Sinus Floor Augmentation With Simultaneous Implant Placement in the Severely Atrophic Maxilla

Abstract

Dental implant placement associated with augmentation of the sinus floor in the severely atrophic maxilla can be performed in 1- or 2-surgical stages, depending on the height of the residual alveolar bone. A minimum of 4 to 5 mm of residual alveolar bone height is recommended for a 1-stage surgical procedure. The present study describes a 1-stage procedure in cases where the residual alveolar bone height in the posterior maxilla was 1 to 2 mm. A total of 55 hydroxyapatite-coated dental implants were inserted in 20 grafted sinuses of 20 patients. No case presented any difficulty in achieving initial stabilization and parallelism. No perforation of the sinus membrane or clinical complications of the sinuses were evident. Prior to exposure, radiographic evaluation revealed bone consolidation and a close bone-implant relation. At second-stage surgery, there was no clinical evidence of crestal bone loss around the implants. All implants were clinically osseointegrated. All patients received fixed implant-supported prosthesis. The mean follow-up was 26.4 months (range 15 to 39 months). There was no implant loss after loading. The following surgical modifications are essential: a wide lateral window opening, the use of a bone mill to homogenize the bone graft, meticulous condensation, and clinical measurements to ensure implant parallelism.

A Minimally Invasive Sinus Augmentation Technique using a Novel Bone Graft Delivery System

“…However, both approaches seem to yield similar success rates. [13][14][15][16] A less invasive and more predictable TSFE technique was conceived by exploiting the superior handling characteristics and unique delivery system of CPS putty. The consistency of CPS putty also helps in minimizing membrane perforations and associated adverse events.…”

Maxillary sinus augmentation - diagnostic and surgical technique

“…(16,17) Other authors consider that 1 mm height of the floor is sufficient for the one-step intervention. (19)(20)(21)(22) Prior to surgery the patient must be accurately evaluated, including medical history and habits [e.g. use of tobacco -as nicotine diminishes tissue healing and inhibits osteoblast activity (23)] A patient with otorhinolaryngological diseases must be first treated by the ENT specialist.…”

“…( figure 11) In the case of the one-step surgery (when the implant and the graft are placed in the same intervention) supplementary clinical measurements will be necessary to ensure the implant parallelism. (19) (figure 12) After the implants are placed, bone graft is introduced and pressed to the maxillary walls, covering the implant(s). ( figure 13) The access window is closed by placing a barrier, a membrane to close the maxillary sinus.…”

The Use of Cancellous Bone-Block Allograft for Reconstruction of the Atrophic Alveolar Ridge

“…It was once limited to cases with a minimum of 4-5 mm of alveolar bone coronally because of concerns about implant stability and accurate implant location, inclination, and parallelism (Hurzeler et al, 1996;Peleg et al, 1998;Smiler et al, 1992;Tatum et al, 1993). More recent research suggests that no specific bone height limit is necessary so long as primary implant stability is assured (Achong & Block, 2006).…”