Alveolar ridge augmentation with lateral approach maxillary sinus lifting: a case report

Abstract

In the maxillary posterior region, increased sinus pneumatisation, decreased density and residual alveolar bone height create difficulty in placing dental implants. Therefore, it is necessary to surgically increase the bone height to obtain sufficient bone height for implantation. The aim of this case was to perform a two-stage lateral approach sinus surgery to create an adequate amount of residual crest for rehabilitation of the severely resorbed posterior maxillary bone and then to allow the use of dental implants of adequate length. A 2-stage lateral approach sinus lifting operation was planned for a patient with insufficient vertical crest height in the region of tooth #26. The patient waited 6 months after the lateral approach sinus lifting operation and Adequate vertical crest height was obtained for implant placement. External sinus lifting is a highly effective technique for increasing vertical bone heigh in atrophic maxillary crests.

Keywords

• Sinus lifting
• dental implant
• PRF

Alveolar Kemiğin Lateral Yaklaşımlı Maksiller Sinüs Lifting ile Ogmentasyonu: Bir Olgu Sunumu

Abstract

In the maxillary posterior region, increased sinus pneumatisation, decreased density and residual alveolar bone height create difficulty in placing dental implants. Therefore, in order to place an implant in the maxillary posterior region, the residual bone height must be increased by a surgical technique. The aim of this case was to perform a two-stage lateral approach sinus surgery to create an adequate amount of residual crest for rehabilitation of the severely atrophic posterior maxilla and then to allow the use of dental implants of adequate length. A 2-stage lateral approach sinus lifting operation was planned for a patient with insufficient vertical crest height in the region of tooth #26. The patient waited 6 months after the lateral approach sinus lifting operation and sufficient vertical crest height was obtained. A 4.1 mm diameter and 11 mm long implant was placed. External sinus lifting is a highly effective technique for increasing vertical bone heigh in atrophic maxillary crests. Key words: Sinus lifting, dental implant, PRF .

Keywords

• Sinüs lifting
• Dental implant
• PRF

Ethical Statement

Patients who routinely undergo CBCT should be counselled that it will be used for scientific purposes and consent was obtained before imaging. This scientific study has been prepared in accordance with ethical principles. The authors declare that there is no conflict of interest.

References

1. Clark D, Levin L. In the dental implant era, why do we still bother saving teeth? Dent Traumatol. 2019;35(6):368-375. doi:10.1111/edt.12492
2. Duong HY, Roccuzzo A, Stähli A, Salvi GE, Lang NP, Sculean A. Oral health-related quality of life of patients rehabilitated with fixed and removable implant-supported dental prostheses. Periodontol 2000. 2022; 88(1):201-237. doi:10.1111/prd.12419
3. Al-Moraissi EA, Alkhutari AS, Abotaleb B, Altairi NH, Del Fabbro M. Do osteoconductive bone substitutes result in similar bone regeneration for maxillary sinus augmentation when compared to osteogenic and osteoinductive bone grafts? A systematic review and frequentist network meta-analysis. Int J Oral Maxillofac Surg. 2020;49(1):107-120. doi:10.1016/j.ijom.2019.05.004
4. Baru O, Buduru SD, Berindan-Neagoe I, et al. Autologous leucocyte and platelet rich in fibrin (L-PRF) - is it a competitive solution for bone augmentation in maxillary sinus lift? A 6-month radiological comparison between xenografts and L-PRF. Med Pharm Rep. 2024;97(2): 222-233. doi:10.15386/mpr-2719
5. Uckan S, Tamer Y, Deniz K. Survival rates of implants inserted in the maxillary sinus area by internal or external approach. Implant Dent. 2011;20(6):476-479. doi:10.1097/ID.0b013e3182386d34
6. Sanz M, Donos N, Alcoforado G, et al. Therapeutic concepts and methods for improving dental implant outcomes. Summary and consensus statements. The 4th EAO Consensus Conference 2015. Clin Oral Implants Res. 2015;26(Suppl 11):202-206. doi:10.1111/clr.12674
7. Yin L, Yu Z, Chen Z, et al. Analysis of bone height changes after maxillary sinus augmentation with simultaneous and delayed placement of dental implants: a clinical and radiographic study. J Prosthodont. 2016;25(6): 440-445. doi:10.1111/jopr.12317
8. van den Bergh JP, ten Bruggenkate CM, Disch FJ, Tuinzing DB. Anatomical aspects of sinus floor elevations. Clin Oral Implants Res. 2000;11(3):256-265. doi:10.1034/j.1600-0501.2000.011003256.x

9. Correia F, Almeida RF, Costa AL. Carvalho J, Felino A. Levantamento do seio maxilar pela técnica da janela lateral: tipos enxertos. Revist Portug Estomatol Med Dentár Cirurgia Maxilofac. 2012;53(3):190-196. doi:10.1016/j.rpemd.2012.03.003
10. Esposito M, Grusovin MG, Felice P, Karatzopoulos G, Worthington HV, Coulthard P. Interventions for replacing missing teeth: horizontal and vertical bone augmentation techniques for dental implant treatment. Cochrane Database Syst Rev. 2009;2009(4):CD003607. doi:10.1002/ 14651858.CD003607.pub4
11. McAllister BS, Haghighat K. Bone augmentation techniques. J Periodontol. 2007;78(3):377-396. doi:10.1902/jop.2007.060048
12. Vogiatzi T, Kloukos D, Scarfe WC, Bornstein MM. Incidence of anatomical variations and disease of the maxillary sinuses as identified by cone beam computed tomography: a systematic review. Int J Oral Maxillofac Implants. 2014;29(6):1301-1314. doi:10.11607/jomi.3644
13. Lozano-Carrascal N, Salomó-Coll O, Gehrke SA, Calvo-Guirado JL, Hernández-Alfaro F, Gargallo-Albiol J. Radiological evaluation of maxillary sinus anatomy: a cross-sectional study of 300 patients. Ann Anat. 2017;214:1-8. doi:10.1016/j.aanat.2017.06.002
14. Sohn DS, Moon JW, Moon KN, Cho SC, Kang PS. New bone formation in the maxillary sinus using only absorbable gelatin sponge. J Oral Maxillofac Surg. 2010;68(6):1327-1333. doi:10.1016/j.joms.2010.02.014
15. Alshamrani AM, Mubarki M, Alsager AS, Alsharif HK, AlHumaidan SA, Al-Omar A. Maxillary sinus lift procedures: an overview of current techniques, presurgical evaluation, and complications. Cureus. 2023; 15(11):e49553. doi:10.7759/cureus.49553
16. Morgan N, Meeus J, Shujaat S, Cortellini S, Bornstein MM, Jacobs R. CBCT for diagnostics, treatment planning and monitoring of sinus floor elevation procedures. Diagnostics (Basel). 2023;13(10):1684. doi:10.3390/diagnostics13101684
17. Ahmed J, Gupta A, Shenoy N, Sujir N, Muralidharan A. Prevalence of incidental maxillary sinus anomalies on cbct scans: a radiographic study. Diagnostics (Basel). 2023;13(18):2918. doi:10.3390/diagnostics13182918
18. Hallman M, Sennerby L, Zetterqvist L, Lundgren S. A 3-year prospective follow-up study of implant-supported fixed prostheses in patients subjected to maxillary sinus floor augmentation with a 80:20 mixture of deproteinized bovine bone and autogenous bone clinical, radiographic and resonance frequency analysis. Int J Oral Maxillofac Surg. 2005;34(3):273-280. doi:10.1016/j.ijom.2004.09.009
19. Li X, Chen SL, Zhu SX, Zha GQ. Guided bone regeneration using collagen membranes for sinus augmentation. Br J Oral Maxillofac Surg. 2012;50(1):69-73. doi:10.1016/j.bjoms.2010.10.013
20. Kim SM, Park JW, Suh JY, Sohn DS, Lee JM. Bone-added osteotome technique versus lateral approach for sinus floor elevation: a comparative radiographic study. Implant Dent. 2011;20(6):465-470. doi:10.1097/ID. 0b013e31823545b2
21. Lyu M, Xu D, Zhang X, Yuan Q. Maxillary sinus floor augmentation: a review of current evidence on anatomical factors and a decision tree. Int J Oral Sci. 2023;15(1):41. doi:10.1038/s41368-023-00248-x
22. Fenner M, Vairaktaris E, Fischer K, Schlegel KA, Neukam FW, Nkenke E. Influence of residual alveolar bone height on osseointegration of implants in the maxilla: a pilot study. Clin Oral Implants Res. 2009;20(6): 555-559. doi:10.1111/j.1600-0501.2008.01598.x
23. Bernardello F, Righi D, Cosci F, Bozzoli P, Soardi CM, Spinato S. Crestal sinus lift with sequential drills and simultaneous implant placement in sites with <5 mm of native bone: a multicenter retrospective study. Implant Dent. 2011;20(6):439-444. doi:10.1097/ID.0b013e3182342052
24. Shulman LB, Jensen OT, Block NS, Iacono VJ. A consensus confer- ence on the sinus graft. In: Jensen OT (ed). The Sinus Bone Graft. Chicago: Quintessence. 1999:209-228.
25. Kardos D, Hornyák I, Simon M, et al. Biological and mechanical properties of platelet-rich fibrin membranes after thermal manipulation and preparation in a single-syringe closed system. Int J Mol Sci. 2018; 19(11):3433. doi:10.3390/ijms19113433