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. 2014:2014:486949.
doi: 10.1155/2014/486949. Epub 2014 Nov 10.

Paradigm shift in the management of the atrophic posterior maxilla

Rabah Nedir  1 , Nathalie Nurdin  1 , Paul Khoury  2 , Marc El Hage  3 , Semaan Abi Najm  4 , Mark Bischof  5
Affiliations

Paradigm shift in the management of the atrophic posterior maxilla

Rabah Nedir et al. Case Rep Dent. 2014.

Abstract

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.

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Figures

Figure 1
Figure 1
Periapical radiographs. The 8 mm tapered implants were placed using the osteotome sinus floor elevation procedure with grafting material (right sinus) and without grafting material (left sinus). In all controls after surgery, implants were clinically stable. A radioopaque area corresponding to the augmented sinus floor was present around the implants placed without graft and around and above the implants placed with graft.
Figure 2
Figure 2
CBCT exam at 5 years. Note the absence of Schneiderian membrane thickening on the coronal view of implant placed with grafting material (right sinus, second molar site) and without grafting material (left sinus, second molar site). The CBCT confirms that the implant in the left sinus protruded into the sinus whereas the implant in the right sinus was completely embedded in peri-implant bone.
Figure 3
Figure 3
New concept for the management of the posterior maxilla using 8 mm tapered implants. The use of OSFE in patients with a maxillary RBH > 2 mm is facilitated by placing tapered implants with a reduced thread pitch. The lateral sinus-lift procedure, with delayed implant placement, is indicated when primary stability cannot be reached with OSFE and when a large amount of bone gain is required.
See this image and copyright information in PMC

References

    1. Pramstraller M., Farina R., Franceschetti G., Pramstraller C., Trombelli L. Ridge dimensions of the edentulous posterior maxilla: A retrospective analysis of a cohort of 127 patients using computerized tomography data. Clinical Oral Implants Research. 2011;22(1):54–61. doi: 10.1111/j.1600-0501.2010.01984.x. - DOI - PubMed
    1. Boyne P. J., James R. A. Grafting of the maxillary sinus floor with autogenous marrow and bone. Journal of Oral Surgery. 1980;38(8):613–616. - PubMed
    1. Wallace S. S., Tarnow D. P., Froum S. J., Cho S.-C., Zadeh H. H., Stoupel J., Fabbro M. D., Testori T. Maxillary sinus elevation by lateral window approach: evolution of technology and technique. Journal of Evidence-Based Dental Practice. 2012;12(3):161–171. doi: 10.1016/S1532-3382(12)70030-1. - DOI - PubMed
    1. Pjetursson B. E., Tan W. C., Zwahlen M., Lang N. P. A systematic review of the success of sinus floor elevation and survival of implants inserted in combination with sinus floor elevation: part I: lateral approach. Journal of Clinical Periodontology. 2008;35(8):216–240. doi: 10.1111/j.1600-051X.2008.01272.x. - DOI - PubMed
    1. Jensen O. T., Shulman L. B., Block M. S., Lacono V. J. Report of the sinus consensus conference of 1996. International Journal of Oral and Maxillofacial Implants. 1998;13(supplement):11–32. - PubMed

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