Vertical Alveolar Ridge Expansion and Simultaneous Implant Placement in Posterior Maxilla Using Segmental Osteotomy: Report of Two Cases

2008 ◽  
Vol 34 (6) ◽  
pp. 313-318 ◽  
Author(s):  
Atsushi Fujita
Keyword(s):  
Distraction Osteogenesis ◽  
Surgical Procedure ◽  
Functional Results ◽  
Alveolar Ridge ◽  
Sinus Floor Elevation ◽  
Radiologic Findings ◽  
Implant Placement ◽  
Posterior Maxilla ◽  
Sinus Floor ◽  
Minimal Invasion

Abstract Implant placement in vertically insufficient alveolar ridges of the posterior maxillae may require bone augmentation, such as sinus floor elevation, onlay grafting, and distraction osteogenesis. The purpose of this report is to evaluate the feasibility of vertical alveolar ridge expansion and simultaneous implant placement in the posterior maxilla using segmental osteotomy without sinus floor elevation, onlay grafting, and distraction osteogenesis. Two patients presenting with vertically insufficient alveolar ridges in the posterior maxillae were treated with the surgical procedure as follows. The edentulous ridge was split vertically using a segmental osteotomy before the preparation of an implant bed, and 1 implant body was placed simultaneously in the ridge with the vertical split. Three months later, abutments were connected and prosthetic loading of the implants was started. The follow-up was performed with the aid of dental and panoramic radiographs, evaluation of peri-implant probing depths, and Periotest values. In both patients, alveolar ridge expansion and implant placement were carried out without problems, good functional results were performed, and the clinical and radiologic findings were satisfactory. The outcome of the surgical procedure showed minimal invasion and good functional results.

Soft-Tissue Enhancement Combined With Biologically Oriented Preparation Technique to Correct Volumetric Bone Defects: A Clinical Case Report

2017 ◽  
Vol 43 (4) ◽  
pp. 307-313 ◽  
Author(s):  
Davide Rancitelli ◽  
Pier Paolo Poli ◽  
Marco Cicciù ◽  
Francesco Lini ◽  
Rachele Roncucci ◽  
...  
Keyword(s):  
Case Report ◽  
Soft Tissue ◽  
Preparation Technique ◽  
Present Case Report ◽  
Sinus Floor Elevation ◽  
Implant Placement ◽  
Posterior Maxilla ◽  
Sinus Floor ◽  
And Function ◽  
Tissue Enhancement

The aim of the present case report was to illustrate how to obtain an ideal alveolar ridge contour by means of peri-implant soft-tissue management combined with the prosthetic approach of the biologically oriented preparation technique (BOPT). A patient presenting a moderate vertical and horizontal bone loss in the posterior maxilla was treated with sinus floor elevation and simultaneous implant placement. During the reentry procedure, the horizontal defect was corrected with an apically repositioned flap combined with a connective tissue graft. To increase the volume of the interimplant papillae, a pedunculated flap originating from the primary flap was turned within the interimplant space. BOPT one-time abutments have been employed to maximize the space available for the papilla-like tissues. A focused and combined surgical and prosthetic procedure has permitted enhancement of both peri-implant esthetics and function without the need for further invasive and costly bone regeneration techniques.

scholarly journals Long-term results of immediate implantation in the maxillary molar area with simultaneous sinus floor elevation by the crestal approach and early loading protocol: A retrospective case series follow-up study

2019 ◽  
Vol 10 (2) ◽  
pp. 68-76
Author(s):  
Nader Ayubian Markazi ◽  
Nasrin Akhondi ◽  
Mostafa Montazeri
Keyword(s):  
Bone Resorption ◽  
Long Term Results ◽  
Osteotomy Site ◽  
Sinus Floor Elevation ◽  
Implant Placement ◽  
Early Loading ◽  
Posterior Maxilla ◽  
Maxillary Molar ◽  
Sinus Floor

Background. This study aimed to determine the long-term survival rate of implants placed in fresh sockets of extracted maxillary molars with simultaneous sinus floor elevation and early loading protocol. Methods. Nineteen maxillary molar teeth were extracted by tooth sectioning, and the sockets were debrided. Drilling for implant placement (Either Xive, Dentsply or Axiom, Antogyr) was terminated 1 mm short of the sinus floor with a pilot drill. Then, according to Summers’ technique, elevation of the Schneiderian membrane and bone grafting were performed. The implants were placed according to non-submerged procedure after sinus grafting and preparation of the desired osteotomy site. Results. The implants had been in function up to 5 years and the mean time of loading was 33.12 months. Analysis of crestal bone loss records indicated a mean of -0.054±0.56 mm of bone resorption (with a range of –0.86 to +0.90 mm). The amount of crestal bone resorption on the mesial and distal surfaces of implants was -0.02±0.559 mm and -0.09±0.59 mm, respectively (P=0.232). Survival rates and success rates were 100% and 95.45%, respectively. Conclusion. Immediate implant placement in the posterior maxilla with simultaneous sinus floor augmentation and early loading was a reliable and predictable approach.

scholarly journals Paradigm Shift in the Management of the Atrophic Posterior Maxilla

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Rabah Nedir ◽  
Nathalie Nurdin ◽  
Paul Khoury ◽  
Marc El Hage ◽  
Semaan Abi Najm ◽  
...  
Keyword(s):  
Lateral Sinus ◽  
Efficient Treatment ◽  
Sinus Floor Elevation ◽  
Implant Placement ◽  
Single Crown ◽  
Posterior Maxilla ◽  
Atrophic Maxilla ◽  
Sinus Floor ◽  
Osteotome Sinus Floor Elevation ◽  
Bone Height

When the posterior maxilla is atrophic, the reference standard of care would be to perform sinus augmentation with an autologous bone graft through the lateral approach and delayed implant placement. However, placement of short implants with the osteotome sinus floor elevation technique and without graft can be proposed for an efficient treatment of clinical cases with a maxillary residual bone height of 4 to 8 mm. The use of grafting material is recommended only when the residual bone height is ≤4 mm. Indications of the lateral sinus floor elevation are limited to cases with a residual bone height ≤ 2 mm and fused corticals, uncompleted healing of the edentulous site, and absence of flat cortical bone crest or when the patient wishes to wear a removable prosthesis during the healing period. The presented case report illustrates osteotome sinus floor elevation with and without grafting and simultaneous implant placement in extreme conditions: atrophic maxilla, short implant placement, reduced healing time, and single crown rehabilitation. After 6 years, all placed implants were functional with an endosinus bone gain.

scholarly journals Assessment of the Simultaneous Use of Biomaterials in Transalveolar Sinus Floor Elevation: Prospective Randomized Clinical Trial in Humans

2020 ◽  
Vol 17 (6) ◽  
pp. 1888 ◽  
Author(s):  
Adrián Maximiano Millán ◽  
Rocío Bravo Álvarez ◽  
Miguel Plana Montori ◽  
María Guerrero González ◽  
David Saura García-Martín ◽  
...  
Keyword(s):  
Test Group ◽  
Control Group ◽  
Simultaneous Application ◽  
Sinus Floor Elevation ◽  
Implant Placement ◽  
Randomized Clinical Study ◽  
Additional Surgery ◽  
Posterior Maxilla ◽  
Sinus Floor ◽  
Bone Gain

Implants inserted in the posterior maxilla frequently need additional surgery for successful bone augmentation. One of the most common procedures for this is transalveolar sinus floor elevation. There are different protocols for this procedure, and there is controversy over the simultaneous application of grafting material upon elevating. In this prospective randomized clinical study in humans, a total of 49 transalveolar sinus floor elevations were performed in 49 different patients, divided into a control group (without graft, 25 patients) and a test group (with graft, 24 patients). The analyzed variables were obtained through digital orthopantomography on day 0 (day of surgery) and 18 months after surgery. These measurements showed a tendency towards greater vertical bone gain in the test group, but this was not statistically significant. Therefore, considering that sinus elevation and implant placement without the application of grafts is a successful treatment with fewer complications, a critical assessment of the need for these biomaterials is necessary.

Complication and salvage of sinus floor elevation in the maxillary sinus with asymptomatic and non-calcified fungus colonization: a case report

2020 ◽  
Author(s):  
Won-Bae Park ◽  
Young-Jin Kim ◽  
Jung Soo Park ◽  
Ji-Young Han ◽  
Hyun-Chang Lim
Keyword(s):  
Postoperative Management ◽  
Sinus Surgery ◽  
Radiographic Examination ◽  
Fungal Colonization ◽  
Membrane Thickness ◽  
Sinus Floor Elevation ◽  
Implant Placement ◽  
Posterior Maxilla ◽  
Sinus Floor ◽  
Sinus Membrane

The present study aimed to report: i) the sequela of sinus floor elevation (SFE) in the posterior maxilla with severe sinus membrane thickening and an undiagnosed fungal colonization but a patent ostium; and ii) a treatment course without implant removal. A 73-year-old woman underwent dental implant placement in the left posterior maxillary area. Although the patient was asymptomatic, severe sinus membrane thickening with Haller cells was observed on a radiographic examination, but the ostium was patent. After SFE and simultaneous implant placement, the patient developed acute sinusitis and was referred to an otolaryngologist. Functional endoscopic sinus surgery (FESS) was performed, resulting in resolution of the infection and salvage of the augmentation and the implant. The histopathologic examination revealed the fungal ball that could not be diagnosed on preoperative dental radiography. During the 2 years following the final prosthesis delivery, a significant reduction in membrane thickness was observed. The implants were functioning well. Clinicians should recognize fungal colonization as an etiology of sinus membrane thickening and provide proper pre- and postoperative management, including FESS.

scholarly journals Antral Membrane Balloon Elevation

2005 ◽  
Vol 31 (2) ◽  
pp. 85-90 ◽  
Author(s):  
Muna Soltan ◽  
Dennis G. Smiler
Keyword(s):  
Preliminary Report ◽  
Sinus Lift ◽  
Bone Augmentation ◽  
Sinus Floor Elevation ◽  
Crown Root ◽  
Implant Placement ◽  
Posterior Maxilla ◽  
Sinus Floor ◽  
Grafting Materials

Abstract Many edentulous posterior maxilla are found to be encumbered by alveolar resorption and increased pneumatization of the sinus. These factors limit the quantity and quality of bone necessary for successful implant placement in these areas. One solution is to use shorter implants, but this often results in an unfavorable crown-root ratio. To create an improved environment in such regions, the classic sinus floor elevation with bone augmentation is a well-accepted technique. However, when the edentulous area is limited to a zone between 1 and 2 teeth, lifting the membrane becomes difficult and may subject it to iatrogenic injury. The antral membrane balloon elevation technique, which is introduced in this preliminary report, is a modification of the currently used sinus lift. It elevates the membrane easily and makes the antral floor accessible for augmentation with grafting materials.

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

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.

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