Comparison of Conventional Transcrestal Sinus Lift and Ultrasound-Enhanced Transcrestal Hydrodynamic Cavitational Sinus Lift for the Filling of Subantral Space: A Human Cadaver Study

2015 ◽  
Vol 41 (6) ◽  
pp. 657-661 ◽  
Author(s):  
Sylvain Catros ◽  
Michel Montaudon ◽  
Christophe Bou ◽  
Reynald Da Costa Noble ◽  
Jean Christophe Fricain ◽  
...  

The implant-supported prosthetic rehabilitation of the posterior maxilla may require sinus-grafting procedures due to poor quality and low volume of bone. This can be accomplished using a “lateral window” sinus augmentation or with an osteotome sinus floor elevation (OSFE). The hydrodynamic ultrasonic cavitational sinus lift (HUCSL) (Intralift) is derived from the osteotome technique and allows the reduction of some of the traumatic effects of the osteotome technique. The aim of this study was to compare OSFE and the HUCSL procedures on fresh human cadaver heads. Primary outcomes were the height and width of the grafting area in the sinus floor area. Eighty-four maxillary sinuses were selected. On each fresh cadaver head, 2 sinus lifts were done using OSFE and HUCSL in the maxillary sinuses. Computerized tomography scans were performed on each head before and after the surgeries. Measurements were done on radiologic pictures using dedicated software, and the integrity of the sinus membrane was observed after dissecting the maxillae. The use of HUCSL resulted in a significantly higher sinus floor augmentation in the mesio-distal and bucco-palatal direction compared with the osteotome technique (P < .001). There was no correlation between mesio-distal and bucco-palatal diameters of sinus floor augmentation when only the osteotome protocol was considered (r = 0.27 and P = .08). In contrast, the mesio-distal and bucco-palatal diameters of floor augmentation were correlated when the HUCSL protocol was considered (r = 0.79, P < .001). HUCSL represents a good alternative method for sinus floor elevation.

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Mario Beretta ◽  
Marco Cicciù ◽  
Ennio Bramanti ◽  
Carlo Maiorana

Maxillary sinus floor elevation via a lateral approach is a predictable technique to increase bone volume of the edentulous posterior maxilla and consequently for dental implants placement. The sinus floor is elevated and it can be augmented with either autologous or xenogeneic bone grafts following an opening bone window created on the facial buccal wall. Maxillary septa are walls of cortical bone within the maxillary sinus. The septa shape has been described as an inverted gothic arch arising from the inferior or lateral walls of the sinus and may even divide the sinus into two or more cavities. Some authors have reported a higher prevalence of septa in atrophic edentulous areas than in nonatrophic ones. Radiographic identification of these structures is important in order to perform the right design of the lateral window during sinus lift. Aim of this investigation is to highlight the correct steps for doing sinus lift surgery in presence of those anatomic variations. Clinicians should always perform clinical and radiographic diagnosis in order to avoid complications related to the sinus lift surgery.


Author(s):  
María Piedad Ramírez Fernández ◽  
Sergio Alexander Gehrke ◽  
Patricia Mazón ◽  
Jose Luis Calvo-Guirado ◽  
Piedad N. De Aza

The aim of the present study was to monitor implant stability after sinus floor elevation with two biomaterials during the first 6 months of healing by a resonance frequency analysis (RFA), and how physico-chemical properties affect the implant stability quotient (ISQ) at the placement and healing sites. Bilateral maxillary sinus augmentation was performed in 10 patients in a split-mouth design using a bobine HA (BBM) as a control and porcine HA (PBM). Six months after sinus lifting, 60 implants were placed in the posterior maxilla. The ISQ was recorded on the day of surgery from RFA at T1 (baseline), T2 (3 months), and T3 (6 months). Statistically significant differences were found in the ISQ values during the evaluation period. The ISQ (baseline) was 63.8±2.97 for BBM and 62.6±2.11 for PBM. The ISQ (T2) was ~ 73.5±4.21 and 67±4.99, respectively. The ISQ (T3) was ~ 74.65±2.93 and 72.9±2.63, respectively. All the used HAs provide osseointegration and statistical increases in the ISQ at baseline, T2 and T3 (follow-up), respectively. The BBM, sintered at high temperature with high crystallinity and low porosity, presented higher stability, which demonstrates that variations in the physico-chemical properties of a bone substitute material clearly influence implant stability.


2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Naofumi Aoki ◽  
Takeo Kanayama ◽  
Michinori Maeda ◽  
Koichiro Horii ◽  
Hironori Miyamoto ◽  
...  

In sinus floor augmentation of an atrophic posterior maxilla, platelet-rich fibrin (PRF) has been used as a graft material. We herein report two cases with histological evaluations of PRF after the surgery. The first case was a 28-year-old female with an atrophic right posterior maxilla who was treated with sinus floor augmentation and simultaneous implant placement using PRF as the sole graft material in our hospital. Twenty-four months after surgery, the implant was unfortunately removed because of occlusal overloading by parafunctional habits. During implant replacement, a tissue sample was obtained from the site of augmentation with PRF and was evaluated histologically. The second case was a 58-year-old man with severe alveolar atrophy of the right maxilla who underwent lateral sinus augmentation using only PRF in a two-stage procedure in our hospital. Samples were obtained at the second-stage surgery and histological examinations were performed. As a result, new bone formation was confirmed histologically in both cases. Our findings show that the use of PRF as a graft material during sinus floor augmentation induces natural bone regeneration.


Materials ◽  
2020 ◽  
Vol 13 (9) ◽  
pp. 2208 ◽  
Author(s):  
Giorgio Lombardo ◽  
Mauro Marincola ◽  
Annarita Signoriello ◽  
Giovanni Corrocher ◽  
Pier Francesco Nocini

As the atrophic posterior maxilla often presents serious limitations for dental implant procedures, a minimally invasive technique was proposed. The study aimed to retrospectively evaluate the outcomes of short and ultra-short locking-taper implants, placed in combination with a modified osteotome sinus floor elevation procedure (internal sinus lift technique) in the posterior maxilla. A total of 31 patients received 51 locking-taper implants. Clinical and radiographic examinations were performed before treatment, at loading time, and after three years. Seven implants of 8.0 mm, 23 implants of 6.0 mm, and 21 implants 5.0 mm in length were rehabilitated with single-crown restorations. Implant survival at three-year follow-up was 96.08%. Pre-operative residual crestal bone height of 5.2 (1.41) (median (interquartile range)) mm increased to 7.59 (1.97) mm at the 36-month follow-up, with an average intra-sinus bone height gain of 3.17 ± 1.13 (mean ± standard deviation) mm. Mean peri-implant crestal bone loss was 0.29 (0.46) mm and mean first bone-to-implant contact point shifted apically to 0.12 (0.34) mm. It can be suggested with confidence that implants used in the study, placed in conjunction with an internal sinus floor elevation technique, can be restored with single crowns as a predictable treatment for the edentulous regions of the posterior maxilla.


2021 ◽  
Author(s):  
Maarten J Boogaard

Introduction: Aim of this investigation is to show that in sites with less than 4 mm of bone height of the sinus floor, synthetic putty bone graft and simultaneous short implant placement in crestal sinus lifting procedures result in sufficient bone gain, and is a valuable option to the more invasive lateral-window approach. Case presentation: Four patients missing a single tooth or more in the posterior maxilla with remaining alveolar ridge height of less than 4mm underwent crestal sinus lift procedures with bone grafting using a synthetic putty material simultaneously. Loading of the short implants was done with a minimum of 4 months after placement showing bone growth around the implant and lift of the Schneiderian membrane between 2.3mm-7.3mm. Conclusion: Crestal sinus lift, in combination with a short implant and a synthetic putty bone graft, is a good alternative for lateral more invasive sinus lift when the thickness of the sinus floor is less than 4mm.


2017 ◽  
Vol 1 (2) ◽  

Maxillary sinus floor augmentation (also termed sinus lift, sinus graft, sinus augmentation or sinus procedure) is a surgical procedure which aims to increase the amount of bone in the posterior maxilla (upper jaw bone), in the area of the premolar and molar teeth, by lifting the lower Schneiderian membrane (sinus membrane) and placing a bone graft [2]. When a tooth is lost the alveolar process begins to remodel. The vacant tooth socket collapses as it heals leaving an edentulous (toothless) area, termed a ridge [3]. This collapse causes a loss in both height and width of the surrounding bone. In addition, when a maxillary molar or premolar is lost, the floor of the maxillary sinus expands, which further diminishes the thickness of the underlying bone. Overall, this leads to a loss in volume of bone that is available for implantation of dental implants, which rely on osseointegration (bone integration), to replace missing teeth [1]. The goal of the sinus lift is to graft extra bone into the maxillary sinus, so more bone is available to support a dental implant. A Special form of Reconstruction of bone, especially changing the vertical structure of the maxillary Sinus floor in the upper jaw and the establishment of the mucous membranes of Sinusitis purpose of dental implant called Sinuslift [4, 5, 6 & 8]. Distance-maxillary sinus is often so low that an implant can not be included in stable long enough. With the incorporation of bone material or bone grafting, maxillary sinus floor, ‘grow’ and that this level can be implanted implants safe. Sinuslift distinguish Extern and Intern [9,10].


2019 ◽  
Author(s):  
Zhaoguo Yue ◽  
Qi Liu ◽  
Haidong Zhang ◽  
Jingwen Yang ◽  
Yalin Zhan ◽  
...  

Abstract Background Residual alveolar bone volume is a critical factor for the dental implants’ survival [1]. When the volume of alveolar bone in the posterior maxillary region is less than 4mm, the maxillary sinus floor elevation (MSFE) with lateral approach is an effective way to solve this problem [2]. Traditionally, this standard approach is usually delivered 4 months after the extraction of the tooth. However, the defective dentition due to the extraction would cause impaired masticatory function during the long period of the bone regeneration, especially when molars on both sides are severely periodontal compromised and need to be extracted. So, as periodontists, we start to wonder if we can maintain a compromised tooth so that we perform the sinus floor elevation before the extraction (the modified MSFE) to take fully advantage of residual strength of the teeth. Methods/Design The proposed study is designed as a prospective single-center, split-mouth design, randomized controlled trial. We plan to recruit 10 patients whose molars on both sides are severely periodontal compromised and in need of dental implant treatment in the atrophied posterior maxilla. The two sides of each patients will be divided into two groups randomly using Randomizer for Clinical Trials (Institute for Medical Informatics, Statistics and Documentation, Medical Univ. Graz). Test group: sinus floor augmentation before tooth extraction (the modified MSFE); Control group: sinus floor augmentation after tooth extraction (the standard MSFE). Implant survival rates, mucosal conditions around the implants, complications, treatment time and postoperative discomfort (visual analogue scale for intraoperative pain and postoperative pain/discomfort) will be recorded. The volume of the alveolar bone will be measured 6, 12, 18, and 24 months after the MSFE surgery by means of CBCT. Histological and histomorphometic analysis will be performed on biopsies retrieved from both side of grafting sites. Discussion The current study will explore the effectiveness of the modified MSFE on minimizing the discomfort period caused by defected dentition. To determine whether the modified MSFE will promote the grafting outcomes, the quality and the quantity of the osteogenesis on the sinus floor will also be compared. Depending on the result of the current study, we will determine all the protocols and details about the modified MSFE, including indications, detailed methods, post-operational complications and managements.


2005 ◽  
Vol 31 (2) ◽  
pp. 85-90 ◽  
Author(s):  
Muna Soltan ◽  
Dennis G. Smiler

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.


Author(s):  
Santhosh B. Shenoy ◽  
Avaneendra Talwar ◽  
Smitha Shetty ◽  
Raghavendra Vamsi Anegundi

AbstractSinus floor elevation is a predictable procedure for vertical bone augmentation in the atrophic posterior maxilla. As with most surgical procedures, complications can be encountered during sinus floor elevation/augmentation. A clinician should have a thorough knowledge of factors that can lead to complications and possible ways to manage. Presurgical evaluation of the sinus is a prerequisite in identifying the concomitant presence of systemic disease and maxillary sinus disease that may lead to postoperative complications. Despite the best efforts, one may encounter adverse events. Complications can broadly be divided into intraoperative, acute, and chronic complications based on the timing of its occurrence. The most commonly encountered complications include membrane perforation and excessive bleeding. Evaluation of anatomic deviations and sound surgical skill is required to reduce intraoperative complications. Prevention is better than cure. It is always better to know how and when a complication might occur so that the clinician might take the necessary steps to avoid it. This article reviews the management of most commonly encountered complications and the best possible ways to manage them.


2020 ◽  
Vol 46 (4) ◽  
pp. 415-422
Author(s):  
Junho Jung ◽  
Jung Soo Park ◽  
Seoung-Jin Hong ◽  
Gyu-Tae Kim ◽  
Yong-Dae Kwon

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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