Maxillary sinus elevation surgery: an overview.
ABSTRACT Maxillary sinus elevation surgery was developed to increase the height of bone available for implant placement in the posterior maxilla. The efficacy and predictability of this procedure have been determined in numerous studies. The basic approach to the sinus (Caldwell-Luc operation) involves an osteotomy performed on the lateral maxillary wall, elevation of the sinus membrane, and placement of bone graft material. The graft materials can be categorized into four groups: autogenous bone, allografts (harvested from human cadavers), alloplasts (synthetic materials), and xenografts (grafts from a nonhuman species). These graft materials can be used alone or in combination with each other. Implant placement can occur at the same surgical procedure (immediate placement) or following a healing period of 6 to 9 months (delayed placement). A more conservative approach to the sinus, the osteotome technique, has been described as well. CLINICAL SIGNIFICANCE: This article provides an overview of the surgical technique, with emphasis on anatomic considerations, preoperative patient evaluation (clinical and radiographic), indications and contraindications to the procedure, and possible risks and complications.
- [show abstract] [hide abstract]
ABSTRACT: This study evaluated the incidence, location, and height of antral septa and demonstrates their clinical implications. One hundred ninety-four maxillary posterior regions, subdivided into four groups (group 1, 61 clinically examined atrophic ridges; group 2, 41 anatomically examined atrophic ridges; group 3, 42 radiographically [CT] examined atrophic ridges; and group 4, 50 CT examined dentate maxillary ridges), were examined for the incidence, location, and height of antral septa. The incidence of antral septa was significantly greater (P<.01) in atrophic edentulous regions (groups 1, 2, and 3) than in dentate regions (group 4). However, the septa were much lower (P<.01). In atrophic maxillae, about 70% of antral septa were located in the anterior (premolar) region. Antral septa are more commonly found in edentulous atrophic maxillae than in dentate maxillae. The septae in edentulous atrophic maxillae are shorter than those found in dentate maxillae. When present, maxillary sinus septae are more common anteriorly than posteriorly. CT scanning is the preferred radiographic method for detecting the presence (or absence) of sinus septae. Panoramic radiography has less sensitivity and specificity than CT scanning for the detection of sinus septa.Journal of Oral and Maxillofacial Surgery 07/1999; 57(6):667-71; discussion 671-2. · 1.33 Impact Factor
- [show abstract] [hide abstract]
ABSTRACT: Local bone grafts are a convenient source of autogenous bone in alveolar reconstruction. The mandibular ramus area provides primarily a cortical graft that is well-suited for veneer-grafting of ridge deficiencies prior to implant placement. The advantages of this method of augmentation include its intraoral access and low morbidity. Similar to bone harvested from the mandibular symphysis, these grafts require short healing periods, exhibit minimal resorption, and maintain their dense quality. Advantages of this donor site over the chin include minimal patient concern for altered facial contour, proximity to posterior mandible recipient sites, and decreased complaints of postoperative sensory disturbances and discomfort. However, the surgical access in some cases is limited, and there is a potential for damage to the mandibular neurovascular bundle. The learning objective of this article is to review and update the reader knowledge of alveolar ridge augmentation using mandibular grafts.Practical periodontics and aesthetic dentistry : PPAD. 04/1996; 8(2):127-35; quiz 138.
- The International journal of oral & maxillofacial implants 02/1988; 3(3):209-14. · 1.91 Impact Factor