Journal of the Korean Association of Oral and Maxillofacial Surgeons

The Korean Association of Oral and Maxillofacial Surgeons (대한구강악안면외과학회)
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Evaluation of the feasibility of bony window repositioning without using a barrier membrane in sinus lateral approach

상악동측방접근법시 차폐막을 사용하지 않는 골창재위치술의 유용성 평가

  • Jeon, Seung-Hwan (Division of Oral and Maxillofacial Surgery, Department of Dentistry, College of Medicine, Hanyang University) ;
  • Cho, Yong-Seok (Private Practice of Oral and Maxillofacial Surgery, Apsun Dental Hospital) ;
  • Lee, Byung-Ha (Division of Oral and Maxillofacial Surgery, Department of Dentistry, College of Medicine, Hanyang University) ;
  • Im, Tae-Yun (Division of Oral and Maxillofacial Surgery, Department of Dentistry, College of Medicine, Hanyang University) ;
  • Hwang, Kyung-Gyun (Division of Oral and Maxillofacial Surgery, Department of Dentistry, College of Medicine, Hanyang University) ;
  • Park, Chang-Joo (Division of Oral and Maxillofacial Surgery, Department of Dentistry, College of Medicine, Hanyang University)
  • 전승환 (한양대학교 의과대학 치과학교실 구강악안면외과) ;
  • 조용석 (앞선차과병원 구강악안면외과) ;
  • 이병하 (한양대학교 의과대학 치과학교실 구강악안면외과) ;
  • 임태윤 (한양대학교 의과대학 치과학교실 구강악안면외과) ;
  • 황경균 (한양대학교 의과대학 치과학교실 구강악안면외과) ;
  • 박창주 (한양대학교 의과대학 치과학교실 구강악안면외과)
  • Received : 2010.05.12
  • Accepted : 2011.03.21
  • Published : 2011.04.29
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Abstract

Introduction: In the lateral window approach for a maxillary sinus bone graft, there has been considerable controversy regarding the placement of a barrier membrane over the osteotomy site. In particular, when there is no damage to the Schneiderian membrane, clinicians should decide whether to use a barrier membrane or not, considering the benefits and costs. This study presents the clinical cases to demonstrate that only repositioning the detached window can lead to satisfactory bony healing of the grafted material without using a barrier membrane in the lateral approach for a maxillary sinus bone graft. Materials and Methods: Five consecutive patients were treated with the same surgical procedures. After performing the antrostomy on the lateral maxillary wall using a round carbide bur and diamond bur, the bony window was detached by a gentle levering action. After confirming no perforation of the Schneiderian membrane, the grafting procedure was carried out the detached window of the lateral maxillary wall was repositioned over the grafted material without using a barrier membrane. A gross examination was carried out at the postoperative 6 month re-entry, and the the preoperative and postoperative dental computed tomography (CT) at re-entry were compared. Results: All the procedures in the 5 patients went on to uneventful healing with no complications associated with the bone graft. Satisfactory bone regeneration without the interference of fibrous tissue on the gap between the repositioned window and lateral wall of the maxillary sinus was observed in the postoperative 6 month re-entry. The CT findings at re-entry revealed the, reconstruction of the external cortical plate including repositioned bony window. In addition, the loss of the discontinuity of the lateral maxillary wall was confirmed. Conclusion: This preliminary report showed that the detached window, which was just repositioned on the grafted material, could function as a barrier membrane in the lateral approach for a maxillary sinus bone graft. Therefore additional morphometric and histologic studies will be needed.

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References

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