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.
SourceAvailable from: Elton Gonçalves Zenóbio[Show abstract] [Hide abstract]
ABSTRACT: This multislice tomographic study evaluated the dimensional changes after maxillary sinus augmentation using autogenous bone or a mixture of hydroxyapatite and autogenous bone. Ten selected patients, requiring a bilateral maxillary sinus augmentation, were divided, in a split mouth, design as follows: control group (CG n = 10 sinus grafted with autogenous bone) and test group (TG, n = 10 sinus grafted with a mixture of hydroxyapatite and autogenous bone at 80 : 20 w/w). Follow a healing period of 15 and 180 days, computed tomography (CT) measurements were taken by two blinded and calibrated examiners to verify the volumetric dimensional changes of the both groups. The interobserver agreement obtained ranged from good to excellent for both groups. Both groups presented significant dimensional changes after 180 days period healing (P < 0.05). The volumetric reduction in test group was lower (25.87%) when compared with the CG (42.30%) (P < 0.05). The both graft materials improved the bone volumetric ability to anchorage a dental implant. Moreover, the mixture of HA and autogenous bone graft showed lower degree of resorption and higher dimensional stability when compared with autogenous bone graft alone, at least at 180 days of healing. The CT exam protocol should be used as an important tool to measure bone grafts volumetric alterations.Clinical Oral Implants Research 09/2013; 25(11). DOI:10.1111/clr.12261 · 3.43 Impact Factor
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ABSTRACT: The purpose of the present study was to explore the maxillary sinus anatomy, its variations and volume in patients with a need for maxillary implant placement. Maxillary sinus data of 101 consecutive patients who underwent spiral computed tomography (CT) scans for preoperative implant planning in the maxilla at the Department of Periodontology, University Hospital, Catholic University of Leuven, Leuven, Belgium were retrospectively evaluated. The alveolar bone height was measured on serial cross-sectional images between alveolar crest and sinus floor, parallel to the tooth axis. In order to describe the size of the maxillary sinus anteroposterior (AP) and mediolateral (ML) diameters of the sinus were measured. The results indicated that the alveolar bone height was significantly higher in the premolar regions in comparison to the molar region (n = 46, P < 0.01). The age showed negative relation to bone dimension (r = - 0.32, P = 0.04). Anterior and posterior border of the maxillary sinuses were mostly located in the first premolar (49%) and second molar (84%) regions, respectively. Maxillary sinus septa were indentified in 47% of the maxillary antra. Almost 2/3 (66%) of the patients showed major (> 4 mm) mucosal thickening mostly at the level of the sinus floor. The present sample did not allow revealing any significant difference (P > 0.05) in maxillary sinus dimensions for partially dentate and edentulous subjects. Cross-sectional imaging can be used in order to obtain more accurate information on the morphology, variation, and the amount of maxillary bone adjacent to the maxillary sinus.01/2010; 1(1):e7. DOI:10.5037/jomr.2010.1107