Editorial Type:
Article Category: Research Article
 | 
Online Publication Date: 01 Aug 2010

Minimally Invasive Sinus Augmentation

DDS, MS,
MS,
MBA, and
Page Range: 295 – 304
DOI: 10.1563/AAID-JOI-D-09-00010
Save
Download PDF

Abstract

Sinus lift surgery has become more common as patients choose dental implants for tooth replacement. The recent development of a graft material that stimulates osteogenesis coupled with the application of tissue engineering principles has allowed for refinement of this surgical modality. A simple nontraumatic subantral sinus lift microsurgery is presented. This sinus lift microsurgery resulted in a 97% implant success rate.

Copyright: 2010 by the American College of Veterinary Internal Medicine
Figures 1–3
Figures 1–3

Figure 1. The graft matrix is penetrated by an endothelial cell, as can be seen entering the graft matrix (GM) on the left with the endothelial nucleus (EN) on the far right. B indicates new bone; V, void. Figure 2. At 6 weeks, the matrix is largely resorbed, leaving isolated islands of graft matrix covered with new bone. Figure 3. Sinus bone anatomy. S indicates sinus; O, osteoid-like layer; A, artifact; CT, soft connective tissue; B, mineralized bone.


Figures 4–8
Figures 4–8

Figure 4. A No. 8 round bur is used to prepare the osteotomy. Figure 5. O indicates osteoid-like bone lining; M, sinus membrane; B, bone. The micropaddle is approximately 1 mm in diameter. Figure 6. The micropaddle is used to dissect the sinus membrane in the immediate area of the osteotomy. Figure 7. After the micropaddle procedure, a microball is used to separate the membrane from the floor of the sinus until the medial wall of the sinus is reached. Figure 8. Regen Biocement is injected between the sinus membrane and the alveolar bone.


Figures 9–14
Figures 9–14

Figure 9. The graft material fills the posterior portion of the graft site on the left, but the sinus membrane remains attached in the mesial portion of the sinus to the ring. Figure 10. A low sinus in the molar region. Figure 11. The sinus has been grafted and pilot holes started. Figure 12. Three months after sinus lift and implant placement. Figure 13. Four months post grafting and implant placement with the implants restored. Figure 14. Clinical photograph of restored implants.


Figures 15–18
Figures 15–18

Figure 15. Twenty months after grafting and implant placement. Figure 16. Root fracture on tooth #5. Figure 17. Root fracture defect with sinus lift osteotomy in white to the left of the image. Figure 18. NB indicates new bone; OB, original bone.


Figures 19–21
Figures 19–21

Figure 19. Seven months, and grafting 3 months after restoration. Figure 20. Seven months after grafting. Three months after restoration. Figure 21. Bone core sample 15 weeks after sinus lift with Regen Biocement.


Contributor Notes

*Corresponding author, e-mail: ggsteiner@steinerlabs.com
  • Download PDF