Benefit of the Replaceable Bony Window in Lateral Maxillary Sinus Augmentation

Abstract

This study demonstrates that the replaceable bony window acts as an osteoinductive homologous barrier membrane over various bone graft materials and accelerates new bone formation in lateral sinus augmentation.

Reposition of the bone plate over the antrostomy in maxillary sinus augmentation: A histomorphometric study in rabbits

“…Despite the presence of residual marginal defects containing adhesive remnants and connective tissue, the bone plates at the test sites appeared to be well incorporated into the newly formed bone within the available area and at the edges of the antrostomy. This is in agreement with retrospective clinical studies (Kim et al, ; Tawil, Tawil, & , Khairallah, A., ) that showed a good incorporation of the bone plate repositioned on the antrostomy both at the surgical inspection and at a CBCT analysis. Also, in an experiment in rabbits previously discussed (Moon et al, ), the bone plate was found incorporated onto the newly formed bone.…”

“…Mean values ± SD and confidence interval of the difference of the means of mineralized new bone and xenograft percentages (%) in the available area and the various region, and of the available area (mm 2 Note. Data of the 3 periods of healing are reported.is in agreement with retrospective clinical studies(Kim et al, 2014;Tawil, Tawil, & , Khairallah, A., 2016) that showed a good incorporation of the bone plate repositioned on the antrostomy both at the surgical inspection and at a CBCT analysis. Also, in an experiment in rabbits previously discussed(Moon et al, 2014), the bone plate was found incorporated onto the newly formed bone.…”

“…A good incorporation of the bone plate was described in both clinical (Kim et al, 2014) and experimental studies in which the bone plate was repositioned onto the antrostomy without fixation. Likewise, in the present study, the bone plates were well integrated to the subjacent newly formed bone, however with some residual defects at the periphery.…”

Paradigm shift regarding sinus augmentation

“…Unlike collagen membranes, replaceable bony windows act as a homologous osteoinductive barrier; as such, homologous bony windows are free from viral cross-contamination of animal or human origin, and precise adaptation of lateral bony windows completely prevents soft tissue ingrowth. Repositioning of the bony window clinically led to complete bone healing between the replaceable bony window and more mature bone was observed along the floor of the replaceable bony window than at the center of the graft site 3 , 4 . It is time to review and accept change to inflexible views regarding sinus augmentation in order to improve patient outcomes.…”

Clinical utilization of ultrasonic piezoelectric bone surgery during osteotomy

“…Because lower rate of mucosal perforation is reported in many studies, PBS is commonly used when crestal and lateral sinus elevation is performed. In addition, the lateral bony window created by the piezoelectric saw insert is repositioned precisely and also acts as an osteoinductive/osteoconductive substrate in the maxillary sinus in bone grafted/non-bone grafted sinus2. On the other hand, collagen barrier has no effect on bone regeneration.…”