Nasal Floor Augmentation for the Reconstruction of the Atrophic Maxilla: A Case Series
Identifieur interne : 002132 ( Pmc/Checkpoint ); précédent : 002131; suivant : 002133Nasal Floor Augmentation for the Reconstruction of the Atrophic Maxilla: A Case Series
Auteurs : Moustafa El-Ghareeb [États-Unis] ; Joan Pi-Anfruns [États-Unis] ; Mohammed Khosousi [États-Unis] ; Tara Aghaloo [États-Unis] ; Peter Moy [États-Unis]Source :
- Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons [ 0278-2391 ] ; 2011.
Abstract
The severely atrophic edentulous maxilla imposes a challenge for dental implant rehabilitation. Nasal floor augmentation (NFA) is a method of augmenting bone height in the anterior maxilla. Autogenous bone has been commonly used as a graft material. Because of variations in results and lack of insufficient studies reporting the use of bone substitutes to graft the nasal floor, this study aims to evaluate the survival and success of dental implants placed in nasally grafted maxillae with osteoconductive bone substitutes.
Six patients with completely edentulous maxillae and inadequate height in the anterior to support implants underwent NFA. The nasal floor was exposed through an intraoral approach and grafted with osteoconductive bone graft substitutes. Twenty-four dental implants were placed, restored with a bar-retained implant-supported overdenture after a traditional healing period, and followed up after prosthetic loading. Patient satisfaction was evaluated with a questionnaire, and responses were expressed on a visual analog scale from 1 to 10. Bone levels were quantified radiographically based on a score ranging from 1 to 3, where 3 represented the highest bone support. Implants were evaluated for thread exposure and soft tissue health and were considered successful if the following criteria were met: absence of mobility; lack of symptoms; bone score of 3; and healthy peri-implant soft tissue without thread exposure.
The age of patients ranged from 48 to 84 years, with a mean of 71.2 years. Three patients underwent NFA and simultaneous implant placement, whereas the other 3 had a mean healing period of 6.5 months before implant placement. Post-loading follow-up ranged from 4 to 29 months, with a mean of 14.2 months. The implant survival rate was 100%, with no complications. Ninety-three percent of the responses to the treatment satisfaction questionnaire had a score of 7 or greater. Bone scores ranged from 2 to 3, with 87.5% of implants having a score of 3 and 12.5% having a score of 2. None of the implants had a bone score of 1.
The use of osteoconductive bone substitutes for NFA, as shown in this small case series, is a reliable method for reconstruction of the anterior atrophic maxilla for implant-supported overdentures.
Url:
DOI: 10.1016/j.joms.2011.09.032
PubMed: 22177805
PubMed Central: 4045105
Affiliations:
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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Purpose</title>
<p id="P1">The severely atrophic edentulous maxilla imposes a challenge for dental implant rehabilitation. Nasal floor augmentation (NFA) is a method of augmenting bone height in the anterior maxilla. Autogenous bone has been commonly used as a graft material. Because of variations in results and lack of insufficient studies reporting the use of bone substitutes to graft the nasal floor, this study aims to evaluate the survival and success of dental implants placed in nasally grafted maxillae with osteoconductive bone substitutes.</p>
</sec>
<sec id="S2"><title>Materials and Methods</title>
<p id="P2">Six patients with completely edentulous maxillae and inadequate height in the anterior to support implants underwent NFA. The nasal floor was exposed through an intraoral approach and grafted with osteoconductive bone graft substitutes. Twenty-four dental implants were placed, restored with a bar-retained implant-supported overdenture after a traditional healing period, and followed up after prosthetic loading. Patient satisfaction was evaluated with a questionnaire, and responses were expressed on a visual analog scale from 1 to 10. Bone levels were quantified radiographically based on a score ranging from 1 to 3, where 3 represented the highest bone support. Implants were evaluated for thread exposure and soft tissue health and were considered successful if the following criteria were met: absence of mobility; lack of symptoms; bone score of 3; and healthy peri-implant soft tissue without thread exposure.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">The age of patients ranged from 48 to 84 years, with a mean of 71.2 years. Three patients underwent NFA and simultaneous implant placement, whereas the other 3 had a mean healing period of 6.5 months before implant placement. Post-loading follow-up ranged from 4 to 29 months, with a mean of 14.2 months. The implant survival rate was 100%, with no complications. Ninety-three percent of the responses to the treatment satisfaction questionnaire had a score of 7 or greater. Bone scores ranged from 2 to 3, with 87.5% of implants having a score of 3 and 12.5% having a score of 2. None of the implants had a bone score of 1.</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">The use of osteoconductive bone substitutes for NFA, as shown in this small case series, is a reliable method for reconstruction of the anterior atrophic maxilla for implant-supported overdentures.</p>
</sec>
</div>
</front>
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<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
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<front><journal-meta><journal-id journal-id-type="nlm-journal-id">8206428</journal-id>
<journal-id journal-id-type="pubmed-jr-id">5090</journal-id>
<journal-id journal-id-type="nlm-ta">J Oral Maxillofac Surg</journal-id>
<journal-id journal-id-type="iso-abbrev">J. Oral Maxillofac. Surg.</journal-id>
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<article-id pub-id-type="doi">10.1016/j.joms.2011.09.032</article-id>
<article-id pub-id-type="manuscript">NIHMS382560</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Nasal Floor Augmentation for the Reconstruction of the Atrophic Maxilla: A Case Series</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>El-Ghareeb</surname>
<given-names>Moustafa</given-names>
</name>
<degrees>BDS, MS</degrees>
<xref ref-type="aff" rid="A1">*</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Pi-Anfruns</surname>
<given-names>Joan</given-names>
</name>
<degrees>DDS</degrees>
<xref ref-type="aff" rid="A2">†</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Khosousi</surname>
<given-names>Mohammed</given-names>
</name>
<xref ref-type="aff" rid="A3">‡</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Aghaloo</surname>
<given-names>Tara</given-names>
</name>
<degrees>MD, DDS, PhD</degrees>
<xref ref-type="aff" rid="A4">§</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Moy</surname>
<given-names>Peter</given-names>
</name>
<degrees>DMD</degrees>
<xref ref-type="aff" rid="A5">║</xref>
</contrib>
</contrib-group>
<aff id="A1"><label>*</label>
Assistant Professor, School of Dentistry, University of California, Los Angeles, Los Angeles, CA</aff>
<aff id="A2"><label>†</label>
Fellow, Dental Implant Center, School of Dentistry, University of California, Los Angeles, Los Angeles, CA</aff>
<aff id="A3"><label>‡</label>
Dental Student, School of Dentistry, University of Southern California, Los Angeles, CA</aff>
<aff id="A4"><label>§</label>
Associate Professor, School of Dentistry, University of California, Los Angeles, Los Angeles, CA</aff>
<aff id="A5"><label>║</label>
Nobel Biocare Endowed Chair, Surgical Implant Dentistry, School of Dentistry, University of California, Los Angeles, Los Angeles, CA</aff>
<author-notes><corresp id="FN1">Address correspondence and reprint requests to Dr Pi-Anfruns: Dental Implant Center, University of California, Los Angeles School of Dentistry, 10833 Le Conte Ave, Room BO-129, Los Angeles, CA 90095; <email>jpidds78@ucla.edu</email>
</corresp>
</author-notes>
<pub-date pub-type="nihms-submitted"><day>4</day>
<month>6</month>
<year>2012</year>
</pub-date>
<pub-date pub-type="epub"><day>16</day>
<month>12</month>
<year>2011</year>
</pub-date>
<pub-date pub-type="ppub"><month>3</month>
<year>2012</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>04</day>
<month>6</month>
<year>2014</year>
</pub-date>
<volume>70</volume>
<issue>3</issue>
<fpage>e235</fpage>
<lpage>e241</lpage>
<pmc-comment>elocation-id from pubmed: 10.1016/j.joms.2011.09.032</pmc-comment>
<permissions><copyright-statement>© 2012 American Association of Oral and Maxillofacial Surgeons</copyright-statement>
<copyright-year>2012</copyright-year>
</permissions>
<abstract><sec id="S1"><title>Purpose</title>
<p id="P1">The severely atrophic edentulous maxilla imposes a challenge for dental implant rehabilitation. Nasal floor augmentation (NFA) is a method of augmenting bone height in the anterior maxilla. Autogenous bone has been commonly used as a graft material. Because of variations in results and lack of insufficient studies reporting the use of bone substitutes to graft the nasal floor, this study aims to evaluate the survival and success of dental implants placed in nasally grafted maxillae with osteoconductive bone substitutes.</p>
</sec>
<sec id="S2"><title>Materials and Methods</title>
<p id="P2">Six patients with completely edentulous maxillae and inadequate height in the anterior to support implants underwent NFA. The nasal floor was exposed through an intraoral approach and grafted with osteoconductive bone graft substitutes. Twenty-four dental implants were placed, restored with a bar-retained implant-supported overdenture after a traditional healing period, and followed up after prosthetic loading. Patient satisfaction was evaluated with a questionnaire, and responses were expressed on a visual analog scale from 1 to 10. Bone levels were quantified radiographically based on a score ranging from 1 to 3, where 3 represented the highest bone support. Implants were evaluated for thread exposure and soft tissue health and were considered successful if the following criteria were met: absence of mobility; lack of symptoms; bone score of 3; and healthy peri-implant soft tissue without thread exposure.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">The age of patients ranged from 48 to 84 years, with a mean of 71.2 years. Three patients underwent NFA and simultaneous implant placement, whereas the other 3 had a mean healing period of 6.5 months before implant placement. Post-loading follow-up ranged from 4 to 29 months, with a mean of 14.2 months. The implant survival rate was 100%, with no complications. Ninety-three percent of the responses to the treatment satisfaction questionnaire had a score of 7 or greater. Bone scores ranged from 2 to 3, with 87.5% of implants having a score of 3 and 12.5% having a score of 2. None of the implants had a bone score of 1.</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">The use of osteoconductive bone substitutes for NFA, as shown in this small case series, is a reliable method for reconstruction of the anterior atrophic maxilla for implant-supported overdentures.</p>
</sec>
</abstract>
</article-meta>
</front>
</pmc>
<affiliations><list><country><li>États-Unis</li>
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<region><li>Californie</li>
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<name sortKey="Moy, Peter" sort="Moy, Peter" uniqKey="Moy P" first="Peter" last="Moy">Peter Moy</name>
<name sortKey="Pi Anfruns, Joan" sort="Pi Anfruns, Joan" uniqKey="Pi Anfruns J" first="Joan" last="Pi-Anfruns">Joan Pi-Anfruns</name>
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