Radiographic bone formation after indirect sinus lift using transcrestal osteotomy with simultaneous implant placement

Dental implants really have transformed the reconstruction and strategic planning of fixed prosthodontics in the edentulous posterior maxilla. Increased bone volume via elevation of sinus membrane enables dental implants to be positioned in dysplastic maxillary ridges. The purpose of the research was to determine retrospectively the volume of hard tissue height acquired through a transcrestal method to sinus lifting utilizing osteotomes, together with the concurrent positioning of implants. Documents from the previous 2-year span of partially edentulous cases checked at Saveetha Dental Hospital were searched for patients undergoing implantation to substitute teeth missing in a posterior edentulous maxillary area with inadequate vertical osseous height. The inclusion criterion, sinus lift operation, was performed without bone grafts. A maximum of 42 people was selected. Among these patients, 35 were classified as cases recommended for indirect sinus lift while 45 were given implants. The implants being used are 3.5 mm or 4.5 mm diameter and 10.5, 11 or 13 mm length. The average survival rate for implants was 97.78 per cent. The mean bone height estimated from alveolar crest to the base of the implant just at the time of implantation was 6.79 mm ± 1.35 mm. Measured mean bone height at the six-month follow-up period was 11.4 mm ±0.88 mm, which was significant (p < 0.05). Transcrestal osteotomy with implants tenting sinus membrane without extra graft material might show a substantial mean osseous height increase of 4.6 mm.

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Radiographic comparison of density and height of posterior maxillary bone after open sinus lift surgery with and without PRF

Journal of Advanced Periodontology & Implant Dentistry ◽

10.15171/japid.2018.008 ◽

2019 ◽

Vol 10 (2) ◽

pp. 43-49

Author(s):

Mohamad Taghi Chitsazi ◽

Ali Hosien Dehghani ◽

Amir Reza Babaloo ◽

Sohrab Amini ◽

Hadi Kokabi

Keyword(s):

Dental Implants ◽

Alveolar Bone ◽

Autogenous Bone ◽

Sinus Lift ◽

Maxillary Bone ◽

Posterior Maxilla ◽

Bone Substitute Materials ◽

Substitute Materials ◽

Bone Height

Background and aims. Expansion of maxillary sinus towards the alveolar crest due to tooth loss or horizontal‒vertical resorption of the alveolar bone decreases the available bone for the placement of dental implants in the posterior maxilla. The method suggested for placing implants with a standard length is the use of sinus lift surgery with autogenous bone graft or bone substitute materials. The aim of the present research, with split-mouth design, was radiographic comparison of the density and height of the posterior of maxillary bone after open sinus lift procedure with and without PRF. Materials and methods. In this split-mouth clinical trial, 14 patients were evaluated, with complete or partial bilateral edentulism of the upper jaw. In each case, for the sinus lift surgery of the test side, PRF was used, while in the sinus lift surgery of the other side of the same patient no graft materials were used. After six months and before the second surgery, CBCT was used to evaluate bone density and height. Results. All the 41 implants were osseointegrated and were clinically stable. The bone height was 1.42 mm higher in the PRF group than the group without PRF, which was statistically significant. The mean density of the bone formed around the dental implants in the PRF group was 52.85 units higher than that of the group without PRF, which was statistically significant. Conclusion. Using PRF in sinus lift surgery might enhance the quantity and quality of bone formation.

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Maxillary Sinus Floor Augmentation to Enable One-Stage Implant Placement by Using Bovine Bone Substitute and Platelet-Rich Fibrin

BioMed Research International ◽

10.1155/2018/6562958 ◽

2018 ◽

Vol 2018 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Horia Mihail Barbu ◽

Claudia Florina Andreescu ◽

Monica Raluca Comaneanu ◽

Daniel Referendaru ◽

Eitan Mijiritsky

Keyword(s):

Bone Substitutes ◽

Bovine Bone ◽

Graft Material ◽

Sinus Lift ◽

Platelet Rich Fibrin ◽

One Stage ◽

Implant Placement ◽

Posterior Maxilla ◽

The Mean ◽

Bone Height

Nowadays it is possible to perform an optimal implant placement and to achieve a good long-term prognosis for an implant-borne prosthesis in the grafted posterior maxilla. This study evaluates the efficiency of one-stage piezosurgery by using as graft material a combination of particulate bovine bone substitutes with platelet-rich fibrin to achieve sinus lift. We included in this study 14 cases of one-stage sinus lift surgeries during which we placed 30 standard implants. The mean vertical bone height gain was 10.12 mm six months after surgery, and the mean postoperative follow-up time was 43.79 months. There were no major complications during or after surgery, and all implants are in use. Therefore, it can be concluded that one-stage sinus piezosurgery using particulate bovine bone substitutes and platelet-rich fibrin can be applied as a predictable and effective technique in the treatment of the posterior edentulous maxilla ensuring 4-5 mm vertical bone height.

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Minimally Invasive Sinus Augmentation

Journal of Oral Implantology ◽

10.1563/aaid-joi-d-09-00010 ◽

2010 ◽

Vol 36 (4) ◽

pp. 295-304

Author(s):

Gregory Gene Steiner ◽

Dainon M. Steiner ◽

Melis P. Herbias ◽

Roslynn Steiner

Keyword(s):

Tissue Engineering ◽

Minimally Invasive ◽

Success Rate ◽

Dental Implants ◽

Graft Material ◽

Sinus Lift ◽

Tooth Replacement ◽

Sinus Augmentation ◽

Surgical Modality

Abstract Sinus lift surgery has become more common as patients choose dental implants for tooth replacement. The recent development of a graft material that stimulates osteogenesis coupled with the application of tissue engineering principles has allowed for refinement of this surgical modality. A simple nontraumatic subantral sinus lift microsurgery is presented. This sinus lift microsurgery resulted in a 97% implant success rate.

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Radiographic Monitoring of Changes in Bone Height after Implant Placement in Combination with an Internal Sinus Lift without Graft Material

Clinical Implant Dentistry and Related Research ◽

10.1111/cid.12138 ◽

2013 ◽

Vol 17 ◽

pp. e267-e274 ◽

Cited By ~ 4

Author(s):

Peter Rammelsberg ◽

Jaleh Mahabadi ◽

Constantin Eiffler ◽

Andreas Koob ◽

Stefanie Kappel ◽

...

Keyword(s):

Graft Material ◽

Sinus Lift ◽

Implant Placement ◽

Bone Height

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Sinus Grafting With a Natural Flourohydroxyapatite for Immediate Load: A Study With Histologic Analysis and Histomorphometry

Journal of Oral Implantology ◽

10.1563/1548-1336-35.4.164 ◽

2009 ◽

Vol 35 (4) ◽

pp. 164-175 ◽

Cited By ~ 11

Author(s):

Cameron Y. S. Lee ◽

Michael D. Rohrer ◽

Hari S. Prasad ◽

John D. Stover ◽

Jon B. Suzuki

Keyword(s):

Retrospective Study ◽

Dental Implants ◽

Platelet Rich Plasma ◽

Survival Rates ◽

Bone Sample ◽

Autogenous Bone ◽

Osteotomy Site ◽

Graft Material ◽

Implant Survival ◽

Posterior Maxilla

Abstract The goal of this retrospective study was to evaluate the survival rates of dental implants placed in sinuses grafted with a 50:50 composite ratio of autogenous bone and a natural flourohydroxyapatite (FHA) combined with platelet-rich plasma (PRP) using an immediate-load protocol. The authors hypothesized that a 50:50 composite ratio of FHA and autogenous bone combined with PRP would permit immediate loading without compromising implant survival rates. Eleven patients with bilateral partial edentulism of the posterior maxilla were enrolled in this retrospective study. Autogenous bone used in the graft procedure was harvested from the tibia of the left lower extremity. Each patient was grafted with a 50:50 composite ratio of autogenous bone and FHA. Membranes were not used to cover the lateral wall osteotomy site. Platelet-rich plasma was added to the graft material to accelerate and enhance bone regeneration. Four to 6 months after the grafting procedure, 37 hydroxyapatite-coated dental implants were surgically placed and immediately loaded between 72 hours and 5 days later with custom titanium abutments and acrylic provisional restorations placed out of functional occlusion. Six months later, definitive ceramometal restorations were cemented on to the custom abutments. Patients were observed over a 52-week period. The overall implant survival rate was 97.3%. Histologic and histomorphometric analysis of core samples revealed formation of new vital bone in different graft specimens ranging from 23% to 34%. In each core bone sample, 100% of the bone sample was determined to be vital. In the grafted maxillary sinus, the natural FHA combined with autogenous bone in a 50:50 composite ratio with PRP is a suitable graft material permitting immediate load without compromising implant survival rates while decreasing the overall healing time.

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Single-Crown, Short and Ultra-Short Implants, in Association with Simultaneous Internal Sinus Lift in the Atrophic Posterior Maxilla: A Three-Year Retrospective Study

Materials ◽

10.3390/ma13092208 ◽

2020 ◽

Vol 13 (9) ◽

pp. 2208 ◽

Cited By ~ 1

Author(s):

Giorgio Lombardo ◽

Mauro Marincola ◽

Annarita Signoriello ◽

Giovanni Corrocher ◽

Pier Francesco Nocini

Keyword(s):

Contact Point ◽

Invasive Technique ◽

Sinus Lift ◽

Sinus Floor Elevation ◽

Single Crown ◽

Posterior Maxilla ◽

Sinus Floor ◽

Osteotome Sinus Floor Elevation ◽

Bone Height

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.

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The Maxillary Sinus Membrane Elevation Procedure: Augmentation of Bone around Dental Implants without Grafts—A Review of a Surgical Technique

International Journal of Dentistry ◽

10.1155/2012/105483 ◽

2012 ◽

Vol 2012 ◽

pp. 1-9 ◽

Cited By ~ 25

Author(s):

Christopher Riben ◽

Andreas Thor

Keyword(s):

Maxillary Sinus ◽

Dental Implants ◽

Blood Clot ◽

Survival Rates ◽

Autogenous Bone ◽

Sinus Lift ◽

Bone Harvesting ◽

Sinus Membrane ◽

Long Term Studies

Background. Long-term edentulism may in many cases result in resorption of the alveolar process. The sinus lift procedure aims to create increased bone volume in the maxillary sinus in order to enable installation of dental implants in the region. The method is over 30 years old, and initially autogenous bone grafts were used and later also different bone substitutes. Since 1997, a limited number of studies have explored the possibility of a graftless procedure where the void under the sinus membrane is filled with a blood clot that enables bone formation.Aim. To describe the evolution of the sinus-lift technique and to review the literature related to the technique with a focus on long-term studies related to the graft-less technique.Methods. The electronic database PubMed was searched, and a systematic review was conducted regarding relevant articles.Results. A relatively few long-term studies using the described technique were found. However, the technique was described as reliable considering the outcome of the existing studies.Conclusion. All investigated studies show high implant survival rates for the graftless technique. The technique is considered to be cost-effective, less time-consuming, and related to lower morbidity since no bone harvesting is needed.

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Indirect Osteotome Maxillary Sinus Floor Elevation: An Update

Journal of Oral Implantology ◽

10.1563/aaid-joi-d-11-00160 ◽

2012 ◽

Vol 38 (6) ◽

pp. 799-804 ◽

Cited By ~ 10

Author(s):

Javier Romero-Millán ◽

Luis Martorell-Calatayud ◽

Maria Peñarrocha ◽

Berta García-Mira

Keyword(s):

Maxillary Sinus ◽

Survival Rates ◽

Graft Material ◽

Sinus Floor Elevation ◽

Posterior Maxilla ◽

Membrane Perforation ◽

Maxillary Sinus Floor ◽

Sinus Floor ◽

Bone Height ◽

Maxillary Sinus Floor Elevation

The objective was to review publications on indirect osteotome maxillary sinus floor elevation (OMSFE) procedures. Studies published between 1999 and 2010 on patients with a minimum of 1 year of follow-up were analyzed. Fourteen studies were included. Indirect OMSFE is indicated for a bone height of 6–8 mm. More bone height was gained when graft material was used. Schneiderian membrane perforation was the most frequent complication. Survival rates varied between 93.5% and 100%. Osteotome sinus membrane elevation is a predictable and effective procedure for placing implants in areas of the posterior maxilla with low bone height.

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Osseodensified Crestal Sinus Window Augmentation: An Alternative Procedure to the Lateral Window Technique

Journal of Oral Implantology ◽

10.1563/aaid-joi-d-19-00288 ◽

2020 ◽

Author(s):

Nilesh Salgar

Keyword(s):

Invasive Technique ◽

Sinus Lift ◽

Sinus Augmentation ◽

Window Technique ◽

Membrane Perforation ◽

Maxillary Molar ◽

Window Approach ◽

Bone Height ◽

Sinus Membrane ◽

Vertical Height

A novel minimally invasive technique, osseodensification, is proposed to facilitate maxillary sinus bone graft augmentation. The Osseodensified Crestal Window overcomes the previous limitations of traditional crestal approaches with respect to residual bone height (RBH) of ≤ 1.5 mm as well as vertical height of augmentation (> 10 mm). Three patients, healthy and non-smoking, with three distinct and difficult clinical situations requiring sinus augmentation and having a maximum of 1.5 mm RBH (0.4 mm – 1.5 mm) were selected for this procedure. Edentulous sections were large (entire posterior sextant, both with and without sinus septa), and small (single maxillary molar). The author ensured compliance with EQUATOR Guidelines (CARE Case Report Checklist). All healing was rapid and uneventful with no instances of sinus membrane perforation or other complications seen. The vertical increase in bone height ranged from 10.3 mm to 13.6 mm. The proposed crestal sinus lift technique is a potentially safe and effective procedure that overcomes the long-established restrictions of transalveolar sinus augmentation. The increase in bone height is comparable to that obtained with lateral window procedures. This innovative technique may possibly provide a viable alternative to the rationale for the lateral window approach.

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Segmental Osteotomy with Interpositional Graft in Posterior Maxilla Area

International Journal of Medical and Surgical Sciences ◽

10.32457/ijmss.2014.031 ◽

2018 ◽

Vol 1 (3) ◽

pp. 257-261

Author(s):

Eder Sigua ◽

Sergio Olate ◽

Lucas Cavalieri-Pereira ◽

Valdir Cabral ◽

Leandro Pozzer ◽

...

Keyword(s):

Case Report ◽

Bone Loss ◽

Dental Implants ◽

Clinical Case ◽

Viable Option ◽

Posterior Maxilla ◽

Real Challenge ◽

Bone Height ◽

Posterior Area ◽

Maxillary Sinuses

A variety of techniques have been documented for the recovery of bone loss in areas where rehabilitation with dental implants is planned. The loss of teeth is followed by the loss of height and thickness of the bone too, precluding the installation of dental implants. The premature bone loss in this region can also cause pneumatization of the maxillary sinuses. So, the corrections of these defects are a real challenge for dentists and oral surgeons. The technique of segmental osteotomy with bone interposition graft has proven to be a viable option to solve this problem. This clinical case report describes the successful application of the technique in the treatment of decreased vertical dimension in the posterior area of the maxilla, where 7 months later 4 dental implants were installed. Two dental implants of 13 mm, and two dental implants of 11 mm, demonstrating success with bone height that was achieved in the case, making the use of this technique very sustainable in bone loss of posterior area of the maxilla with pneumatized maxillary sinuses.

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