scholarly journals Paradigm Shift in the Management of the Atrophic Posterior Maxilla

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Rabah Nedir ◽  
Nathalie Nurdin ◽  
Paul Khoury ◽  
Marc El Hage ◽  
Semaan Abi Najm ◽  
...  

When the posterior maxilla is atrophic, the reference standard of care would be to perform sinus augmentation with an autologous bone graft through the lateral approach and delayed implant placement. However, placement of short implants with the osteotome sinus floor elevation technique and without graft can be proposed for an efficient treatment of clinical cases with a maxillary residual bone height of 4 to 8 mm. The use of grafting material is recommended only when the residual bone height is ≤4 mm. Indications of the lateral sinus floor elevation are limited to cases with a residual bone height ≤ 2 mm and fused corticals, uncompleted healing of the edentulous site, and absence of flat cortical bone crest or when the patient wishes to wear a removable prosthesis during the healing period. The presented case report illustrates osteotome sinus floor elevation with and without grafting and simultaneous implant placement in extreme conditions: atrophic maxilla, short implant placement, reduced healing time, and single crown rehabilitation. After 6 years, all placed implants were functional with an endosinus bone gain.

Materials ◽  
2020 ◽  
Vol 13 (9) ◽  
pp. 2208 ◽  
Author(s):  
Giorgio Lombardo ◽  
Mauro Marincola ◽  
Annarita Signoriello ◽  
Giovanni Corrocher ◽  
Pier Francesco Nocini

As the atrophic posterior maxilla often presents serious limitations for dental implant procedures, a minimally invasive technique was proposed. The study aimed to retrospectively evaluate the outcomes of short and ultra-short locking-taper implants, placed in combination with a modified osteotome sinus floor elevation procedure (internal sinus lift technique) in the posterior maxilla. A total of 31 patients received 51 locking-taper implants. Clinical and radiographic examinations were performed before treatment, at loading time, and after three years. Seven implants of 8.0 mm, 23 implants of 6.0 mm, and 21 implants 5.0 mm in length were rehabilitated with single-crown restorations. Implant survival at three-year follow-up was 96.08%. Pre-operative residual crestal bone height of 5.2 (1.41) (median (interquartile range)) mm increased to 7.59 (1.97) mm at the 36-month follow-up, with an average intra-sinus bone height gain of 3.17 ± 1.13 (mean ± standard deviation) mm. Mean peri-implant crestal bone loss was 0.29 (0.46) mm and mean first bone-to-implant contact point shifted apically to 0.12 (0.34) mm. It can be suggested with confidence that implants used in the study, placed in conjunction with an internal sinus floor elevation technique, can be restored with single crowns as a predictable treatment for the edentulous regions of the posterior maxilla.


2021 ◽  
Vol 23 (05) ◽  
pp. 392-411
Author(s):  
Dr. Ali Nahi Hamdi ◽  
◽  
Dr. Shehab Ahmed Hemd ◽  

Dental implants are considered the first choice to replace lost or non-restorable teeth. However, the posterior maxilla remains a challenge in its management because of the quality of bone in the posterior maxilla. Osseo densification (OD) concept has been proposed in the literature to improve primary implant stability, which is an important aspect of osseointegration. Densah bur is novel drills specially designed to enhance a bone density by Osseo densification, which in turn increases primary stability. This present study was conducted to assess crestal sinus floor elevation by osteotome in comparison to Densah bur in the posterior atrophic maxilla. This was a randomized controlled clinical trial conducted on 20 patients to evaluate available crestal bone height loss, implant stability after implant placement in healed posterior maxillary alveolar ridge, whole bone height, Schneiderian membrane trauma, and post-operative complication.


2021 ◽  
Vol 49 (12) ◽  
pp. 030006052110606
Author(s):  
Xun Xia ◽  
Zhen-Yu Wei ◽  
Hong-Wu Wei

An increasing number of studies have investigated the use of osteotome sinus floor elevation (OSFE) with simultaneous implant placement for maxillary sinus floor residual bone height (RBH) <4 mm. Many studies have reported good clinical results, but very few have reported complications related to this procedure. Here, the case of a 50-year-old female patient with an RBH in the left upper posterior region of 1–4 mm, who underwent OSFE with simultaneous placement of three Bicon short® implants, is described. One of the implants was found to be displaced during the second-stage surgery. The displaced implant was removed using piezosurgery, OSFE with simultaneous implant placement was repeated, and the missing tooth was reconstructed 6 months later. This case suggests that OSFE with simultaneous implant placement is feasible for severely atrophic maxillary sinus floor, but carries a risk of implant displacement.


2009 ◽  
Vol 10 (3) ◽  
pp. 81-88 ◽  
Author(s):  
Shilpa Kolhatkar ◽  
Leyvee Cabanilla ◽  
Monish Bhola

Abstract Aim The purpose of this report is to provide a brief literature review of the bone-added osteotome sinus floor elevation (BAOSFE) procedure and to present a case utilizing this technique. Background Implant placement in the posterior maxillary region is often compromised due to anatomic limitations. In clinical situations where there is inadequate vertical bone dimension, the BAOSFE technique can be employed to increase bone height and allow placement of implants with an appropriate length dimension. Case Report A case of a 60-year-old female with inadequate vertical bone dimension in the area of an extracted #13 is presented. The BAOSFE technique was performed which facilitated the placement of a 3.75 X 13 mm implant. Summary Anatomic limitations such as inadequate vertical bone dimension in the posterior maxillary region may result in placement of shorter implants. Sinus floor elevation (SFE) procedures using a crestal approach such as the BAOSFE, in certain selected cases, can effectively and predictably increase bone height. Clinical Significance The BAOSFE technique is an excellent procedure that can overcome limitations associated with the posterior maxillary region. Citation Kolhatkar S, Cabanilla L, Bhola M. Inadequate Vertical Bone Dimension Managed by Bone-added Osteotome Sinus Floor Elevation (BAOSFE): A Literature Review and Case Report. J Contemp Dent Pract 2009 May; (10)3:081-088.


2020 ◽  
Vol 46 (4) ◽  
pp. 415-422
Author(s):  
Junho Jung ◽  
Jung Soo Park ◽  
Seoung-Jin Hong ◽  
Gyu-Tae Kim ◽  
Yong-Dae Kwon

The aim of this study was to measure the convexity of the lateral wall of the maxillary (Mx) sinus and identify the locational distribution of antral septa in relation to the zygomaticomaxillary buttress (ZMB), in order to suggest another anatomical consideration and surgical modification of sinus floor elevation procedures. This study was designed as a cross-sectional study, and a total of 134 patients and 161 sinuses containing edentulous alveolar ridges were analyzed. The angle between the anterior and lateral walls of the Mx sinus (lateral sinus angle [LSA]), and the angle between the midpalatal line and the anterior sinus wall (anterior sinus angle [ASA]) were measured. Mean LSAs and ASAs were 105.9° ± 9.86° and 58.4° ± 6.43°, respectively. No significant difference between left and right sides was found (LSA, P = .420; right = 105.5° ± 9.27°; left = 105.5° ± 9.27° and ASA, P = .564; right = 57.9° ± 6.80°; left = 58.8° ± 6.02°). The prevalence of septa was 37.3%, and it was most frequently noted in the second molar region (32.8%), followed by the first molar (20.9%), retromolar (16.4%), and second premolar regions (14.9%). Septa were most frequently located posterior to the ZMB (49.2%), while ZMB was mostly located in the first molar region (66.4%). Narrow LSAs may complicate the surgical approach to the posterior maxilla, especially when sinus elevation should be used in the second molar region. Considering the occasional presence of antral septa, membrane elevation may be complicated when a septum is encountered during the procedure. These results suggest that 3-dimensional examination of the convexity of the Mx sinus should be performed preoperatively to choose proper surgical techniques and minimize surgical complications.


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