were performed 1 week before surgery (T0), 1 week after surgery (T1), and 1 month after surgery (T2). The results were compared statistically. BPPV was observed in three patients. Eleven patients had nystagmus at the T1 evaluation and seven at the T2 evaluation. The difference between the T0 and T1 time points was statistically significant (P=0.001). BPPV is a possible complication of Le Fort I osteotomy. Surgeons should be aware of this complication, and the diagnosis of BPPV should be considered in patients who have undergone Le Fort I osteotomy.