Sinus implant

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Paranasal sinus. A. Frontal sinus B. Line of basolacrimal duct C. Maxillary sinus. Gray1199 labeled.svg
Paranasal sinus. A. Frontal sinus B. Line of basolacrimal duct C. Maxillary sinus.

A Sinus implant is a medical device that is inserted into the sinus cavity. Implants can be in conjunction with sinus surgery to treat chronic sinusitis and also in sinus augmentation to increase bone structure for placement of dental implants. [1]

Contents

Types

Maxillary implant

A maxillary implant is an implant that is placed between the jaw and the maxillary sinuses. It is inserted during a sinus lift or augmentation, and is used to increase the amount of bone to support dental implants. [1] Implants are either inserted after drilling, or by using a non-drilling method known as the osteotome technique. [1] Issues such as bulging within the sinuses can occur with maxillary implants. [2] [3]

Maxillary implants can also be made by using Choukroun's technique with subsinus filling material. [4] The material is used to stimulate natural bone regeneration. A clinical study of this technique detailed that all patients within the study had continuous stable implants six months after placement. It also showed a vertical bone gain in all subjects. [4]

Rhinoplasty

Numerous different types of material have been used as sinus implants during rhinoplasty procedures. Plaster of Paris is often used during rhinoplasty and implanted into the frontal sinus. [5] Implants used in rhinoplasty have also been reported to cause enophthalmos. [6]

Sinus stent

Steroid-eluting sinus stents maybe used in addition to endoscopic sinus surgery. They are, however, of unclear benefit as of 2015. [7]

See also

Related Research Articles

<span class="mw-page-title-main">Plastic surgery</span> Medical surgical specialty

Plastic surgery is a surgical specialty involving the restoration, reconstruction, or alteration of the human body. It can be divided into two main categories: reconstructive surgery and cosmetic surgery. Reconstructive surgery includes craniofacial surgery, hand surgery, microsurgery, and the treatment of burns. While reconstructive surgery aims to reconstruct a part of the body or improve its functioning, cosmetic surgery aims to improve the appearance of it. A comprehensive definition of plastic surgery has never been established, because it has no distinct anatomical object and thus overlaps with practically all other surgical specialties. An essential feature of plastic surgery is that it involves the treatment of conditions that require or may require tissue relocation skills.

<span class="mw-page-title-main">Rhinoplasty</span> Surgical procedure to enhance or reconstruct a human nose

Rhinoplasty, commonly called nose job, medically called nasal reconstruction is a plastic surgery procedure for altering and reconstructing the nose. There are two types of plastic surgery used – reconstructive surgery that restores the form and functions of the nose and cosmetic surgery that changes the appearance of the nose. Reconstructive surgery seeks to resolve nasal injuries caused by various traumas including blunt, and penetrating trauma and trauma caused by blast injury. Reconstructive surgery can also treat birth defects, breathing problems, and failed primary rhinoplasties. Rhinoplasty may remove a bump, narrow nostril width, change the angle between the nose and the mouth, or address injuries, birth defects, or other problems that affect breathing, such as a deviated nasal septum or a sinus condition. Surgery only on the septum is called a septoplasty.

<span class="mw-page-title-main">Stent</span> Type of medical device

In medicine, a stent is a tube usually constructed of a metallic alloy or a polymer. It is inserted into the lumen of an anatomic vessel or duct to keep the passageway open. Stenting refers to the placement of a stent. The word "stent" is also used as a verb to describe the placement of such a device, particularly when a disease such as atherosclerosis has pathologically narrowed a structure such as an artery.

<span class="mw-page-title-main">Dental implant</span> Surgical component that interfaces with the bone of the jaw

A dental implant is a prosthesis that interfaces with the bone of the jaw or skull to support a dental prosthesis such as a crown, bridge, denture, or facial prosthesis or to act as an orthodontic anchor. The basis for modern dental implants is a biological process called osseointegration, in which materials such as titanium or zirconia form an intimate bond to the bone. The implant fixture is first placed so that it is likely to osseointegrate, then a dental prosthetic is added. A variable amount of healing time is required for osseointegration before either the dental prosthetic is attached to the implant or an abutment is placed which will hold a dental prosthetic/crown.

Chin augmentation using surgical implants alter the underlying structure of the face, intended to balance the facial features. The specific medical terms mentoplasty and genioplasty are used to refer to the reduction and addition of material to a patient's chin. This can take the form of chin height reduction or chin rounding by osteotomy, or chin augmentation using implants. Altering the facial balance is commonly performed by modifying the chin using an implant inserted through the mouth. The intent is to provide a suitable projection of the chin as well as the correct height of the chin which is in balance with the other facial features.

<span class="mw-page-title-main">Orthognathic surgery</span> Surgery of the jaw

Orthognathic surgery, also known as corrective jaw surgery or simply jaw surgery, is surgery designed to correct conditions of the jaw and lower face related to structure, growth, airway issues including sleep apnea, TMJ disorders, malocclusion problems primarily arising from skeletal disharmonies, and other orthodontic dental bite problems that cannot be treated easily with braces, as well as the broad range of facial imbalances, disharmonies, asymmetries, and malproportions where correction may be considered to improve facial aesthetics and self-esteem.

<span class="mw-page-title-main">Bone grafting</span> Bone transplant

Bone grafting is a surgical procedure that replaces missing bone in order to repair bone fractures that are extremely complex, pose a significant health risk to the patient, or fail to heal properly. Some small or acute fractures can be cured without bone grafting, but the risk is greater for large fractures like compound fractures.

<span class="mw-page-title-main">Alveolar process</span> Bulge on jaws holding teeth

The alveolar process or alveolar bone is the thickened ridge of bone that contains the tooth sockets on the jaw bones. The structures are covered by gums as part of the oral cavity.

Silent sinus syndrome is a spontaneous, asymptomatic collapse of an air sinus associated with negative sinus pressures. It can cause painless facial asymmetry, diplopia and enophthalmos. Diagnosis is suspected based on symptoms, and can be confirmed using a CT scan. Treatment is surgical involving making an outlet for mucous drainage from the obstructed sinus, and, in some cases, paired with reconstruction of the orbital floor. It is slightly more common in middle age.

<span class="mw-page-title-main">Sinus lift</span> Surgery to restore bone for tooth implants

Maxillary sinus floor augmentation is a surgical procedure which aims to increase the amount of bone in the posterior maxilla, in the area of the premolar and molar teeth, by lifting the lower Schneiderian membrane and placing a bone graft.

<span class="mw-page-title-main">Orbital blowout fracture</span> Medical condition

An orbital blowout fracture is a traumatic deformity of the orbital floor or medial wall that typically results from the impact of a blunt object larger than the orbital aperture, or eye socket. Most commonly this results in a herniation of orbital contents through the orbital fractures. The proximity of maxillary and ethmoidal sinus increases the susceptibility of the floor and medial wall for the orbital blowout fracture in these anatomical sites. Most commonly, the inferior orbital wall, or the floor, is likely to collapse, because the bones of the roof and lateral walls are robust. Although the bone forming the medial wall is the thinnest, it is buttressed by the bone separating the ethmoidal air cells. The comparatively thin bone of the floor of the orbit and roof of the maxillary sinus has no support and so the inferior wall collapses mostly. Therefore, medial wall blowout fractures are the second-most common, and superior wall, or roof and lateral wall, blowout fractures are uncommon and rare, respectively. They are characterized by double vision, sunken ocular globes, and loss of sensation of the cheek and upper gums from infraorbital nerve injury.

Guided bone regeneration (GBR) and guided tissue regeneration (GTR) are dental surgical procedures that use barrier membranes to direct the growth of new bone and gingival tissue at sites with insufficient volumes or dimensions of bone or gingiva for proper function, esthetics or prosthetic restoration. Guided bone regeneration typically refers to ridge augmentation or bone regenerative procedures; guided tissue regeneration typically refers to regeneration of periodontal attachment.

Steroid-eluting sinus stents may be used in addition to endoscopic sinus surgery. They are, however, of unclear benefit as of 2015.

Platelet-rich fibrin (PRF) or leukocyte- and platelet-rich fibrin (L-PRF) is a derivative of PRP where autologous platelets and leukocytes are present in a complex fibrin matrix to accelerate the healing of soft and hard tissue and is used as a tissue-engineering scaffold in oral and maxillofacial surgeries. PRF falls under FDA Product Code KST, labeling it as a blood draw/Hematology product classifying it as 510(k) exempt.

Zygoma implants are different from conventional dental implants in that they anchor in to the zygomatic bone rather than the maxilla. They may be used when maxillary bone quality or quantity is inadequate for the placement of regular dental implants. Inadequate maxillary bone volume may be due to bone resorption as well as to pneumatization of the maxillary sinus or to a combination of both. The minimal bone height for a standard implant placement in the posterior region of the upper jaw should be about 10 mm to ensure acceptable implant survival. When there is inadequate bone available, bone grafting procedures and sinus lift procedures may be carried out to increase the volume of bone. Bone grafting procedures in the jaws have the disadvantage of prolonged treatment time, restriction of denture wear, morbidity of the donor surgical site and graft rejection.

Alveoloplasty is a surgical pre-prosthetic procedure performed to facilitate removal of teeth, and smoothen or reshape the jawbone for prosthetic and cosmetic purposes. In this procedure, the bony edges of the alveolar ridge and its surrounding structures is made smooth, redesigned or recontoured so that a well-fitting, comfortable, and esthetic prosthesis may be fabricated or implants may be surgically inserted. This pre-prosthetic surgery which may include bone grafting prepares the mouth to receive a prosthesis or implants by improving the condition and quality of the supporting structures so they can provide support, better retention and stability to the prosthesis.

Hector L. Sarmiento is an American periodontist involved in dental implant complications research.

<span class="mw-page-title-main">Alveolar cleft grafting</span> Surgical procedure

Alveolar cleft grafting is a surgical procedure, used to repair the defect in the upper jaw that is associated with cleft lip and palate, where the bone defect is filled with bone or bone substitute, and any holes between the mouth and the nose are closed.

<span class="mw-page-title-main">Gingival grafting</span>

Gingival grafting, also called gum grafting or periodontal plastic surgery, is a generic term for the performance of any of a number of periodontal surgical procedures in which the gum tissue is grafted. The aim may be to cover exposed root surfaces or merely to augment the band of keratinized tissue.

Nasal surgery is a medical procedure designed to treat various conditions that cause nasal blockages in the upper respiratory tract, for example nasal polyps, inferior turbinate hypertrophy, and chronic rhinosinusitis. It encompasses several types of techniques, including rhinoplasty, septoplasty, sinus surgery, and turbinoplasty, each with its respective postoperative treatments. Furthermore, nasal surgery is also conducted for cosmetic purposes. While there are potential risks and complications associated, the advancement of medical instruments and enhanced surgical skills have helped mitigate them.

References

  1. 1 2 3 Summers RB (February 1994). "A new concept in maxillary implant surgery: the osteotome technique". Compendium. 15 (2): 152, 154–6, 158 passim, quiz 162. PMID   8055503.
  2. Sbordone L, Toti P, Menchini-Fabris G, Sbordone C, Guidetti F (2009). "Implant success in sinus-lifted maxillae and native bone: a 3-year clinical and computerized tomographic follow-up". The International Journal of Oral & Maxillofacial Implants. 24 (2): 316–24. PMID   19492648.
  3. Tidwell JK, Blijdorp PA, Stoelinga PJ, Brouns JB, Hinderks F (August 1992). "Composite grafting of the maxillary sinus for placement of endosteal implants. A preliminary report of 48 patients". International Journal of Oral and Maxillofacial Surgery. 21 (4): 204–9. doi:10.1016/S0901-5027(05)80219-X. PMID   1328414.
  4. 1 2 Simonpieri A, Choukroun J, Del Corso M, Sammartino G, Dohan Ehrenfest DM (February 2011). "Simultaneous sinus-lift and implantation using microthreaded implants and leukocyte- and platelet-rich fibrin as sole grafting material: a six-year experience". Implant Dentistry. 20 (1): 2–12. doi: 10.1097/ID.0b013e3181faa8af . PMID   21278521. S2CID   11294041.
  5. Raghavan U, Jones NS, Romo T (2004). "Immediate autogenous cartilage grafts in rhinoplasty after alloplastic implant rejection". Archives of Facial Plastic Surgery. 6 (3): 192–6. doi:10.1001/archfaci.6.3.192. PMID   15148130.
  6. Eloy JA, Jacobson AS, Elahi E, Shohet MR (June 2006). "Enophthalmos as a complication of rhinoplasty". The Laryngoscope. 116 (6): 1035–8. doi:10.1097/01.mlg.0000217254.22699.09. PMID   16735922. S2CID   45753208.
  7. Huang, Z; Hwang, P; Sun, Y; Zhou, B (10 June 2015). "Steroid-eluting sinus stents for improving symptoms in chronic rhinosinusitis patients undergoing functional endoscopic sinus surgery". The Cochrane Database of Systematic Reviews (6): CD010436. doi: 10.1002/14651858.CD010436.pub2 . PMID   26068957.