Fluid Dynamic Transcrestal Sinus Floor Elevation Using a New Surgical Instrument, Flusilift and Hyaluronic Acid as Only Biomaterial: A Case Report

Despite validated surgical techniques and the development of biomaterials, the procedures aimed at increasing the maxillary bone volume by sinus floor elevation have complications with various degrees of relevance. The perforation of the Schneiderian membrane is one of the most frequent events while performing the detachment of the membrane and it can increase the risk of iatrogenic sinusitis, impairment of functional homeostasis, dispersion of the graft material in the antral cavity as well as its bacterial colonization with a subsequential failure of the procedure. This report presents a case where transcrestal sinus lift was performed using Flusilift (Sweden & Martina, Due Carrare PD), a new instrument that allows fluid dynamic elevation of the sinus floor using saline solution to detach the Schneider’s membrane in an atraumatic way without using a sinus elevator and obtain an adequate alveolar ridge regeneration using hyaluronic acid in gel formulation to support an implant placement. Hyaluronic acid seems to play a key role in wound healing and contributes to a faster bone neoformation in bone regeneration procedures.

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The Incidence of Maxillary Sinus Membrane Perforation During Endoscopically Assessed Crestal Sinus Floor Elevation: A Pilot Study

Journal of Oral Implantology ◽

10.1563/aaid-joi-d-12-00083 ◽

2012 ◽

Vol 38 (4) ◽

pp. 345-359 ◽

Cited By ~ 21

Author(s):

Antoanela Garbacea ◽

Jaime L Lozada ◽

Christopher A. Church ◽

Aladdin J. Al-Ardah ◽

Kristin A. Seiberling ◽

...

Keyword(s):

Pilot Study ◽

Maxillary Sinus ◽

Surgical Procedure ◽

Surgical Techniques ◽

Graft Material ◽

Sinus Floor Elevation ◽

Membrane Perforation ◽

Sinus Floor ◽

Sinus Membrane Elevation ◽

Sinus Membrane

Transcrestal sinus membrane elevation is a surgical procedure performed to increase the bone volume in the maxillary sinus cavity. Because of visual limitations, the potential for maxillary sinus membrane perforations may be greater than with the lateral approach technique. The aim of this study was to macroscopically investigate ex vivo the occurrence of sinus membrane perforation during surgery using 3 transcrestal sinus floor elevation methods. Twenty fresh human cadaver heads, with 40 intact sinuses, were used for simultaneous sinus membrane elevation, placement of graft material, and dental implants. Real-time sinus endoscopy, periapical digital radiographs, and cone-beam computerized tomography (CBCT) images were subsequently used to evaluate the outcome of each surgical procedure. Perforation rates for each of the 3 techniques were then compared using a significance level of P < .05. No statistically significant differences in the perforation rate (P = .79) were found among the 3 surgical techniques. Although the sinus endoscope noted a higher frequency of perforations at the time of implant placement as compared with instrumentation or graft insertion, the difference was not statistically significant (P = .04). The CBCT readings were judged to be more accurate for identifying evidence of sinus perforations than the periapical radiographs when compared with the direct visualization with the endoscope. This pilot study demonstrated that a sinus membrane perforation can occur at any time during the sinus lift procedure, independent of the surgical method used.

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Sinus Floor Elevation with Modified Crestal Approach and Single Loaded Short Implants: A Case Report with 4 Years of Follow-Up

Case Reports in Dentistry ◽

10.1155/2017/7829179 ◽

2017 ◽

Vol 2017 ◽

pp. 1-7

Author(s):

Michele Perelli ◽

Roberto Abundo ◽

Giuseppe Corrente ◽

Carlo Saccone ◽

Paolo G. Arduino

Keyword(s):

Surgical Techniques ◽

Sinus Floor Elevation ◽

Implant Placement ◽

Basal Bone ◽

Short Implants ◽

Sinus Floor ◽

Bone Gain ◽

Bone Height ◽

Functional Loading

Tooth extraction is usually followed by bone reduction. In the maxillary posterior region, this remodelling combined with sinus pneumatisation and periodontal defects may lead to a reduced basal bone height available for implant placement. Sinus floor elevation can be performed with different surgical techniques. Crestal approach has demonstrated to be effective, less invasive, and associated with a reduced morbidity. This article reports a modified sinus floor elevation by means of rotary, noncutting instruments, addition of xenograft, and 2 short-threaded implant placements. The aim of the study was to evaluate the implant’s success and intrasinus radiographical bone gain after 4 years of functional loading. The premolar implant site presented a starting basal bone height of 6 mm, while the molar site was of 2 mm. In the first surgical step, sinus floor elevation was performed mesially and the implant was inserted, and distally only sinus floor elevation was performed. After 6 months, the mesial implant was uncovered and the second implant was inserted; 4 months later, the second fixture was uncovered, and both fixtures were loaded with single provisional screw-retained crowns and later with single screw-retained porcelain fused to metal crowns. Implants integrated successfully, and crestal bone remodelling did not exceed the smooth collar. Bone gain was 3 mm for the mesial implant and more than 5 mm for the distal one.

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Simultaneous Sinus Floor Elevation and Implant Placement Using Leukocyte- and Platelet-Rich Fibrin as a Sole Graft Material

The International Journal of Oral & Maxillofacial Implants ◽

10.11607/jomi.7371 ◽

2019 ◽

Vol 34 (5) ◽

pp. 1195-1201 ◽

Cited By ~ 3

Author(s):

Bo Molemans ◽

Simone Cortellini ◽

Reinhilde Jacobs ◽

Wim Teughels ◽

Nelson Pinto ◽

...

Keyword(s):

Graft Material ◽

Sinus Floor Elevation ◽

Platelet Rich Fibrin ◽

Implant Placement ◽

Sinus Floor

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Maxillary Sinus-Floor Elevation with Nanoporous Biphasic Bone Graft Material for Early Implant Placement

Clinical Implant Dentistry and Related Research ◽

10.1111/j.1708-8208.2012.00484.x ◽

2012 ◽

Vol 16 (3) ◽

pp. 365-373 ◽

Cited By ~ 6

Author(s):

Christian Mertens ◽

Daniel Wiens ◽

Helmut G. Steveling ◽

Anja Sander ◽

Kolja Freier

Keyword(s):

Bone Graft ◽

Maxillary Sinus ◽

Graft Material ◽

Sinus Floor Elevation ◽

Bone Graft Material ◽

Implant Placement ◽

Maxillary Sinus Floor ◽

Sinus Floor ◽

Maxillary Sinus Floor Elevation

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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.

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