Subantral sinus augmentation using hydraulic lift system and alloplastic phosphosilicate putty followed by simultaneous implant placement for the rehabilitation of an atrophic posterior maxilla: A case report
Background: Tooth extraction is generally accompanied by bone remodeling and pneumatization of the maxillary sinus in the posterior region of the maxilla, which can result in a reduction in the height and width of the bone and compromise the placement of the implant. However, this anatomic deficiency can be restored through maxillary sinus elevation. Among the various surgical methods used, the indirect sinus floor elevation technique is relatively less invasive and less complex.
Aim: Herein, we present the case of a 58-year-old partially edentulous female who underwent rehabilitation of the right maxillary molar region using the indirect sinus floor elevation technique. The hydraulic lift system was used followed by immediate implant placement.
Relevance for Patients: This technique incorporates the advantages of both the lateral wall and crestal approaches for sinus elevation and is associated with a lower incidence of sinus membrane
perforation and minimum bone loss.
[1] Schropp L, Wenzel A, Kostopoulos L, Karring T. Bone Healing and Soft Tissue Contour Changes Following
Single-Tooth Extraction: A Clinical and Radiographic 12-Month Prospective Study. Int J Periodontics Restorative
Dent 2003;23:313-24.
[2] Sato T, Hara T, Mori S, Shirai H, Minagi S. Threshold for Bone Resorption Induced by Continuous and Intermittent Pressure in the Rat Hard Palate. J Dent Res 1998;77:387-92.
[3] Garg A. Augmentation Grafting of the Maxillary Sinus for the Placement of Dental Implants: Anatomy, Physiology, and Procedure. Implant Dent 1994;8:36.
[4] Thomas GJ. Sinus Lifts. APossible Solution to the Atrophic Maxilla. J Macomb Dent 1990;29:9.
[5] Albrektsson T, Dahl E, Enbom L, Engevall S, Engquist B, Eriksson AR, et al. Osseointegrated Oral Implants.
A Swedish Multicenter Study of 8139 Consecutively Inserted Nobelpharma Implants. J Periodontol 1988;59:287-96.
[6] Singh AV, Gazmawe A, Randelzhofer P. Immediate Implant in the Extraction Socket. In: Goswami N, editor. Clinical Implantology. 1st ed. New Delhi: Elsevier Publishers; 2013. p. 165-6.
[7] Kantarci M, Karasen RM, Alper F, Onbas O, Okur A, Karaman A. Remarkable Anatomic Variations in Paranasal Sinus Region and their Clinical Importance. Eur J Radiol 2004;50:296-302.
[8] Jivraj S, Corrado P, Chee W. An Interdisciplinary Approach to Treatment Planning in Implant Dentistry. Br Dent J 2007;202:11-7.
[9] Asai S, Shimizu Y, Ooya K. Maxillary Sinus Augmentation Model in Rabbits: Effect of Occluded Nasal Ostium on New Bone Formation. Clinical Oral Implants Research 2002;13:405-9.
[10] Misch CE, editor. Contemporary Implant Dentistry. 3rd ed. New Delhi: Elsevier Publishers; 2008. p. 241-5.
[11] Pommer B, Zechner W, Watzek G, Palmer G. To Graft or Not to Graft? Evidence-Based Guide to Decision Making in Oral Bone Graft Surgery. In: Zorzi A, de Miranda JB, editors. Bone Grafting. Rijeka, Croatia: InTech; 2012. p. 159-82.
[12] Boyne PJ, James RA. Grafting of the maxillary sinus floor with autogenous marrow and bone. J Oral Surg
1980;38:613-16.
[13] Tatum OH Jr. Osseous Grafts in Intra-Oral Sites. J Oral Implantol 1996;22:51-2.
[14] Hatano N, Shimizu Y, Ooya K. A Clinical Long-Term Radiographic Evaluation of Graft Height Changes after
Maxillary Sinus Floor Augmentation with a 2:1 Autogenous Bone/Xenograft Mixture and Simultaneous Placement of Dental Implants. Clin Oral Implants Res 2004;15:339-45.
[15] Jenson OT, Shulman LB, Block MS Iacona VJ. Reports of the Sinus Consensus Conference of 1996. Int J Oral
Maxillofac Implants 1998;13:11-45.
[16] Summers RB. The Osteotome Technique: Part 3-Less Invasive Methods of Elevating the Sinus Floor. Compend Contin Educ Dent 1994;15:698-710.
[17] Coatoam GW. Indirect Sinus Augmentation Procedures Using One-Stage Anatomically Shaped Root Form
Implants. J Oral Implantol 1997;23:25-42.
[18] Sotirakis EG, Gonshor A. Elevation of the Maxillary Sinus Floor with Hydraulic Pressure. J Oral Implantol
2005;31:197-204.
[19] Agnihotri A, Agnihotri D. Maxillary Sinus Lift Up: An Indirect Approach for Implant Placement in Posterior
Maxilla. Int J Oral Implant Clin Res 2012;3:101-4.
[20] Misch CE. Maxillary Sinus Augmentation for Endosteal Implants: Organized Alternative Treatment Plans. Int J Oral Implantol 1987;4:49-58.
[21] Agamy TM, Niedermeier W. Indirect Sinus Floor Elevation for Osseointegrated Prostheses. A 10-Year Prospective Study. J Oral Implantol 2010;36:113-21.
[22] Engelke W, Deckwer I. Endoscopically Controlled Sinus Floor Augmentation. A Preliminary Report. Clin Oral Implants Res 1997;8:527-31.
[23] Kher U, Loannou AL, Kumar T, Siormpas K, Mitsias ME, Mazor Z, et al. A Clinical and Radiographic Case Series of Implants Placed with the Simplified Minimally Invasive Antral Membrane Elevation Technique in the Posterior Maxilla. J Craniomaxillofac Surg 2014;42:1942-7.
[24] Pommer B, Unger E, Sütö D, Hack N, Watzek G. Mechanical Properties of the Schneiderian Membrane
In Vitro. Clin Oral Implants Res 2009;20:633-7.
[25] Gonzalez S, Tuan MC, Ahn KM, Nowzari H. Crestal Approach for Maxillary Sinus Augmentation in Patients
with ≤ 4 mm of Residual Alveolar Bone.Clin Implant Dent Relat Res 2014;16:827-35.
[26] Borengo M, Sivolella S, Majzoub ZA, Cordioli G.Endoscopic Evaluation of the Bone-Added Osteotome
Sinus floor Elevation Procedure. Int J Oral Maxillofac Surg 2001;33:189-94.
[27] Peleg M, Garg AK, Mazor Z. Predictability of Simultaneous Implant Placement in the Severely Atrophic Posterior Maxilla: A 9-Year Longitudinal Experience Study of 2132 Implants Placed Into 731 Human Sinus Grafts. Int J Oral Maxillofac Implants 2006;21:94-102.
[28] Rosen PS, Summers R, Mellado JR, Salkin LM, Shanaman RH, Marks MH, et al. The Bone-Added
Osteotome Sinus Floor Elevation Technique: Multicenter Retrospective Report of Consecutively Treated Patients. Int J Oral Maxillofac Implants 1999;14:853-8.
[29] Nedir R, Bischof M, Vazquez L, Szmukler-Moncler S, Bernard JP. Osteotome Sinus Floor Elevation without
Grafting Material: A 1-Year Prospective Pilot Study with ITI Implants. Clin Oral Implants Res 2006;17:679-86.
[30] Nkenke E, Schlegel A, Schultze-Mosgau S, Neukam FW, Wiltfang J. The Endoscopically Controlled Osteotome Sinus Floor Elevation: A Preliminary Prospective Study. Int J Oral Maxillofac Implants 2002;17:557-66.
[31] Toffler M. Osteotome-Mediated Sinus Floor Elevation: A Clinical Report. Int J Oral Maxillofac Implants
2004;19:266-73.
[32] Vitkov L, Gellrich NC, Hannig M. Sinus Floor Elevation Via Hydraulic Detachment and Elevation of the Schneiderian Membrane. Clin Oral Implants Res 2005;16:615-21.
[33] Ferrigno N, Laureti M, Fanali S. Dental Implants Placement in Conjunction with Osteotome Sinus Floor Elevation: A12-Year Life-Table Analysis from a Prospective Study on 588 ITI Implants. Clin Oral Implants Res 2006;17:194-205.
[34] Pikos MA. Maxillary Sinus Membrane Repair: Update on Technique for Large And Complete Perforations. Implant Dent 2008;17:24-31.
[35] Raghoebar GM, Timmenga NM, Reinstema H, Stegenga B, Vissink A. Maxillary Bone Grafting for Insertion of Endoosseous Implants: Results After 12 to 124 Months. Clin Oral Implants Res 2001;12:279-86.
[36] Nandal S, Ghalaut P, Shekhawat H. A Radiological Evaluation of Marginal Bone Around Dental Implants: An In-Vivo Study. Nat J Maxillofac Surg 2014;5:1-12.
[37] Chugh A, Nandal S. Original Research Radiological Evaluation of Marginal Bone Around Dental Implants:
A Pilot Study. Eur J Prosthodont 2014;2:58-61.