Sinus Membrane Elevation Research Articles

Antral Balloon Sinus Elevation and Grafting Prior to Dental Implant Placement: Review of 34 Cases

The objective of this study was to assess the antral balloon technique for sinus elevation followed by bone graft and implant placement. A total of 34 patients with atrophic edentulous posterior maxillary ridges underwent antral balloon sinus elevation followed by bone grafting (autogenous bone retrieved from the chin mixed with platelet-rich plasma) and implant placement. The population consisted of 26 male and 8 female patients with a mean age of 42 years (range, 33 to 56 years). Successful sinus membrane balloon elevation was performed in all 34 patients, and 62 implants were placed. A membrane tear in one patient was managed intraoperatively by placement of a collagen membrane. Two implants failed within 6 months, and the survival rate of the other 60 implants was 100% after 3 years of follow-up. The mean inflated balloon volume was 1.96 mL and the mean elevated sinus height by balloon was 11.6 mm. An average bone gain of 7.5 mm (range, 5.2 to 10.5 mm) was observed. This case series demonstrates the feasibility of antral balloon sinus membrane elevation followed by bone augmentation and implant placement. This technique offers optimal assurance for membrane safety, and it is less invasive than the routine lateral window technique, safe, and associated with less postoperative bleeding and discomfort. This method is predictable, easy to learn, and associated with low complication rates. However, large comparative studies with other techniques are required.

Autogenous Bone with Collagen Material and Surgicel for Maxillary Sinus Membrane Elevation (Sinus Lift) in Human Subjects

Autogenous Bone with Collagen Material and Surgicel for Maxillary Sinus Membrane Elevation (Sinus Lift) in Human Subjects

Comparison of Piezosurgery and Conventional Rotative Instruments in Direct Sinus Lifting

The purpose of this study was to compare the intraoperative and postoperative effects of Piezosurgery and conventional rotative instruments in direct sinus lifting procedure. Twenty-three patients requiring direct sinus lifting were enrolled. The osteotomy and sinus membrane elevation were performed either with Piezosurgery tips or rotative diamond burs and manual membrane elevators. Time elapsed between bony window opening and completion of membrane elevation (duration), incidence of membrane perforation, visibility of the operation site, postoperative pain, swelling, sleeping, eating, phonetics, daily routine, and missed work as well as patient's expectation before and experience after the operation were evaluated. There was no significant difference between Piezosurgery and conventional groups regarding incidence of membrane perforation, duration, and operation site visibility as well as patient's expectation before and experience after the operation (P > 0.05). However, there were significantly more pain and swelling in the conventional group compared with the Piezosurgery group (P ≤ 0.05). Sinus lifting procedure performed with Piezosurgery causes less pain and swelling postoperatively compared with conventional technique. Patients' daily life activities and experience about the operation are not affected from the surgical technique.

Functional Endoscopic Sinus Surgery for a Patient with Maxillary Sinusitis Occurring after Implant Placement

Maxillary sinus membrane elevation and bone graft have been performed routinely in alveolar bone with insufficient residual bone height. There are a number of causes for development of maxillary sinusitis after these procedures. When maxillary sinusitis is caused by sinus membrane elevation, bone graft, and implant placement, various treatment such as medication, incision and drainage (I&D), implant removal, and the Caldwell-Luc procedure can be considered. Removal of an implant or the Caldwell-Luc procedure can be harmful if inflammation is not present in the oral cavity and survival of grafted bone and implant osseointegration can be expected despite the presence of maxillary sinusitis. In this case, functional endoscopic sinus surgery, which was often used in the otorhinolaryngology department, was performed without removal of the implant for a patient with maxillary sinusitis after one month following implant placement. Thus, we report on this case with a review of the literature.

Novel Devices to Prevent Membrane Perforation in Transcrestal Sinus Floor Augmentation Surgery

Bone volume available for dental implant placement in the posterior maxilla is frequently reduced by maxillary sinus expansion and resorption of the alveolar ridge following tooth loss. Internal bone augmentation of the sinus floor is routinely performed by elevation of the maxillary sinus membrane via a lateral or transcrestal approach. The key issue in minimally invasive transcrestal techniques is the avoidance of membrane perforation in the course of osteotomy and membrane elevation. Novel devices to reduce the risk of membrane perforation have been recently developed and pro- tected by patents. The present review presents recent sinus membrane elevation techniques (balloon-mediated elevation, hydraulic injection, gel-pressure technique) as well as new approaches to prevent sinus membrane perforation during tran- screstal osteotomy (lasers, piezoelectric devices, auto-stop drills). The overview of patented designs is supplemented by an outlook on future surgical techniques and technical possibilities in transcrestal sinus floor augmentation surgery.

A Novel Technique for Osteotome Internal Sinus Lifts With Simultaneous Placement of Tapered Implants to Improve Primary Stability

A Novel Technique for Osteotome Internal Sinus Lifts With Simultaneous Placement of Tapered Implants to Improve Primary Stability

Comparative Radiologic Analyses of Newly Formed Bone After Maxillary Sinus Augmentation With and Without Bone Grafting

The present study examined the formation and density of new bone after sinus membrane elevation, with and without bone grafting, and evaluated the bone formation at the apices of the implants with these 2 different maxillary sinus floor elevation techniques. In a prospective randomized controlled study design, patients requiring reconstruction of their atrophic maxilla were included and divided randomly into grafted and nongrafted groups. Implants were inserted in each group by way of sinus membrane elevation. The formation and density of new bone were evaluated using cone beam computed tomography, performed preoperatively and 1 week, 3 weeks, and 6 months postoperatively. A total of 24 implants were placed in 14 patients, with all implants maintaining stability during 6months of follow-up. New bone formation was determined in both groups using radiography. No significant differences were found between the 2 groups in terms of new bone density preoperatively nor at 1week or 3 months postoperatively. However, the density of bone in the nongrafted group was higher than that in the grafted group 6 months after surgery. These results suggest that the simple elevation of the sinus membrane without bone grafting material can lead to bone formation around implants and that the newly formed bone in the nongrafted group was denser than that in the grafted group.

Erratum

Clinical Implant Dentistry and Related ResearchVolume 15, Issue 3 p. 470-470 ErratumFree Access Erratum This article corrects the following: Implant Placement in Combination with Sinus Membrane Elevation without Biomaterials: A 1-Year Study on 15 Patients Piero Balleri MD, DDS, Mario Veltri DDS, PhD, Niccolò Nuti DDS, Marco Ferrari MD, DDS, PhD, Volume 14Issue 5Clinical Implant Dentistry and Related Research pages: 682-689 First Published online: December 22, 2010 First published: 06 May 2013 https://doi.org/10.1111/cid.12081AboutSectionsPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat In 1, the following errors were published on page 682. The authors' names were listed as: Balleri Piero, MD, DDS;* Veltri Mario, DDS, PhD;* Nuti Niccolò, DDS;* Ferrari Marco, MD, DDS, PhD† This was incorrect; the author listing should have read: Piero Balleri, MD, DDS;* Mario Veltri, DDS, PhD;* Niccolò Nuti, DDS;* Marco Ferrari, MD, DDS, PhD† We apologize for this error. Reference 1 Balleri P, Veltri M, Nuti N, Ferrari M. Implant Placement in Combination with Sinus Membrane Elevation without Biomaterials: A 1-Year Study on 15 Patients. Clinical Implant Dentistry and Related Research 2012; 14: 682– 689. doi: 10.1111/j.1708-8208.2010.00318.x Wiley Online LibraryPubMedWeb of Science®Google Scholar Volume15, Issue3June 2013Pages 470-470 ReferencesRelatedInformation

Immediate Loading of Implants Placed Simultaneously with Sinus Membrane Elevation in the Posterior Atrophic Maxilla: A Two‐Year Follow‐Up Study on 10 Patients

Clinical studies on immediate loading of implants in the posterior atrophic maxilla are rare. The study aims to evaluate immediate loading of implants placed with sinus membrane elevation without additional grafting material for bone augmentation of the maxillary sinus floor. The study group comprised of 10 patients in whom a total of 10 maxillary sinus floor augmentations were performed. A total of 21 dental implants (1 to 4) were inserted through the residual bone to protrude into the maxillary sinus under the elevated sinus membrane. The implant site was underprepared to improve primary stability. All the implants were inserted with a torque insertion no less than 20 Ncm. Implants were loaded immediately after surgery with a screw-retained temporary acrylic restoration. Intraoral X-rays were taken at implant insertion, after 6 months loading, and after 1st and 2nd year of loading. Resonance frequency analysis (RFA) was performed at the time of initial placement and after 6 months of functional loading. RFA after implant insertion gave an implant stability quotient (ISQ) level with a range from 62 to 72. All implants remained clinically stable during the follow-up period of 2 years. Radiography demonstrated on average 5.7 ± 3.4 mm of intrasinus new bone formation after 6 months of implant loading. RFA measurements showed ISQ mean values of 67 (range: 62-72) and 68 (range: 62-71) at placement and after 6 months of loading, respectively. Within the limits of this case series report, it is concluded that maxillary sinus membrane elevation with simultaneous placement and immediate loading of implants without the use of any additional grafting material shows predictable results after 2 years of functional loading. Moreover, evidence of intrasinus bone formation around the implants was found in all patients. Further studies are needed to study the influence of immediate loading on the mineralization of bone forming at dental implant sites.

Assessment of dentists' subjective satisfaction with a newly developed device for maxillary sinus membrane elevation by the crestal approach.

PurposeThe purposes of this study were to assess the dentists' subjective satisfaction with the crestal approach sinus (CAS) kit, a device for maxillary sinus membrane elevation by the crestal approach using a special drilling system and hydraulic pressure, and to summarize the subjective satisfaction of dental implants placed after a sinus lift procedure with the CAS kit.MethodsThirty dental clinicians who had experience with dental implant placement after a sinus lift procedure with the CAS kit from June 2010 to May 2012 were included in this study. The questionnaire for the evaluation of the dentists' subjective satisfaction with the CAS kit was sent to the respondents and returned. The questionnaire was composed of two main parts. The first part was related to the sinus membrane perforation rate. The second part was related to the dentists' subjective satisfaction with the CAS kit.ResultsA total of 28 dentists answered the questionnaire. Among 924 implant cases, sinus membrane perforation occurred in 38 cases (4.1%). Among the 28 dentists, 26 dentists (92.9%) were satisfied or very satisfied with the CAS kit. In particular, 24 dentists (85.7%) reported that safety, cutting performance, and user-friendliness of the CAS drill were advantages of the CAS kit. However, 7 dentists (25%) did not routinely use the hydraulic lifter for sinus membrane elevation.ConclusionsFrom the survey, it was shown that the respondents were generally satisfied with the CAS kit and that the cutting performance and safety of the drill component were considered strengths of the CAS kit.

MAXILLARY SINUS AUGMENTATION AND IMPLANT PLACEMENT USING VENOUS BLOOD WITHOUT GRAFT MATERIAL: A CASE LETTER.

Abstract AbstractObjective: Restoration of lost dentition in the severely atrophic posterior maxilla has been successfully treated with various sinus augmentation techniques such as using bone grafts and bone substitutes are frequently used to enable placement of dental implants. The aim of this study was to evaluate whether sinus membrane elevation and the simultaneous insertion of titanium implants without additional grafting material constitute a valid technique for bone augmentation of the maxillary sinus floor.Material and methods: A 35-year-old female patient evaluated with lost dentition in the left posterior maxilla. Preoperative cone beam computerized tomography (CBCT) were taken to guide the surgery. The sinus lift was performed and two implants were placed simultaneously in the residual subantral bone. The collected peripheral venous blood was applied to support the sinus membrane over the implant apex. Computed tomography (CT) was performed after 6 months healing period.Results: Comparisons of pre- and postoperative CT radiography clearly demonstrated new bone formation and new sinus floors were found within the compartment created by the sinus membrane elevation procedure. All implants remained stable during the healing period in clinical evaluations therefore definitive fixed prosthesis inserted. Conclusion: The case report showed that sinus membrane elevation without the use of bone graft material was found to be a predictable technique for bone augmentation of the maxillary sinus floor.

Evaluation of the Effectiveness of a Water Lift System in the Sinus Membrane‐Lifting Operation as a Sinus Surgical Instrument

The effectiveness of a Water Lift System in the sinus membrane-lifting operation was examined. This investigation focused on the capability of this equipment to reduce the risk of Schneiderian membrane perforation. A preliminary clinical study on the use of the Water Lift System in sinus membrane elevation to place implants through the sinus floor was conducted. A total of 70 sinus membrane-lifting operations were performed on patients with various bone heights ranging from 1.2 to 9.9 mm (most commonly in the range of 4-6 mm) through the lateral approach (four cases) or the crestal approach (66 cases). In all of the cases performed using the lateral approach, sinus membrane perforation did not occur. In the 66 cases performed using the crestal approach, Schneiderian membrane tearing occurred in two cases. The membrane tearing occurred during elevation of the Schneiderian membrane but not when a hole was drilled to access the Schneiderian membrane. One case of membrane tearing resulted from previous inflammation in the maxillary sinus, and the other case of membrane tearing was caused by application of excessive hydraulic pressure. In addition, similar outcomes were obtained and no microbial infections were observed in a total of 68 successful cases. In this study, the Water Lift System was confirmed to effectively reduce the risk of Schneiderian membrane perforation during the sinus membrane-lifting operation. We conclude that the Water Lift System deserves to be considered as a sinus surgical instrument, which ensures safety in the sinus membrane-lifting operation.

Sinus augmentation via transcrestal approach: a comparison between the balloon and osteotome technique in a cadaver study

The transcrestal approach with osteotomes is a commonly applied and predictable technique for maxillary sinus floor elevation. However, Schneiderian membrane perforation is a common and often inevitable intraoperative complication. Recently, the use of balloons has been proposed to reduce the risk of sinus membrane perforation and to facilitate the surgical technique. The aim of this study was to determine membrane elevation height and perforation rate using the transcrestal balloon technique (B) and a conventional osteotome approach, as control (C). Ten fresh, completely edentulous cadaver heads (seven male and three female) were selected. In a split-mouth design, each sinus was randomly assigned to either the experimental or the control technique. Pre-surgical planning was aided by cone-beam computed tomography. During the procedure, an endoscope was used to monitor the elevation procedure and the occurrence of sinus perforation. The elevation continued until either 15mm (measured from the alveolar crest) was reached or a perforation occurred. The residual ridge and the elevated membrane height were measured and compared with the paired Student's t-test. Presence of sinus perforation was recorded at three cutoff points: 10, 12, and 15mm. The mean age of the specimens was 77.7±14.2years (range 49-92). The mean initial, final, and elevated sinus membrane height for the B group was 5.3±1.9, 13.7±1.9, and 8.3±3.1mm, whereas the correspondent values for the C group were 5.1±2.1, 13.2±2.8, and 8.1±3.1mm. The incidence of sinus perforation, using 10, 12, and 15mm as end points was 0%, 22.2%, and 44.4% in the B group, whereas in the C group the respective values were 10.0%, 20.0%, and 50.0%. No statistically significant differences were found between the two groups for all the above-mentioned variables. In addition, mean residual ridge height was not significantly different between the non-perforation and perforation sites in the B group (5.2±2.2 and 5.5±1.7mm) and in the C group (5.2±2.5 and 5.0±2.0mm). Three cadavers had perforations in both sinuses, accounting for 66.6% of total number of perforations. Based on the findings of this study, the balloon and the conventional osteotome approach are comparable in terms of perforation rate as it relates to the elevation height. Also, the amount of residual alveolar bone was not related to the incidence of perforation and the height of sinus elevation.

The Incidence of Maxillary Sinus Membrane Perforation During Endoscopically Assessed Crestal Sinus Floor Elevation - A Pilot Study

Transcrestal sinus membrane elevation is a surgical procedure performed to increase the bone volume in the maxillary sinus cavity. Because of visual limitations, the potential for maxillary sinus membrane perforations may be greater than with the lateral approach technique. The aim of this study was to macroscopically investigate ex vivo the occurrence of sinus membrane perforation during surgery using 3 transcrestal sinus floor elevation methods. Twenty fresh human cadaver heads, with 40 intact sinuses, were used for simultaneous sinus membrane elevation, placement of graft material, and dental implants. Real-time sinus endoscopy, periapical digital radiographs, and cone-beam computerized tomography (CBCT) images were subsequently used to evaluate the outcome of each surgical procedure. Perforation rates for each of the 3 techniques were then compared using a significance level of P < .05. No statistically significant differences in the perforation rate (P = .79) were found among the 3 surgical techniques. Although the sinus endoscope noted a higher frequency of perforations at the time of implant placement as compared with instrumentation or graft insertion, the difference was not statistically significant (P = .04). The CBCT readings were judged to be more accurate for identifying evidence of sinus perforations than the periapical radiographs when compared with the direct visualization with the endoscope. This pilot study demonstrated that a sinus membrane perforation can occur at any time during the sinus lift procedure, independent of the surgical method used.

Indirect Osteotome Maxillary Sinus Floor Elevation: An Update

The objective was to review publications on indirect osteotome maxillary sinus floor elevation (OMSFE) procedures. Studies published between 1999 and 2010 on patients with a minimum of 1 year of follow-up were analyzed. Fourteen studies were included. Indirect OMSFE is indicated for a bone height of 6-8 mm. More bone height was gained when graft material was used. Schneiderian membrane perforation was the most frequent complication. Survival rates varied between 93.5% and 100%. Osteotome sinus membrane elevation is a predictable and effective procedure for placing implants in areas of the posterior maxilla with low bone height.

The Incidence of Maxillary Sinus Membrane Perforation During Endoscopically Assessed Crestal Sinus Floor Elevation: A Pilot Study

Transcrestal sinus membrane elevation is a surgical procedure performed to increase the bone volume in the maxillary sinus cavity. Because of visual limitations, the potential for maxillary sinus membrane perforations may be greater than with the lateral approach technique. The aim of this study was to macroscopically investigate ex vivo the occurrence of sinus membrane perforation during surgery using 3 transcrestal sinus floor elevation methods. Twenty fresh human cadaver heads, with 40 intact sinuses, were used for simultaneous sinus membrane elevation, placement of graft material, and dental implants. Real-time sinus endoscopy, periapical digital radiographs, and cone-beam computerized tomography (CBCT) images were subsequently used to evaluate the outcome of each surgical procedure. Perforation rates for each of the 3 techniques were then compared using a significance level of P < .05. No statistically significant differences in the perforation rate (P = .79) were found among the 3 surgical techniques. Although the sinus endoscope noted a higher frequency of perforations at the time of implant placement as compared with instrumentation or graft insertion, the difference was not statistically significant (P = .04). The CBCT readings were judged to be more accurate for identifying evidence of sinus perforations than the periapical radiographs when compared with the direct visualization with the endoscope. This pilot study demonstrated that a sinus membrane perforation can occur at any time during the sinus lift procedure, independent of the surgical method used.

The Maxillary Sinus Membrane Elevation Procedure: Augmentation of Bone around Dental Implants without Grafts—A Review of a Surgical Technique

Background. Long-term edentulism may in many cases result in resorption of the alveolar process. The sinus lift procedure aims to create increased bone volume in the maxillary sinus in order to enable installation of dental implants in the region. The method is over 30 years old, and initially autogenous bone grafts were used and later also different bone substitutes. Since 1997, a limited number of studies have explored the possibility of a graftless procedure where the void under the sinus membrane is filled with a blood clot that enables bone formation. Aim. To describe the evolution of the sinus-lift technique and to review the literature related to the technique with a focus on long-term studies related to the graft-less technique. Methods. The electronic database PubMed was searched, and a systematic review was conducted regarding relevant articles. Results. A relatively few long-term studies using the described technique were found. However, the technique was described as reliable considering the outcome of the existing studies. Conclusion. All investigated studies show high implant survival rates for the graftless technique. The technique is considered to be cost-effective, less time-consuming, and related to lower morbidity since no bone harvesting is needed.

Dental Implants in Posterior Maxilla: Diagnostic and Treatment Aspects

Dental implantology is one of the most popular and intensively researched topics of current dental medicine. The necessity for the former complicated preprosthetic surgical procedures to facilitate the partial dentures has recently been decreased with the widespread construction of implant-supported prosthesis. Nevertheless, the alveolar deficiency that impedes the insertion of dental implants makes a number of similar reconstructive procedures inevitable. The posterior maxilla is one of the most challenging anatomic locations for the implant placement that requires adjunctive surgical procedures. This special issue covers leading researches and reviews on this topic that we believe would contribute to clinicians. Insufficient bone quality and quantity in posterior maxilla is a common clinical state which makes the implant applications challenging in this site. The main reason for that is the pneumatization of sinus subsequent to the tooth loss and the concomitant excessive alveolar resorption. Insufficient subantral bone and coexisting increased interarch distance necessitate a combined sinus lifting and augmentation procedures. T. Kanno et al. reported the results of their retrospective study entitled “Simultaneous sinus lifting and alveolar distraction of a severely atrophic posterior maxilla for oral rehabilitation with dental implants” in which they performed combined sinus lifting and alveolar distraction osteogenesis in a case series with 27 individuals. The study revealed a histomorphometric similarity between the new bone formed by the presented technique and the bone generated via the sinus lifting only. They also accomplished stable implant rehabilitations within this topic. The quality and the quantity of the host bone are the key determinants for successful dental implants. The quantity of the bone may be estimated via advanced radiological techniques in a high precision. However, a definitive accuracy cannot be pronounced although a number of techniques are available to evaluate the quality of bone. H. Bilhan et al. have reviewed the current techniques used for the estimation of the quality of the host bone while they simultaneously reported the results of a pilot experimental study that compares the densitometric evaluation of the dental volumetric tomography (DVT) with micro CT with their study entitled “How precise is dental volumetric tomography in the prediction of bone density?”. The results of this study revealed that the Hounsfield unit evaluation via DVT is not a reliable method to evaluate the density of bone. C. Riben and A. Thor have published their review on “graftless augmentation procedures” which became a popular topic on sinus floor elevation, regarding a conventional surgical approach for the posterior maxillae. Their study entitled “The maxillary sinus membrane elevation procedure: augmentation of bone around dental implants without grafts—a review of a surgical technique” includes the technical details of the procedure. The alveolar bone loss principally initiates with the tooth loss and this state may complicate the ideal placement of the implants. A number of surgical methods is advocated to prevent the bone loss. G. Pagni et al. reviewed these techniques in their study entitled “Postextraction alveolar ridge preservation in the molar area: biological basis and treatments”. The study provides comprehensive information about the socket healing and biology of the alveoloar bone resorption subsequent to extraction. They stated that the improvements in the grafting technologies would give rise to less invasive surgical interventions. The recent advances in the implant surface characteristics led to major modifications in former fundamentals. An increased osseointegration rate with the improvement of the surface characteristics of dental implants resulted in a numerous successful reports for the implants shorter than 10 mm. Today, many companies appear in the dental market with their recently introduced 6 mm or shorter dental implants. Owing to this, clinicians now can be able to offer effective and noninvasive remedies to their patients avoiding advanced complicated surgeries in case of severe alveolar atrophy. Although a number of clinical reports reveals high success rates for the mandible, the use of short implants in the maxilla is still debatable especially for the single-tooth replacements due to its porous nature. D. Lops et al. compared the clinical success rates for 8 mm. Implants with that of 10 mm. In their long-term study entitled “Short implants in partially edentulous maxillae and mandibles: a 10 to 20 years retrospective evaluation”. In general, they declared similar success rates for 8 mm and longer implants. The results of this study revealed that the use of 8 mm implants seems to be safe in the posterior maxilla.

Rabbit maxillary sinus augmentation model with simultaneous implant placement: differential responses to the graft materials

PurposeThis study was performed to establish an experimental rabbit model for single-stage maxillary sinus augmentation with simultaneous implant placement.MethodsTwelve mature New Zealand white rabbits were used for the experiments. The rabbit maxillary sinuses were divided into 3 groups according to sinus augmentation materials: blood clot (BC), autogenous bone (AB), and bovine-derived hydroxyapatite (BHA). Small titanium implants were simultaneously placed in the animals during the sinus augmentation procedure. The rabbits were sacrificed 4 and 8 weeks after surgery and were observed histologically. Histomorphometric analyses using image analysis software were also performed to evaluate the parameters related to bone regeneration and implant-bone integration.ResultsThe BC group showed an evident collapse of the sinus membrane and limited new bone formation around the original sinus floor at 4 and 8 weeks. In the AB group, the sinus membrane was well retained above the implant apex, and new bone formation was significant at both examination periods. The BHA group also showed retention of the elevated sinus membrane above the screw apex and evident new bone formation at both points in time. The total area of the mineral component (TMA) in the area of interest and the bone-to-implant contact did not show any significant differences among all the groups. In the AB group, the TMA had significantly decreased from 4 to 8 weeks.ConclusionsWithin the limits of this study, the rabbit sinus model showed satisfactory results in the comparison of different grafting conditions in single-stage sinus floor elevation with simultaneous implant placement. We found that the rabbit model was useful for maxillary sinus augmentation with simultaneous implant placement.

Maxillary Sinus Floor Augmentation Surgery with Autogenous Bone Grafts as Ceiling: A Pilot Study and Test of Principle

Studies have pointed out that the mere elevation of the maxillary sinus membrane might suffice to allow for bone formation indicating the additional use of augmentation materials to be redundant. The purpose of this study was to assess whether elevation of the sinus mucosal lining combined with applying an autologous bone graft as a ceiling and placement of a short implant would allow for bone formation around the implant thus surpassing the need for applying augmentation materials around the installed implants. Fourteen consecutive patients were subjected to maxillary sinus floor elevation surgery and simultaneous placement of an implant. Using the lateral bone-wall window technique, the membrane was exposed and elevated. Next, a bone graft taken from the zygomatic rim was placed as a ceiling above the inserted implant to ensure that the sinus membrane would not collapsed around a significant part of the implant. Finally, the bone window was returned in place. After connecting the healing abutment, the wound was closed. All implants were stable and no implants were lost. There were no complications after harvesting the bone graft. Radiographic evaluation showed a bone gain of 3.2 ± 0.9 mm after 3 months and 3.6 ± 0.9 mm after 1 year. Less than 6% of the implant was not covered by bone after 1 year. Maxillary sinus membrane elevation and simultaneous placement of short endosseous implants with a bone graft as a ceiling on top of the implant result in predictable bone formation around the implant and good osseointegration on radiographs.