OSTEOTOME SITE DEVELOPMENT TECHNIQUE: A SUCCESSFUL TREATMENT FOR MAXILLARY SINUS AUGMENTATION
Abstract
Introduction. Lateral window is a successful treatment for maxillary sinus augmentation. However, this technique is highly invasive and associated with additional morbidity, cost and long waiting periods prior to implant placement. (1-2) Crestal approach is an alternative technique have been described for augmenting the maxillary sinus floor for implant therapy. (4) However studies have shown that the minimum residual bone from the crest to floor of sinus for this technique should be 4-5 mm for the higher implant success rate otherwise is better to do osteotome site development technique and place implant on second stage. (5-7). The following 2 cases demonstrate the application of osteotome site development technique for maxillary sinus augmentation. Case presentation. Case 1: A 41 y.o female patient presented with missing tooth # 14, sinus pneumatization, and very limited available bone height (3.4 mm from the crest to the sinus floor confirmed with CBCT). A crestal incision was made from tooth # 13 to # 15, full thickness flap was raised and a crestal approach sinus kit and osteotomes were used to elevate the sinus membrane. Xenograft and collagen membrane were used for sinus augmentation. 4 month later, 5 x 11 mm implant was placed. Case 2: A 44 y.o. female patient presented with missing tooth # 3, inadequate available bone height due to maxillary sinus pneumatization on this site (5 mm from the crest to the sinus floor confirmed with CBCT) and need for an implant placement. After crestal incision and full thickness flap reflection, a crestal approach sinus kit and osteotomes were used to elevate the sinus membrane. Xenograft and collagen membrane were used for sinus augmentation. 4 month after sinus augmentation, a 5 x 11 mm implant was placed. Deviation From the Expected. Osteotome site development technique could be a successful alternative to lateral wall technique for the patients who need sinus graft for implant placement and have minimum bone from the crest to the floor of sinus Discussion. Both sinus grafts and implants healed uneventfully. 4 month after sinus augmentation, bone gain of 9 mm for case # 1 and up to 7 mm for case # 2 confirmed with a CBCT. Patients were seen at 1 week, 2 weeks, 4 weeks and 4 month after sinus augmentation and they followed up to 3 month after implant placement. After 3 months implants osseointegrated. Impressions were taken and final crowns were delivered. Conclusion. Osteotome site development technique could be a successful alternative to lateral wall technique for the patients who need sinus graft for implant placement. This technique is less aggressive, less time consuming and less expensive for the patient. Grants. This study was partially funded by a grant from the HPD Research Committee
OSTEOTOME SITE DEVELOPMENT TECHNIQUE: A SUCCESSFUL TREATMENT FOR MAXILLARY SINUS AUGMENTATION
POSTER PRESENTATIONS
Introduction. Lateral window is a successful treatment for maxillary sinus augmentation. However, this technique is highly invasive and associated with additional morbidity, cost and long waiting periods prior to implant placement. (1-2) Crestal approach is an alternative technique have been described for augmenting the maxillary sinus floor for implant therapy. (4) However studies have shown that the minimum residual bone from the crest to floor of sinus for this technique should be 4-5 mm for the higher implant success rate otherwise is better to do osteotome site development technique and place implant on second stage. (5-7). The following 2 cases demonstrate the application of osteotome site development technique for maxillary sinus augmentation. Case presentation. Case 1: A 41 y.o female patient presented with missing tooth # 14, sinus pneumatization, and very limited available bone height (3.4 mm from the crest to the sinus floor confirmed with CBCT). A crestal incision was made from tooth # 13 to # 15, full thickness flap was raised and a crestal approach sinus kit and osteotomes were used to elevate the sinus membrane. Xenograft and collagen membrane were used for sinus augmentation. 4 month later, 5 x 11 mm implant was placed. Case 2: A 44 y.o. female patient presented with missing tooth # 3, inadequate available bone height due to maxillary sinus pneumatization on this site (5 mm from the crest to the sinus floor confirmed with CBCT) and need for an implant placement. After crestal incision and full thickness flap reflection, a crestal approach sinus kit and osteotomes were used to elevate the sinus membrane. Xenograft and collagen membrane were used for sinus augmentation. 4 month after sinus augmentation, a 5 x 11 mm implant was placed. Deviation From the Expected. Osteotome site development technique could be a successful alternative to lateral wall technique for the patients who need sinus graft for implant placement and have minimum bone from the crest to the floor of sinus Discussion. Both sinus grafts and implants healed uneventfully. 4 month after sinus augmentation, bone gain of 9 mm for case # 1 and up to 7 mm for case # 2 confirmed with a CBCT. Patients were seen at 1 week, 2 weeks, 4 weeks and 4 month after sinus augmentation and they followed up to 3 month after implant placement. After 3 months implants osseointegrated. Impressions were taken and final crowns were delivered. Conclusion. Osteotome site development technique could be a successful alternative to lateral wall technique for the patients who need sinus graft for implant placement. This technique is less aggressive, less time consuming and less expensive for the patient. Grants. This study was partially funded by a grant from the HPD Research Committee