Evaluation of the Efficiency of Sinus Lifting Techniques

Abstract

Right after teeth extraction in posterior regions, there is a following process that consists of physiological resorption and nonfunctional atrophy of the remained alveolar bone ridge. That also impacts the quality on the quality and quantity of the remained bone tissue, what later makes the implant incorporation and the prosthetic restoration much harder and complicated than usual it is. In the posterior region of the upper jaw additional complication of the prosthetic restoration process causes the existing of paranasal sinus that is located right in the body of the upper jaw maxilla. It’s post extraction pneumatization reduces the height of bone tissue what causes difficulties in dental implants placement. The aim of this survey is to evaluate the clinical outcome and the efficiency of the most often used sinus lifting techniques. Were analyzed totally 78 published studies that were done in the last 12 years. The study is made on narrative review of published articles that were investigating the related subject. Research was done by using the most common data bases: NCBI (US National Library of Medicine), Emedicine, PubMEd, Webmd. By using the open method for sinus lifting there needs to be formed lateral window in the bone tissue first by elevating the mucoperiosteal flap on the vestibular surface of the maxillary alveolar ridge and after that creating iatrogenic fenestration on the cortical lamina without perforating the sinus membrane. After the sinus membrane is being separated, the following step is augmentation. For this step are used four different types of bone substituent: autogenous, allogeneic, xenogeneic bone graft and synthetic alloplastic materials. The closed method for sinus lifting is performed after previous created place for the future implant in the residual alveolar bone ridge in the maxilla, after that with special instruments a perforation is being made in the bone floor of the maxillary sinus and carefully elevating the sinus membrane up for a few millimeters. In the created space a bone graft material is being placed and at the same time a dental implant is being applied. From the gathered results, both of the techniques are considered to be effective, in all of the followed cases the implant placements were successful with high rate of postoperative osseointegration, the healing period was without complications and also successful. There was no prosthetic failure in any case. From this survey the final conclusion is that both of the techniques are successful when it comes to sinus lifting. Very important is to have a qualitative imaging like computed tomography or roentgen before placing the implants to be able to estimate the bone volume and height. If the residual bone height is less than 5 mm the survival rate of the future implants is not guaranteed.