Approach For Sinus Floor Elevation Research Articles

Radiographic and Histomorphometric Evaluation of Sinus Floor Augmentation Using Biomimetic Octacalcium Phosphate Alloplasts: A Prospective Pilot Study.

This prospective single-arm clinical study aimed to radiographically and histomorphometrically evaluate the efficacy of the lateral approach for sinus floor elevation (LSFE) using biomimetic octacalcium phosphate (OCP) synthetic bone graft (Bontree®). LSFE using Bontree® was performed on 10 patients (15 implant placement sites) willing to undergo implant surgery, followed by implant placements after 6 months of the healing period. The vertical bone height (VBH) and Hounsfield unit (HU) values at each implant placement site were evaluated radiographically using cone-beam computed tomography at baseline immediately after surgery (T1) and 6 months after surgery (T2). A histomorphometric evaluation of the bone core biopsy specimen was also performed. The mean VBH and HU changes at all sites included a decrease by 0.91 mm and a statistically significant increase by 431.86, respectively, from T1 to T2. The mean ratio of the newly formed bone (23.34% ± 10.63%) was greater than that of the residual bone graft (19.09% ± 8.74%), indicating that Bontree® is effective for new bone formation. This pilot study suggests that Bontree® is a promising bone substitute for LSFE.

A Novel Variation of the Lateral Window Approach for Sinus Floor Elevation in a Case of Bony Nodular Prominence.

In sinus floor augmentation, bony nodular prominence at the floor of themaxillary sinus is an obstruction to lateral window approach. It is challenging to detach and elevate the sinus membrane without making any perforations around the nodular prominence, because the membrane is very thin. To overcome these difficulties, we developed a novel method. The membrane was not detached from the surface of the nodular prominence except for at the basal point, but the nodular prominence was cut at the base. Nodular prominence and sinus membrane were elevated upward together. A resorbable collagen membrane was placed beneath it to provide mechanical support and cover any partial tear in the sinus membrane. Autogenous bone and/or bone substitute were packed in the vacant compartment depending on the condition. This method is very easy to be carried out without any difficulties and worries. Itgives us great benefit on the sinus floor augmentation. The online version contains supplementary material available at 10.1007/s12663-021-01572-7.

Effect of Medical-Grade Polyurethane Sponges on Sinus Membrane Perforation With a Lateral Window Approach.

The most commonly reported complication during the sinus elevation surgical procedure is the perforation of the Schneiderian membrane. The aim of this retrospective study was to compare the rate of sinus membrane perforation during lateral window augmentation using either conventional sinus curettes or medical-grade polyurethane sponges. This retrospective study included patients who received a lateral window approach for sinus floor elevation. The sinus elevation procedures using medical-grade polyurethane sponges (test) or conventional curettes (control) were recorded and analyzed. All subjects' demographic data and preexisting conditions were evaluated. A total of 38 procedures met inclusion criteria, and those data were evaluated for analysis. There were no statistically significant differences in demographic data or preexisting conditions including age, sex, treatment location, presence and absence of septum, Schneiderian membrane thickness, and residual bone height between test and control groups. The membrane perforation rate was 7% in the test group and 43% in the control group; however, this difference did not reach statistical significance (P = .064). Within the limitations of this study, although there was no statistically significant reduction of sinus membrane perforation with the use of medical-grade polyurethane sponges, the decreased incidence of perforation might be of clinical significance.

Sinus augmentation in atrophic maxilla: Lateral window approach

Rehabilitation of edentulous posterior maxillary regions by means of implant placement often poses challenging situations due to inadequate alveolar ridge height and poor bone quality. Since resorption of posterior residual ridge is caused by sinus pneumatization or traumatic extractions, maxillary sinus floor elevation (SFE) and bone augmentation with graft materials remains the method of choice. This scientific, evidence-based, preprosthetic procedure is a corrective technique available for almost two decades in such surgically compromised cases. In this article, we will discuss and review instrumentation by lateral window approach for SFE in conjunction with bone augmentation for delayed implant placement postgraft maturation in the healing period.

Age-Related Alteration in the Lateral Wall Thickness of the Maxillary Sinus in Partially or Completely Edentulous Posterior Maxilla: A Cone-Beam Computed Tomography Study

Introduction: Osteotomy of the lateral wall in the lateral window approach for sinus floor elevation carries the risk of perforating the Schneiderian membrane. In this regard, this study aims to evaluate the relationship between age and lateral wall thickness (LWT) of the maxillary sinuses in patients with posterior edentulism. Materials and Methods: A total of 311-cone beam computed tomography (CBCT) scans are analyzed. To measure the lateral sinus, the deepest point in the maxillary sinus floor is selected, a tangent line is drawn to this point, and another line is drawn perpendicular to the previous line. On the latter line, three points are marked at 3, 7, and 10 mm distance from the sinus floor and three lines are drawn passing through these points parallel to the tangent line. The thickness of the lateral sinus wall is measured on these lines. LWT of males and females is compared in different age groups and patients with complete or partial edentulism. The collected data are analyzed using the one-way ANOVA, Scheffe’s test, t-test, and Pearson’s correlation coefficient. Results: There is a significant relationship between age and LWT of the maxillary sinuses. It is so that the LWT decreases as the age increases (P 0.05). Conclusion: Age and edentulism type affect the LWT of the maxillary sinuses.

Changes in the thickness of schneiderian membrane and sinus pathology after implant placement with a transalveolar approach for sinus floor elevation

Changes in the thickness of schneiderian membrane and sinus pathology after implant placement with a transalveolar approach for sinus floor elevation

Sinus floor elevation utilizing the transalveolar approach.

A transalveolar approach for sinus floor elevation with subsequent placement of dental implants was first suggested by Tatum in 1986. In 1994, Summers described a different transalveolar approach using a set of tapered osteotomes with increasing diameters. The transalveolar approach of sinus floor elevation, also referred to as 'osteotome sinus floor elevation', the 'Summers technique' or the 'Crestal approach', may be considered as being more conservative and less invasive than the conventional lateral window approach. This is reflected by the fact that more than nine out of 10 patients who experienced the surgical procedure would be willing to undergo it again. The main indication for transalveolar sinus floor elevation is reduced residual bone height, which does not allow standard implant placement. Contraindications for transalveolar sinus floor elevation may be intra-oral, local or medical. The surgical approach utilized over the last two decades is the technique described by Summers, with or without minor modifications. The surgical care after implant placement using the osteotome technique is similar to the surgical care after standard implant placement. The patients are usually advised to take antibiotic prophylaxis and to utilize antiseptic rinses. The main complications reported after performing a transalveolar sinus floor elevation were perforation of the Schneiderian membrane in 3.8% of patients and postoperative infections in 0.8% of patients. Other complications reported were postoperative hemorrhage, nasal bleeding, blocked nose, hematomas and benign paroxysmal positional vertigo. Whether it is necessary to use grafting material to maintain space for new bone formation after elevating the sinus membrane utilizing the osteotome technique is still controversial. Positive outcomes have been reported with and without using grafting material. A prospective study, evaluating both approaches, concluded that significantly more bone gain was seen when grafting material was used (4.1mm mean bone gain compared with 1.7mm when no grafting material was utilized). In a systematic review, including 19 studies reporting on 4388 implants inserted using the transalveolar sinus floor elevation technique, the 3-year implant survival rate was 92.8% (95% confidence interval: 87.4-96.0%). Furthermore, a subject-based analysis of the same material revealed an annual failure rate of 3.7%. Hence, one in 10 subjects experienced implant loss over 3years. Several of the included studies demonstrated that transalveolar sinus floor elevation was most predictable when the residual alveolar bone height was ≥5mm and the sinus floor anatomy was relatively flat.

Bone-Added Osteotome Technique Versus Lateral Approach for Sinus Floor Elevation: A Comparative Radiographic Study

The aim of this study was to evaluate and compare the radiographic results of bone-added osteotome sinus floor elevation (BAOSFE) and lateral approach sinus floor elevation techniques. The 43 patients who had undergone implant procedure with either BAOSFE or lateral approach method on their maxillary molar edentulous area were included. Their dental records were confirmative and the radiographic-changes using orthopantomographs were consistently checked up during 2 years after the procedure (immediately after procedure and 6 months, 12 months, and 24 months after implant placement). The radiographic evaluation after 2 years of implantation with sinus elevation showed the significant amount of bone formation (6.75 mm for BAOSFE and 11.36 mm for lateral approach method). Largest amount of grafted height loss occurred during the first 6 months (62.8% of total amount of bone loss), but the resorption was minimal (1.35 mm for BAOSFE and 1.36 mm for lateral approach method) for overall 24 months. Long-term stability of graft height was achieved using both BAOSFE and lateral approach sinus floor elevation. Overall, graft height decreased gradually during 2 years after procedures, but the changes were minimal.

Direct sinus elevation and composite bone grafting for immediate implant placement in the posterior maxillary region

An atrophied posterior maxilla is the most challenging intraoral area confronting the implantologists, requiring utmost skill for the achievement of successful results. This case report exemplifies the use of a lateral wall osteotomy approach for sinus floor elevation, combined with the composite grafting to provide the ideal milieu for placement of a dental implant.

Piezoelectric Internal Sinus Elevation (PISE) Technique: A New Method for Internal Sinus Elevation

This article reports the surgical procedure of a transalveolar approach for sinus floor elevation using piezoelectric surgery without a mallet, called piezoelectric internal sinus elevation (PISE) technique. PISE is the modified technique of the osteotome-mediated sinus floor elevation. Osteotome-mediated sinus floor elevation uses a mallet to break the sinus floor and to push sinus membrane up. Using this technique might possibly bring positional vertigo to the patient. PISE technique does not use a mallet during the procedure to break the sinus floor and to elevate the sinus membrane; therefore, it can reduce the possibility of postoperative positional vertigo.