Inadequate keratinized mucosa decreased cleansibility of implant sites and increased mucosal inflammation. There is a possibility that PA in implant sites caused more pronounced inflammatory response compared to contralateral tooth.

IntroductionPerforation of the Schneiderian membrane is the most common complication in sinus floor augmentation (SFA). When volume of grafting is qualified to prevent enlargement of the membrane perforation, lack of bone volume may occur in optimal site.Case presentationSFA was performed in sites #24 to 26 in a 63-year-old male. However, a 10-mm size perforation of the Schneiderian membrane occurred in site #26. Although the sinus cavity was grafted with deproteinized bovine bone mineral (DBBM) after repair of membrane perforation, insufficient bone formation was observed on palatal and distal aspects of site #26 at 5 months after SFA. Although additional SFA was required for implant placement, it seemed to be difficult to elevate the membrane by a conventional lateral approach in the palatal aspect of the sinus floor (site #26). Considering the configuration of new bone formation, it was decided to perform the palatal antrostomy approach. The Schneiderian membrane was elevated without perforation, and the sinus cavity was grafted with DBBM mixed with venous blood. Two 12-mm long, 4.1-mm diameter implants were placed in sites #14 and 16. Four months after implant placement, abutment-connection surgery was successfully performed. The radiographic image indicated improved radiopacity, without obvious bone resorption in site #26.ConclusionThe palatal window osteotomy technique could be considered as an alternative method for augmentation of maxillary sinus in cases where difficulty is encountered to elevate a membrane by a conventional approach (e.g., in cases in which buccal bone height is long).

Steric analysis of morphological changes is important for evaluation of surgical techniques. This study was performed to assess the measurement accuracy of alveolar soft tissue contour with a laboratory laser scanner. The width of the maxillary alveolar soft tissue contour was evaluated in 20 volunteers. Measurement sites were established in the alveolar soft tissue contour of the maxillary incisor and canine areas. Each site was evaluated by direct measurement with a microcaliper for each subject (DMM) and image measurement using a laboratory laser scanner (IMS). The accuracy of measurement methods was evaluated. Additionally, two plaster models obtained from the same subjects were scanned and superimposed, and the nonoverlapping areas were measured. Each measurement method exhibited a strong correlation (r = 0.89). The interclass correlation coefficient (single measure) between examiners was also high for each measurement method (PMM 0.978; IMS 0.997). In the superimposed images of the two plaster models, the distance of the nonoverlapping region was only 0.06 ± 0.08 mm in the labial aspect and 0.07 ± 0.09 mm in the palatal aspect. The image measurement of the scanning data shows high accuracy in evaluation of the alveolar soft tissue contour. This technique is useful for evaluation of chronological changes in the alveolar contour after soft and hard tissue augmentation.

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