A narrative review of the survival of dental implants placed simultaneously with lateral sinus floor elevations without the use of graft materials

Background: Bone atrophy and pneumatization of the maxillary sinus resulting from tooth loss, associated with low bone density in the region, do not usually allow adequate quantity and quality for the installation of osseointegrated implants. Objective: To evaluate the efficacy of crestal and lateral sinus lift techniques which are performed on same patients. Materials and Methods: Ten patients who required both crestal and lateral approaches in 20 sinus lifts were selected; 31 endosseous dental implants were placed into these patients, with a reported timeline for each approach. Assessment of the surgical procedures in all patients was done using a Visual Analog Scale (VAS). Clinical and radiographic parameters, including Pocket Probing Depth (PPD), distance between the implant shoulder and the mucosal margin (DIM) and distance between the implant shoulder and first visible bone-implant contact (DIB), were analyzed to compare implant survival for both approaches. Results: All implants were successfully osseointegrated. No significant differences were observed between lateral and crestal approaches in PPD, DIM and DIB (p-values = 0.0504, 0.7784 and 0.18170, respectively), and in the total VAS scores (p-value ≥ 0.05). Most of the patients preferred the crestal approach due to the delay in implant placements with the lateral approach. Conclusion: Evaluation of the sinus floor elevation is more precise when both techniques are performed on the same patient. Furthermore, although post-operative vertigo is a major concern with the crestal approach; patients preferred this approach over the lateral technique because it is less invasive and required less time for the procedure.

Download Full-text

Axial Triangle of the Maxillary Sinus, and its Surgical Implication With the Position of Maxillary Sinus Septa During Sinus Floor Elevation: A CBCT Analysis

Journal of Oral Implantology ◽

10.1563/aaid-joi-d-18-00229 ◽

2020 ◽

Vol 46 (4) ◽

pp. 415-422

Author(s):

Junho Jung ◽

Jung Soo Park ◽

Seoung-Jin Hong ◽

Gyu-Tae Kim ◽

Yong-Dae Kwon

Keyword(s):

Maxillary Sinus ◽

Surgical Techniques ◽

Lateral Sinus ◽

Sinus Floor Elevation ◽

Second Molar ◽

Sinus Wall ◽

Posterior Maxilla ◽

Significant Difference ◽

Sinus Floor ◽

Molar Region

The aim of this study was to measure the convexity of the lateral wall of the maxillary (Mx) sinus and identify the locational distribution of antral septa in relation to the zygomaticomaxillary buttress (ZMB), in order to suggest another anatomical consideration and surgical modification of sinus floor elevation procedures. This study was designed as a cross-sectional study, and a total of 134 patients and 161 sinuses containing edentulous alveolar ridges were analyzed. The angle between the anterior and lateral walls of the Mx sinus (lateral sinus angle [LSA]), and the angle between the midpalatal line and the anterior sinus wall (anterior sinus angle [ASA]) were measured. Mean LSAs and ASAs were 105.9° ± 9.86° and 58.4° ± 6.43°, respectively. No significant difference between left and right sides was found (LSA, P = .420; right = 105.5° ± 9.27°; left = 105.5° ± 9.27° and ASA, P = .564; right = 57.9° ± 6.80°; left = 58.8° ± 6.02°). The prevalence of septa was 37.3%, and it was most frequently noted in the second molar region (32.8%), followed by the first molar (20.9%), retromolar (16.4%), and second premolar regions (14.9%). Septa were most frequently located posterior to the ZMB (49.2%), while ZMB was mostly located in the first molar region (66.4%). Narrow LSAs may complicate the surgical approach to the posterior maxilla, especially when sinus elevation should be used in the second molar region. Considering the occasional presence of antral septa, membrane elevation may be complicated when a septum is encountered during the procedure. These results suggest that 3-dimensional examination of the convexity of the Mx sinus should be performed preoperatively to choose proper surgical techniques and minimize surgical complications.

Download Full-text

Role of bone window repositioning in lateral sinus floor elevation: comparative evaluation based on the preliminary results of an ongoing randomized, controlled trial

10.26226/morressier.5ac3832a2afeeb00097a39c7 ◽

2018 ◽

Author(s):

Zsuzsanna Papp

Keyword(s):

Randomized Controlled Trial ◽

Comparative Evaluation ◽

Controlled Trial ◽

Lateral Sinus ◽

Sinus Floor Elevation ◽

Preliminary Results ◽

Randomized Controlled ◽

Bone Window ◽

Sinus Floor

Download Full-text

Imaging study of the anatomical variations and the maxillary sinus pathology in patients with missing lateral teeth for the application of dental implants

ORL ro ◽

10.26416/orl.30.1.2016.517 ◽

2016 ◽

Vol 1 (1) ◽

pp. 6-12

Author(s):

Iulian Damian ◽

Gheorghe-Ionel Comșa

Keyword(s):

Computed Tomography ◽

Maxillary Sinus ◽

Dental Implants ◽

Preoperative Evaluation ◽

Anatomical Variations ◽

Accurate Information ◽

Maxillary Artery ◽

Lateral Sinus ◽

Sinus Wall ◽

Increased Risk

Preoperative evaluation of maxillary sinus anatomy is very important to avoid surgical complications due to close anatomical relations between the sinus and the posterior maxillary teeth and/or edentulous alveolar ridge. Posterior superior alveolar artery is a branch of the maxillary artery and provides the vascularization of the lateral sinus wall and underlying mucosa. Maxillary artery branches should be taken into consideration during sinus lifting procedures and bone augmentation due to increased risk of bleeding by damaging the artery during the osteotomy. Computed tomography (CT) explores three-dimensional anatomic structures and provides complex and accurate information about them. Cone Beam Computed Tomography (CBCT) offers an accurate view of the teeth and surrounding structures at high resolution, despite low-dose radiation used. In this study, the incidence of anatomical variations and sinus pathology were assessed using CBCT. The aim is to evaluate the presence of sinus pathology (sinus mucosal thickening, oro-antral communications, sinus tumors, cysts, polyps), presence and position of the posterior superior alveolar artery. These issues are important because they are about the limits of the dental implants in the posterior maxillary area. The presence of sinus pathology and anatomical variations may predispose to complications and even failures of implantation therapy.

Download Full-text