Microsurgical Approach to Sinus Floor Elevations Using Xenogen Grafts

Yıl 2020, Cilt: 47 Sayı: 1-3, 109 - 114, 31.12.2020

Abdullah Çapcı

Öz

Sinus floor elevation is a long-lasting and well-supported technique in literature when there is not enough bone volume in the posterior maxilla. The most common intraoperative complications of sinus floor elevation when using lateral window approach are the perforation of the Schneiderian membrane and the bleeding caused by the antral alveolar anastomosis. This complications mostly occurs when using xenogen particulated graft materials in cases where the height of the alveolar crest is considerably reduced. Reducing the size of the lateral window to 4-5 mm can reduce the risk of bleeding, while the superior illumination, magnification and increased precision of the surgeon can prevent the risk of Schneiderian membrane perforation and associated complications.

Anahtar Kelimeler

Complications, Microsurgery, Sinus Floor Augmentation, Xenograft

KSENOJEN GREFTLERİN KULLANILDIĞI SİNÜS TABAN ELEVASYONLARINDA MİKROCERRAHİ YAKLAŞIM

Öz

Sinüs taban elevasyonu, posterior maksillada yeterli kemik hacmi bulunmadığında uzun zamandır uygulanan ve literatür olarak oldukça iyi desteklenmiş bir cerrahi tekniktir. Al-veolar kret yüksekliğinin oldukça azaldığı durumlarda tercih edilen ksenojen partikül greft materyalleri kullanılarak yapılan lateral pencere yaklaşımı ile sinüs taban elevasyonunda intraoperatif olarak en sık karşılaşılan komplikasyonlar Schneiderian membranın perforas-yonu ve antral alveolar anastomozdan kaynaklanan kanamadır. Lateral pencerenin 4-5 mm olacak kadar küçültülmesi kanama riskini azaltırken, mikroskoplar ile çalışmanın sağladığı üstün aydınlatma, büyütme ve cerrahın el-parmak hassasiyetinin artması ile Schneiderian membran perforasyon riski ve buna bağlı komplikasyonlar önlenebilir.

Anahtar Kelimeler

Ksenogreft, Komplikasyonlar, Mikrocerrahi, Sinüs Taban Yükseltilmesi

Kaynakça

• 1. Brånemark P-I, Hansson BO, Adell R, Breine U, Lindström J, Hallén O, et al. Osseointegrated implants in the treatment of the edentulous jaw. Experience from a 10-year period. Stockholm: Almqvist & Wiksell International, 1977.
• 2. Carreño Carreño, J., Aguilar-Salvatierra, A., and Gómez-Moreno, G. (2016). Update of Surgical Techniques for Maxillary Sinus Augmentation: A Systematic Literature Review. Implant Dent. 25, 839–844.
• 3. Danesh-Sani, S.A., Loomer, P.M., and Wallace, S.S. (2016). A comprehensive clinical review of maxillary sinus floor elevation: anatomy, techniques, biomaterials and complications. Br. J. Oral Maxillofac. Surg. 54, 724–730.
• 4. Pjetursson, B.E., Tan, W.C., and Zwahlen, M. (2008). A systematic review of the success of sinus floor elevation and survival of implants inserted in combination with sinus floor elevation. J. Clin. Periodontol. 35, 216–240.
• 5. Katranji, A., Fotek, P., and Wang, H.-L. (2008). Sinus Augmentation Complications: Etiology and Treatment: Implant Dent. 17, 339–349.
• 6. Starch-Jensen, T., and Jensen, J.D. (2017). Maxillary Sinus Floor Augmentation: a Review of Selected Treatment Modalities. J. Oral Maxillofac. Res. 8. Available at: http://www.ejomr.org/JOMR/archives/2017/3/e3/v8n3e3ht.htm [Accessed May 24, 2019].
• 7. Tan, W.C., Lang, N.P., and Zwahlen, M. (2008). A systematic review of the success of sinus floor elevation and survival of implants inserted in combination with sinus floor elevation Part II: Transalveolar technique. J. Clin. Periodontol. 35, 241–254.
• 8. Shanelec, D.A. (2003). Periodontal Microsurgery. J. Esthet. Restor. Dent. 15, 402–407.
• 9. Carr, G.B., and Murgel, C.A.F. (2010). The Use of the Operating Microscope in Endodontics. Dent. Clin. North Am. 54, 191–214.
• 10. Velasco-Torres, M., Padial-Molina, M., and Alarcón, J.A. (2016). Maxillary Sinus Dimensions With Respect to the Posterior Superior Alveolar Artery Decrease With Tooth Loss: Implant Dent. 25, 464–470.
• 11. Tadjoedin ES, de Lange GL, Bronckers AL, Lyaruu DM, Burger EH: Deproteinized cancellous bovine bone (Bio-Oss) as bone substitute for sinus floor elevation. A retrospective, histomorphometrical study of five cases. Journal Clinical Periodontology. 2003, 30: 261-270. 10.1034/j.1600-051X.2003.01099.x.
• 12. Ruoff, H. and H. Terheyden : Retrospective radiographic investigation of the long-term stability of xenografts (Geistlich Bio-Oss) in the sinus. Z Zahnärztl Impl 2009; 25(2): 160-169.
• 13. Shakibaie-M, Behnam. (2008). Microscope-guided External Sinus Floor Elevation (MGES) - A new minimally invasive surgical technique. Implantologie. 16.