Bilateral Partial Sinusectomy Using Bichat’s Fat Pads and Collagen Membrane to Close Access, With Immediate Installation of Implants Using All-On-Four Technique: A Case Study

Abstract

Rehabilitation with dental implants is considered a reliable practice that continues to evolve. In resorbed alveolar ridges, such as in posterior regions of the maxilla, they present challenges to the dental surgeon, due to the pneumatization of the sinus cavity. Maxillary sinus elevation is a safe and predictable technique in these cases, however complications such as the migration of implants to the paranasal sinuses can occur, resulting in oroantral communications and secondary infections. The objective of this article is to present a case report in which bilateral partial sinusectomy was performed using Bichat's adipose body and collagen membrane to close the access, followed by implant installation using the all-on-four technique. Patient who, after six months of surgery, presented displacement of 2 of the 4 implants installed in the maxilla into both cavities of the maxillary sinus, resulting in bilateral oral-sinus communication. Access to the maxillary sinuses was performed, followed by a partial sinusectomy maneuver, removal of the displaced implants, decontamination of the cavity, displacement of the Bichat adipose body into the cavity on the right side and on the left side, a type 1 collagen membrane was adapted for closure. and protection of the anteroposterior window of the maxillary sinus. Conclusion: Partial sinusectomy using Bichat's adipose body and collagen membrane to close the access with immediate implant installation showed promising results in maxillary rehabilitation.