Abstract
Purpose: To assess surgical success rate of placing dental implants in the atrophic posterior maxilla engaging the maxillary sinus floor in patients with inadequate posterior maxillary alveolar bone height (PMABH). Methods: 26 patients with PMABH of 7 - 10 mm had 39 implants placed between July 2012 and June 2014. These implants were placed protruding apically 1 - 3 mm into the maxillary sinus engaging the sinus floor. At stage one, implants and cover screws were placed, followed by stage two, 5 - 6 months later. The implants were considered osseo-integrated in the absence of symptoms, mobility and inflammation. Periapical radiographs were taken to rule out peri-implant radiolucency. Restorative treatment was completed 2 months thereafter. Patients were scheduled to have a dental exam (6 - 12 months after delivery of prosthesis) and the implants were evaluated clinically and radiographically. A retrospective review was conducted to assess the surgical success rate of this treatment modality. Clinic charts, radiographs and digital implant log were reviewed for all patients with PMABH of 7 - 10 mm who received dental implants in the posterior maxilla to determine the success rate of this treatment modality. Results: 26 patients who had 39 implants placed were included in the study. All implants (100%) were osseo-integrated at the time of uncovering (stage 2). None of the implants (0%) had mobility or inflammation around them. Stage 2 was successfully performed on all 39 implants (100%). All implants (100%) in these patients had been restored, and were in good condition without mobility or inflammation, and had been functioning well 6 - 12 months after restoration. Conclusion: This study suggests that a high success rate can be attained placing dental implants in the posterior maxilla while perforating and engaging the cortical maxillary sinus floor. A future prospective study that compares this technique with the internal sinus lift would likely help elucidate this suggestion.
Highlights
Dental implant placement has become a popular and successful procedure for replacing missing teeth
This study suggests that a high success rate can be attained placing dental implants in the posterior maxilla while perforating and engaging the cortical maxillary sinus floor
An implant osteotomy is made short of the maxillary sinus floor by about 2 mm and osteotomes are used to fracture up the sinus floor and particulate bone graft material is placed between the created implant osteotomy and the fractured sinus floor, resulting in increased eventual posterior maxillary alveolar bone height (PMABH)
Summary
Dental implant placement has become a popular and successful procedure for replacing missing teeth. Posterior maxillary alveolar height can be increased successfully via a lateral wall sinus augmentation known as a “direct sinus lift” When this bone deficiency is greater than 3 mm, a “direct sinus lift” is performed through the lateral maxillary sinus wall by lifting the sinus membrane under direct visualization and placement of bone graft with or without concomitant implant placement. An implant osteotomy is made short of the maxillary sinus floor by about 2 mm and osteotomes are used to fracture up the sinus floor and particulate bone graft material is placed between the created implant osteotomy and the fractured sinus floor, resulting in increased eventual PMABH. This study was conducted to assess the success rate of this procedure in our patient population
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