Browse > Article
http://dx.doi.org/10.5125/jkaoms.2011.37.2.122

Evaluation of the feasibility of bony window repositioning without using a barrier membrane in sinus lateral approach  

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)
Publication Information
Journal of the Korean Association of Oral and Maxillofacial Surgeons / v.37, no.2, 2011 , pp. 122-126 More about this Journal
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.
Keywords
Bone graft; Dental implants; Membrane;
Citations & Related Records
Times Cited By KSCI : 1  (Citation Analysis)
연도 인용수 순위
1 Vlassis JM, Fugazzotto PA. A classification system for sinus membrane perforations during augmentation procedures with options for repair. J Periodontol 1999;70:692-9.   DOI
2 Proussaefs P, Lozada J, Kim J, Rohrer MD. Repair of the perforated sinus membrane with a resorbable collagen membrane: a human study. Int J Oral Maxillofac Implants 2004;19:413-20.
3 Wallace SS, Froum SJ. Effect of maxillary sinus augmentation on the survival of endosseous dental implants.A systematic review. Ann Periodontol 2003;8:328-43.   DOI   ScienceOn
4 Zitzmann NU, Scharer P. Sinus elevation procedures in the resorbed posterior maxilla. Comparison of the crestal and lateral approaches. Oral Surg Oral Med Oral Pathol Oral RadiolEndod 1998;85:8-17.   DOI   ScienceOn
5 Lee JK. Outfracture osteotomy on lateral maxillary wall as a modified sinus graft technique. J Oral MaxillofacSurg 2010;68: 1639-41.   DOI   ScienceOn
6 Margolin MD, Cogan AG, Taylor M, Buck D, McAllister TN, Toth C, et al. Maxillary sinus augmentation in the non-human primate: a comparative radiographic and histologic study between recombinant human osteogenic protein-1 and natural bone mineral. J Periodontol 1998;69:911-9.   DOI   ScienceOn
7 Tarnow DP, Wallace SS, Froum SJ, Rohrer MD, Cho SC. Histologic and clinical comparison of bilateral sinus floor elevations with and without barrier membrane placement in 12 patients: part 3 of an ongoing prospective study. Int J Periodontics Restorative Dent 2000;20:117-25.
8 Lorenzoni M, Pertl C, Wegscheider W, Keil C, Penkner K, Polansky R, et al. Retrospective analysis of Frialit-2 implants in the augmented sinus. Int J Periodontics Restorative Dent 2000;20:255-67.
9 Zijderveld SA, Schulten EA, Aartman IH, ten Bruggenkate CM. Long-term changes in graft height after maxillary sinus floor elevation with different grafting materials: radiographic evaluation with a minimum follow-up of 4.5 years. Clin Oral Implants Res 2009;20:691-700.   DOI   ScienceOn
10 de Vicente JC, Hernandez-Vallejo G, Brana-Abascal P, Pena I. Maxillary sinus augmentation with autologous bone harvested from the lateral maxillary wall combined with bovine-derived hydroxyapatite: clinical and histologic observations. Clin Oral Implants Res 2010;21:430-8.   DOI   ScienceOn
11 Froum SJ, Tarnow DP, Wallace SS, Rohrer MD, Cho SC. Sinus floor elevation using anorganic bovine bone matrix (OsteoGraf/N) with and without autogenous bone: a clinical, histologic, radiographic, and histomorphometric analysis-Part 2 of an ongoing prospective study. Int J Periodontics Restorative Dent 1998;18:528-43.
12 Boyne PJ, James RA. Grafting of the maxillary sinus floor with autogenous marrow and bone. J Oral Surg 1980;38:613-6.
13 Wallace SS, Froum SJ, Cho SC, Elian N, Monteiro D, Kim BS, et al. Sinus augmentation utilizing anorganic bovine bone (Bio- Oss) with absorbable and nonabsorbable membranes placed over the lateral window: histomorphometric and clinical analyses. Int J Periodontics Restorative Dent 2005;25:551-9.
14 Jurisic M, Markovic A, Radulovic M, Brkovic BM, Sandor GK. Maxillary sinus floor augmentation: comparing osteotome with lateral window immediate and delayed implant placements. An interim report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008;106:820-7.   DOI   ScienceOn
15 Tawil G, Mawla M. Sinus floor elevation using a bovine bone mineral (Bio-Oss) with or without the concomitant use of a bilayered collagen barrier (Bio-Gide): a clinical report of immediate and delayed implant placement. Int J Oral Maxillofac Implants 2001;16:713-21.
16 Wallace SS, Froum SJ, Tarnow DP. Use of barrier membranes in sinus augmentation. In: Jensen OT, ed. The sinus bone graft. 2nd ed. Chicago: Quintessence Publishing Co.; 2006:229-39.
17 Song SI, Jeong HR, Kim HM, Lee JK. Clinical investigation on the feasibility of outfracture osteotomy sinus graft technique. J Korean Assoc Oral MaxillofacSurg 2009;35:367-71.