Abstract
Purpose: The present study investigates sinus membrane rupture in direct maxillary sinus lift with the rotary technique and with ultrasound, examining the survival of implants placed after sinus augmentation, and analyzing the bone gain obtained after the operation and 12 months after placement of the prosthetic restoration. Material and Methods: A retrospective study was made of 45 patients requiring maxillary sinus lift or augmentation for implant-prosthetic rehabilitation. Use was made of the hand piece and ostectomy drills for the rotary technique, and of specific tips for ultrasound. The implant success criteria were based on those developed by Buser. The bone gain obtained as a result of sinus lift was calculated from the postoperative panoramic X-rays. Results: A total of 57 direct elevations of the maxillary sinus were carried out: 32 with the rotary technique and 25 with ultrasound. Perforations of Schneider’s membrane with the rotary technique and ultrasound occurred in 7% and 1.7% of the cases, respectively, with membrane integrity being preserved in 91.2%. Of the 100 implants placed, 5 failed after one year of follow-up in the rotary technique group, while one implant failed in the ultrasound group. The rotary technique in turn afforded a bone gain of 5.9 mm, versus 6.7 mm with ultrasound. Conclusions: Perforations of the membrane sinusal in direct lift were more frequent with the rotary technique (7%) than with ultrasound (1.7%). Implant survival and bone gain were both greater when ultrasound was used. Key words:Bone sectioning, maxillary sinus augmentation, piezosurgery.
Highlights
Sinus elevation allows maxillary bone augmentation and facilitates implant rehabilitation in patients with severe posterior maxillary atrophy
In direct maxillary sinus lift a vestibular osteotomy is performed, a bone window is prepared, and access is gained to the maxillary sinus for elevation of the membrane
The present retrospective study was designed to compare the performance of the rotary technique versus ultrasound in application to sinus lift, analyzing sinus membrane rupture in direct maxillary sinus lift with both instruments, examining the post-augmentation survival of implants 12 months after prosthetic restoration, and analyzing the bone gain obtained after the operation and 12 months after placement of the prosthetic restoration
Summary
Sinus elevation allows maxillary bone augmentation and facilitates implant rehabilitation in patients with severe posterior maxillary atrophy. In direct maxillary sinus lift a vestibular osteotomy is performed, a bone window is prepared, and access is gained to the maxillary sinus for elevation of the membrane. In elevation with the rotary technique, the main intraoperative complication is perforation of Schneider’s membrane, which is observed in between 10-35% of all such operations [2], and which usually occurs in the osteotomy drilling phase while preparing the window for access to the sinus [3]. The present retrospective study was designed to compare the performance of the rotary technique versus ultrasound in application to sinus lift, analyzing sinus membrane rupture in direct maxillary sinus lift with both instruments, examining the post-augmentation survival of implants 12 months after prosthetic restoration, and analyzing the bone gain obtained after the operation and 12 months after placement of the prosthetic restoration
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