Sinus Floor Elevation via an Osteotome Technique without Biomaterials

Abstract

According to classic Hirschfeld studies, the first teeth to be lost are the first and second maxillary molars. After the teeth are extracted and the alveolar process is developed, the maxillary sinus is reabsorbed and pneumatized with a decrease in bone availability in the posterior sector of the maxilla. This process often creates the need to perform regeneration techniques for the placement of implants in this area due to the low availability of bone. The most frequently used and documented technique for the elevation of the sinus maxillary floor is elevation by the side window, as proposed by Tatum. In 1994, Summers proposed a technique that allowed the elevation of the sinus floor from a crestal access using an instrument called an osteotome, as well as the placement of the implant in the same surgical act. The aimed of the study was to evaluate the survival of 32 implants placed in posterior maxilla with bone availability less than 5 mm performing a sinus lift augmentation technique with osteotome without biomaterials. The results of this study show a survival rate of 100% for 32 implants placed in situations with an initial bone availability of 2 to 5 mm without the use of graft material. The infra-drilling technique used offers an increase in the primary stability of implants that allows adequate osteointegration Implants placed were charged at 12 weeks. In all cases, spontaneous bone formation was observed, even in cases where a positive Valsalva maneuver was observed. This proposed technique reduces treatment time and the need for more invasive maxillary sinus augmentation techniques.

Tilted Implants and Sinus Floor Elevation Techniques Compared in Posterior Edentulous Maxilla: A Retrospective Clinical Study over Four Years of Follow-Up

“…Regardless of possible complications, studying the cone beam CT scan before proceeding with any type of surgical approach may be crucial to evaluate the residual bone height and maxillary sinus conformation and, subsequently, to make the most appropriate surgical choice [15][16][17][18][19][20][21][22]48].…”

“…Less than 5 mm, inadequate bone volume in the retrocanine area for tilted implant placement at least 10 mm long, impossibility of combining a tilted implant with an axial one and absence of any contraindication to sinus augmentation [15][16][17][18][19] Minimum of 5 mm [20][21][22] Less than 7 mm, adequate bone volume in the retrocanine area for tilted implant placement at least 10 mm long, possibility of combining a tilted implant with an axial one and contraindication to sinus augmentation [18][19][20][21][22] Written informed consent for implant prosthetic rehabilitation was obtained from all patients prior to the beginning of the study, and the local ethical committee approved the study; professional oral hygiene was provided before surgery.…”

“…In addition, implant placement in basal bone should always be considered in the presence of any conditions that could represent a possible contraindication to sinus augmentation, such as sinusitis, including allergic rhinitis, polyp, cyst, or tumor in the maxillary sinus, and a history of sinus surgery [21,22].…”

Modified Osteotome Sinus Floor Elevation Technique for Multiple Edentulous Spaces: A Non-Randomized Controlled Trial

“…[12][13][14]. Few studies have evaluated the existence of Schneider membrane perforation after OSFE, which would complicate the OSFE surgery and affect the success rate of implants [15]. In particular, the alteration of the surface tension coefficient of the Schneiderian membrane while performing OSFE adjacent to edentulous spaces via different techniques might have an impact on the integrity of the Schneiderian membrane, which demands exploration and discussion.…”

Tilted Implants and Sinus Floor Elevation Techniques Compared in Posterior Edentulous Maxilla: Retrospective Clinical Study of Four Years Follow-up

“…If residual bone height is at minimum of 5 millimetres, the transcrestal sinus lift technique, described by Summer in 1994 [15][16], could be considered adequate [17].…”