Antral Membrane Balloon Elevation Research Articles

Minimally invasive techniques for sinus floor elevation using dental implants among Indians.

It is of interest to compare conventional lateral window technique, trans-alveolar technique with minimally invasive technique like modified trephine technique and antral membrane balloon elevation technique for sinus floor elevation in placement of dental implants. The current study included 140 participants (191 dental implants) who had maxillary posterior edentulous regions and had low sinuses and insufficient alveolar ridges but had chosen an implant-retained prosthesis. The minimally invasive techniques of sinus augmentation can be suitable alternative to conventional traumatic techniques due to low incidence of pain, gingival swelling. Moreover, the success rate of implants and increase in total bone height was almost same in minimally invasive techniques of sinus augmentation as compared to conventional traumatic techniques.

Efficacy of Two Different Hydrodynamic Sinus Lift Systems for Atraumatic Elevation in Immediate Implant Placement.

To evaluate the efficacy of two hydrodynamic sinus lifting procedures and to successfully place immediate implants in maxillary posterior sites that have a compromised native bone as a result of periodontal or endodontic disease. A total of 26 patient sites were enrolled with 13 sites each in the Minimally Invasive Antral Membrane Balloon Elevation (MIAMBE) and Drill Integrated Hydrodynamics for the transcrestal sinus floor elevation (DIHSFE) groups who received transcrestal sinus floor elevation followed by immediate implant placement. Clinical parameters such as sinus membrane perforations, nasal bleeding, postoperative sinusitis, VAS scores at Day-7 for pain and discomfort, primary implant stability and time taken were evaluated. The DIHSFE had greater sinus membrane perforations and incidence of nasal bleeding when compared with MIAMBE with (p = 0.066) and (p = 0.141). Post-operative sinusitis was evident in both the groups with (p = 0.619). The mean VAS score was statistically significant between both the groups (p ≤ 0.005). The insertion torque values, and mean time taken for surgical procedure was not statistically significant between groups. The present study highlighted that MIAMBE is superior to DIHSFE in its ability to cause less severe patient morbidities and post-operative complications.

The assessment of the effect of the size of lateral-antrostomy in graftless balloon elevation of the maxillary sinus membrane with simultaneous implant placement (a randomized controlled clinical trial).

The overlying maxillary sinus frequently restrains the height of the posterior maxillary bones. Evaluating the effect of downsizing the antrostomy side-window on the stability of the installed implants and vertical bone gain, after employing a graftless antral membrane balloon elevation (AMBE). The study is a randomized controlled clinical trial conducted on 20 patients with 30 deficient maxillary alveolar ridges underwent graftless (AMBE) after being allocated into a (5 mm) entry antrostomy group (the test group) and a (10 mm) entry antrostomy group (the control group) implementing a radiographic linear bone height and implant stability quotations (ISQ) comparison among both groups immediately after the placement of 38 Implants and 6 months after. Radiographic bone gain of the test group (5.55 ± 0.93 mm) was significantly higher than the control group (2.86 ± 0.60 mm) (p <0.001). There was no significant difference in primary stability between the test (65 ± 5.32) and control groups (62.67 ± 4.46) (p = 0.202); while the test group (73.43 ± 4.39) showed significantly higher secondary stability than the control group (64.83 ± 6.05) (p <0.001). ISQ values recorded at 6 months were significantly higher than those recorded at insertion in the test group (p <0.001), while they were insignificant in the control group (p = 0.148). Undersizing the antrostomy window deemed beneficial concerning the vertical bone gain and the simultaneously placed root form dental implants' secondary stability.

Maxillary sinus balloon lifting and deferred implantation of 50 osseointegrated implants: a prospective, observational, non-controlled study

The aim of this study was to assess the effectiveness of minimally invasive antral membrane balloon elevation (MIAMBE). Twenty-seven patients with severe resorption of the posterior maxilla were treated by balloon catheter-assisted sinus lift procedure with deferred implant placement. Panoramic radiographs and computed tomography scans were obtained prior to surgery and at 6 months after surgery, before implantation. Data collected following surgery included inflammation, pain, bleeding, infection, and haematoma. Pain and inflammation were recorded using a six-point verbal rating scale (VRS). The patients were followed up for an average of 15 months. The initial sinus floor height was measured for each planned implant and compared with the height at 6 months post-surgery. The average bone height gain was 8.10±3.45mm (range 0.5–13.95mm). Inflammation on the VRS ranged from 0 to 3 (mean 0.97±0.85), while pain ranged from 0 to 4 (mean 0.87±1.19). There was a perforation of the Schneiderian membrane smaller than 2mm in one case. In another case, the balloon lift procedure had to be aborted and changed to the conventional Tatum technique due to breakage of the balloon inside the sinus. The results of this study show the balloon sinus lift technique to be an easy procedure to perform, with apparently low rates of inflammation and pain, and to provide sufficient quantity and quality of bone for the placement of osseointegrated implants.

Management of maxillary posterior inadequate ridge height for prosthetic rehabilitation

The rehabilitation of patients affected by posterior maxillary atrophy by the aid of implant-supported fixed prosthesis presents a challenge in many cases. The available residual alveolar ridge is insufficient for the placement of dental implants because of alveolar bone resorption, pneumatization of the maxillary sinus, or their combination. Maxillary sinus floor augmentation is the treatment of choice in such cases. Sinus lift procedure can be carried with or without simultaneous implant placement. Recently, various newer techniques have been introduced for sinus floor elevation such as antral membrane balloon elevation, water lift technique, and piezosurgery. Furthermore, short implants and zygomatic implants can also be done in severe posterior atrophied maxilla.

Minimally invasive antral membrane balloon elevation as an alternative approach to sinus augmentation with simultaneous implant placement. A review and case series

Minimally invasive antral membrane balloon elevation as an alternative approach to sinus augmentation with simultaneous implant placement. A review and case series

The Effectiveness of Oxidized Regenerated Cellulose as a Graft Material in Transalveolar Osteotome Sinus Lift Procedure.

The posterior maxilla is challenged with postextraction alveolar bone resorption and pneumatization drive of the Schneiderian membrane that reduces the subantral distance. To overcome such anatomic obstacle a sinus augmentation procedure was introduced either via lateral or crestal approach depending on residual ridge height. The current study evaluated oxidized regenerated cellulose (ORC) as a grafting material versus osteon II by measuring bone gain and graft density, 24 weeks postoperatively. Twenty consecutive patients (24 cases) aged from 20 to 65 years were considered eligible after clinical and radiographic evaluation. These patients were allocated in 2 groups (study and control) that underwent transcrestal osteotome antral membrane balloon elevation and surgical void augmentation with ORC in the study group, while the control group grafted with collagen membrane and osteon II with simultaneous dental implant placement in both groups and were followed up for 1 year. Cone beam computed tomography was taken for all patients preoperatively and postoperatively to verify neoformed bone and density in Hounsfield units (HU). The mean gained height of the bone was 6.48 mm (5.94 mm in the study and 7.02 mm in the control). The mean density of graft above implant apex was 497.99 HU (434.23 HU in the study and 561.75 HU in the control). Apart from Schneider membrane thickening in 2 patients from the control group, there were no serious complications reported throughout the study. These results demonstrate that ORC is a reasonable grafting material with comparable outcomes when compared to osteon II with less postoperative complications.

An Assessment of the Efficacy of Sinus Balloon Technique on Transcrestal Maxillary Sinus Floor Elevation Surgery

Background: A minimally invasive antral membrane balloon elevation (MIAMBE) has been introduced to overcome the invasiveness of modified Caldwell-Luc (lateral approach) and the drawbacks of the osteotome (summers' technique) in maxillary sinus floor elevation surgery. Materials and methods: A total of 13 adult Iraqi patients aged 28-55 years, 4 males and 9 females underwent sinus floor elevation surgery via crestal approach by using sinus balloon technique. A panoramic radiograph and (Cone beam computed tomography (CBCT)/or medical CT scan) were obtained before and after surgery. Postoperative gained bone was assessed and the patient reactions including pain, nasal bleeding, and ecchymosis were recorded. The whole follow up period was 1year following the sinus lift surgery. Results:The total performed sinus floor elevation cases were 17 with a total of 27 sinus floor elevation sites. The maximum gained bone with sinus balloon technique was 10.6 mm. Twenty three dental implants placed in augmented maxillary sinuses, two implants early failed 8.70 % and the survival rate of the dental implants was (91.30 %). Schneider's membrane perforation didn’t occur in any case of this study 0%. Conclusion: Sinus floor elevation via crestal approach using the balloon technique solve the limitations for original osteotome technique (summers' technique) for cases even when the subantral bone height is less than 3 mm. The utilization of hydraulic pressure in combination with balloon technique also shows a great role in both sinus membrane elevation and as a diagnostic aid of Schneider's membrane perforation. Key words: Sinus lift surgery, antral membrane balloon elevation, Schneiderian membrane perforation.

Minimally Invasive Antral Membrane Balloon Elevation (MIAMBE): A 3 cases report

Abstract: Long-standing partial edentulism in the posterior segment of an atrophic maxilla is a challenging treatment. via Cadwell Luc has several anatomical restrictions, post-operative discomfort and the need of complex surgical techniques. The osteotome approach is a significantly safe and efficient tecnique, as a variation of this technique the minimal invasive membrane balloon elevation (MIAMBE) has been developed, which use a hydraulic system. We present three cases in which the system was used MIAMBE for tooth replacement in the posterior. This procedure seems to be a relatively simple and safe solution for the insertion of endo-osseus implants in the posterior atrophic maxilla. Keywords: Dental Implants[MeSH], Sinus floor augmentation[MeSH], balloon. Elevacion minimamente invasiva mediante globo de la membrana (MIAMBE): Presentacion de 3 casos clinicos. Abstract: El edentulismo parcial de larga data en el segmento posterior en un maxilar atrofico supone un reto terapeutico. La de seno via Cadwell Luc presenta restricciones anatomicas, incomodidades post-operatorias y la necesidad de tecnicas quirurgicas complejas. El enfoque con osteotomos tiene una eficacia y seguridad considerable, como una variacion a esta se ha desarrollado la elevacion minimamente invasiva mediante globo de la membrana antral (MIAMBE), que utiliza un sistema hidraulico. Se presentan tres casos en los que se utilizo el sistema MIAMBE para el reemplazo de dientes en el sector posterior. Este procedimiento parece ser una solucion relativamente sencilla y segura para insercion de implates endo-oseos en el caso de un maxilar atrofico posterior. Palabras clave: Implantes dentales, sinusal, globo.

The effects of sinus membrane pathology on bone augmentation and procedural outcome using minimal invasive antral membrane balloon elevation.

Abstract Objectives: Membrane pathology tends to complicate the post procedural course of open sinus lift by ostio-meatal complex (OMC) obstruction and consequently acute sinusitis. The objective of this study was to evaluate the outcome of subjects with considerable sinus membrane pathology undergoing maxillary sinus floor augmentation and simultaneously implants placement using the minimal invasive antral membrane balloon elevation (MIAMBE) method. Material and methods: Retrospective chart review of MIAMBE procedures performed in the presence of significant sinus membrane pathology. Results: 16 patients with maxillary sinus membrane thickening in well ventilated OMC as determined by dental computerized tomography (CT) underwent sinus augmentation and simultaneous implants placement using the MIAMBE technique. All 16 procedures were successfully concluded without significant procedural or post-procedural complications or implant failure. Post MIAMBE membrane pathology regressed or disappeared in 8 patients (50%) or remained unchanged in six 6 patients (37.5%), while in 2 patients the sinus membrane pathology was limited to evaluation by periapical x-rays. Conclusions: Sinus augmentation using the MIAMBE technique can be performed safely in asymptomatic patients in the presence of sinus membrane pathology if the OMC is not obstructed. In significant proportion of these cases complete resolution of the membrane pathology after MIAMBE is observed. When compared to open sinus lift, OMC obstruction is less likely to occur when employing the MIAMBE method.

Flapless Approach to Maxillary Sinus Augmentation Using Minimally Invasive Antral Membrane Balloon Elevation

In the atrophic posterior maxilla, successful implant placement is often complicated by the lack of quality and volume of available bone. In these cases, sinus floor augmentation is recommended to gain sufficient bone around the implants. Sinus elevation can be performed by either an open lateral window approach or by a closed osteotome approach depending on available bone height. This case series demonstrates the feasibility and safety of minimally invasive antral membrane balloon elevation, followed by bone augmentation and implant fixation in 20 patients with a residual bone height of 2 to 6 mm below the sinus floor. The surgical procedure was performed using a flapless approach. At 18 months follow-up, the implant survival rate was 100%. Absence of patient morbidity and satisfactory bone augmentation with this minimally invasive procedure suggests that minimally invasive antral membrane balloon elevation should be considered as an alternative to some of the currently used methods of maxillary bone augmentation.

Minimally Invasive Subnasal Elevation and Antral Membrane Balloon Elevation Along With Bone Augmentation and Implants Placement

Atrophic edentulous anterior maxilla is a challenging site for implant placement and has been successfully treated surgically by anterior maxillary osteoplasty. This procedure is associated with considerable discomfort, morbidity, and cost-and consequently reduced patient acceptance. The efficacy and safety of minimally invasive bone augmentation of the posterior maxilla has not been extended thus far to the anterior subnasal maxilla. We present 2 representative cases in which minimally invasive subnasal floor elevation was performed along with minimally invasive antral membrane balloon elevation. Both segments underwent bone grafting and implant placement during the same sitting. Minimally invasive anterior maxilla bone augmentation appears to be feasible. Designated instruments for alveolar ridge splitting and nasal mucosa elevation are likely to further enhance this initial favorable experience.

Minimally Invasive Antral Membrane Balloon Elevation – Results of a Multicenter Registry

ABSTRACTBackground and Purpose: Frequently, the posterior maxilla lacks sufficient bone mass to support dental implants. This multiphysician registry assessed the feasibility and safety of minimally invasive antral membrane balloon elevation (MIAMBE), followed by bone augmentation and implant fixation.Materials and Methods: One hundred twelve consecutive patients were referred for MIAMBE. Following pre‐procedural assessment and informed consent, patients underwent alveolar crest exposure, and 3 mm osteotomy followed by MIAMBE. Platelet‐rich fibrin and bone substitutes were injected under the antral membrane; implant placement and primary closure were executed at the same sitting. Implant loading was carried out 6 to 9 months later.Results: One hundred nine (97.3%) patients successfully concluded the initial procedure. Three patients had membrane tear requiring procedure abortion. One case of infection was documented at 4 weeks. Procedure time was 58 ± 23 minutes. Incremental bone height consistently exceeded 10 mm, and implant survival of 95% was observed at 6 to 9 months.Conclusion: MIAMBE can be applied to all patients in need of posterior maxilla bone augmentation with high procedural success, low complication rate, and satisfactory bone augmentation and implant survival. As it is minimally invasive and associated with minimal discomfort, MIAMBE should be an alternative to the currently employed methods of maxillary bone augmentation.

Minimally Invasive Antral Membrane Balloon Elevation in the Presence of Antral Septa: A Report of 26 Procedures

Antral septa of the maxillary sinus occurs in approximately one third of patients undergoing posterior maxillary bone augmentation and is considered a relative contraindication for lateral maxillary window ("hinge osteotomy"). We present the results of 26 consecutive cases of patients with septated maxillary sinus who underwent minimally invasive antral membrane balloon elevation (MIAMBE) followed by bone augmentation and implant fixation. After undergoing preprocedural assessment and signing an informed consent, 57 consecutive patients were referred for posterior maxillary bone augmentation. Alveolar crest exposure (via 3-mm osteotomies), MIAMBE, and bone augmentation were followed by implant placement and primary closure (executed at the same sitting). Implant loading was done 6-9 months later. Twenty-six out of 57 (45.6%) patients had significant septa (detected on computed tomography) in the designated augmentation region. Twenty-four (92%) concluded the initial procedure successfully. Two patients had membrane tear requiring procedure abortion. Mean procedure time was 48 +/- 23 minutes. Incremental bone height consistently exceeded 10 mm, and implant survival of 95.2% was observed at 6-9 months. MIAMBE can be applied to patients in need of posterior maxilla bone augmentation in the presence of septated maxillary sinus with high procedural success, low complication rate, and satisfactory bone augmentation and implant survival. MIAMBE should be an alternative to the currently employed methods of maxillary bone augmentation, especially in the presence of septated maxilla.

Minimally Invasive Antral Membrane Balloon Elevation: Report of 36 Procedures

The posterior maxillary segment frequently has insufficient bone mass to support dental implants. This registry evaluated the feasibility and safety of minimally invasive antral membrane balloon elevation (MIAMBE), followed by bone augmentation and implant fixation. Thirty-six consecutive patients referred for posterior maxillary bone augmentation underwent alveolar crest exposure and implant osteotomy followed by MIAMBE (> 10 mm). Fibrin and bone particles were injected beneath the antral membrane, implants were placed into the osteotomies, and primary closure was executed at the same sitting. All 36 patients successfully concluded the procedure with no significant procedural complications or discomfort. Procedure time was 48 +/- 15 minutes. Incremental bone height consistently exceeded 8 mm, and implant survival of 97% was observed at 6 to 8 months. MIAMBE resulted in high procedural success and satisfactory bone augmentation implant survival and complication rates. Because it is minimally invasive, this procedure may be an alternative to the currently used surgical methods.

Minimally Invasive Antral Membrane Balloon Elevation Followed by Maxillary Bone Augmentation and Implant Fixation

The posterior maxillary segment frequently suffers from insufficient bone mass to support dental implants. Current bone augmentation methods, including the lateral maxillary approach (ie, hinge osteotomy) and sinus elevation by osteotome, have many shortcomings. The objective of our study was to assess the safety and efficacy of minimally invasive antral membrane balloon elevation (MIAMBE) followed by bone augmentation and implant fixation (executed during the same procedure). Alveolar crest exposure and implant osteotomy were followed by sequential balloon inflations yielding > 10 mm MIAMBE. A mix of autologous fibrin and bone particles with bone speckles was injected beneath the antral membrane. Implants were fixated into the osteotomies, and primary closure was performed during the same sitting. A total of 24 patients were enrolled. Successful conclusion of this procedure was accomplished in 91.6% of the initial 12 patients and 100% in the second dozen cases without significant complications. Patient discomfort was minimal. Long-term follow up revealed satisfactory bone formation, resulting in adequate implant stability. We conclude that the protocol of MIAMBE results in an excellent success rate, low complication rate, minimal discomfort, and long-term safety and durability. Because it requires only basic equipment and a short learning curve, this clinical approach should be widely employed.

Antral Membrane Balloon Elevation

Many edentulous posterior maxilla are found to be encumbered by alveolar resorption and increased pneumatization of the sinus. These factors limit the quantity and quality of bone necessary for successful implant placement in these areas. One solution is to use shorter implants, but this often results in an unfavorable crown-root ratio. To create an improved environment in such regions, the classic sinus floor elevation with bone augmentation is a well-accepted technique. However, when the edentulous area is limited to a zone between 1 and 2 teeth, lifting the membrane becomes difficult and may subject it to iatrogenic injury. The antral membrane balloon elevation technique, which is introduced in this preliminary report, is a modification of the currently used sinus lift. It elevates the membrane easily and makes the antral floor accessible for augmentation with grafting materials.