• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.18 no.2
• /
• pp.236-244
• /
• 1996

The maxillary sinus elevation for simultaneous placement of dental implants and combination grafts of autogenous bone harvested from the maxillary tuberosity and demineralized freeze dried bone and HA is relatively easy and safely done under local anesthesia in out patients clinic. This article is to introduce the sinus floor elevation method which has been performed to 5 patients in the department of Dentistry/Oral & Maxillofacial Surgery, Kangnam Sacred Heart Hospital, Hallym University, from 1993.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.35 no.5
• /
• pp.346-352
• /
• 2009

There have been reports of successful bone formation with sinus floor elevation by simply elevating the maxillary sinus membrane and filling the sinus cavity below the lifted sinus membrane with a blood clot. But, in a review of the current literature, we found no animal study that substantiated blood clot's ability in this respect. The aim of this study was to investigate the effect of the method of maxillary sinus floor augmentation using the patient's own venous blood in conjunction with a sinus membrane elevation procedure. An implant was placed bilaterally in the maxillary sinus of six adult mongrel dogs so that it protruded 8 mm into the maxillary sinus after sinus membrane elevation. On one side of the maxillary sinus, the resultant space between the membrane and the sinus floor was filled with autologous venous blood retrieved from the dog. On the opposite side, the maxillary sinus was left untreated as a control. The implants were left in place for six months. The mean height of the newly formed bone in the sinus was 3.7 mm on the side without venous blood and 3.5 mm on the side with venous blood (p>0.05). There was no difference between the two sides regarding new bone height in the sinus. Our results indicate that filling the space between the lifted sinus membrane and the sinus floor with venous blood has no effect on bone formation around implants placed in the maxillary sinus cavity.

• Journal of Periodontal and Implant Science
• /
• v.36 no.2
• /
• pp.345-359
• /
• 2006

Loss of maxillary molar teeth leads to rapid loss of crestal bone and inferior expansion of the maxillary sinus floor (secondary pneumatization). Rehabilitation of the site with osseointegrated dental implants often represents a clinical challenge because of the insufficient bone volume resulted from this phenomenon. Boyne & James proposed the classic procedure for maxillary sinus floor elevation entails preparation of a trap door including the Schneiderian membrane in the lateral sinus wall. Summers proposed another non-invasive method using a set of osteotome and the osteotome sinus floor elevation (OSFE) was proposed for implant sites with at least 5-6mm of bone between the alveolar crest and the maxillary sinus floor. The change of grafted material in maxillary sinus is important for implant survival and the evaluation of graft height after maxillary sinus floor elevation is composed of histologic evaluation and radiomorphometric evaluation. The aim of the present study was radiographically evaluate the graft height change after maxillary sinus floor elevation and the influence of the graft material type in height change and the bone remodeling of grafts in sinus. A total of 59 patients (28 in lateral approach and 31 in crestal approach) who underwent maxillary sinus floor elevation composed of lateral approach and crestal approach were radiographically followed for up to about 48 months. Change in sinusgraft height were calculated with respect to implant length (IL) and grafted sinus height(BL). It was evaluated the change of the graft height according to time, the influence of the approach technique (staged approach and simultaneous approach) in lateral approach to change of the graft height, and the influence of the type of graft materials to change of the graft height. Patients were divided into three class based on the height of the grafted sinus floor relative to the implant apex and evaluated the proportion change of that class (Class I, in which the grafted sinus floor was above the implant apex; Class II, in which the implant apex was level with the grafted sinus floor; and Class III, in which the grafted sinus floor was below the implant apex). And it was evaluated th bone remodeling in sinus during 12 months using SGRl(by $Br\ddot{a}gger$ et al). The result was like that; Sinus graft height decreased significantly in both lateral approach and crestal approach in first 12 months (p$MBCP^{TM}$ had minimum height loss. Class III and Class II was increased by time in both lateral and crestal approach and Class I was decreased by time. SGRI was increased statistically significantly from baseline to 3 months and 3 months(p<0.05) to 12 months(p$ICB^{(R)}$ single use, more reduction of sinusgraft height was appeared. Therefore we speculated that the mixture of graft materials is preferable as a reduction of graft materials. Increasing of the SGRI as time goes by explains the stability of implant, but additional histologic or computed tomographic study will be needed for accurate conclusion. From the radiographic evaluation, we come to know that placement of dental implant with sinus floor elevation is an effective procedure in atrophic maxillary reconstruction.

• The Journal of the Korean dental association
• /
• v.48 no.3
• /
• pp.205-217
• /
• 2010

Purpose The aim of this study is to evaluate the survival rates and analyze the stability of lateral approach and trans-crestal approach for maxillary sinus floor elevation of simultaneous implant placement. Materials and method 407 patients who have been treated in LivingWell dental hospital between 2003 to 2009 were selected. Lateral window technique, osteotome technique and sinus drill technique were used for sinus floor elevation procedure. A total of 714 implants-MP-1 HA coated implant(Tapered Screw $Vent^{TM}$, $Spline^{TM}$, Zimmer, USA), FBR surfaced implant(Pitt-$Easy^{TM}$, Oraltronics, Germany)-were placed in grafted maxillary sinus simultaneously. The autogenous bone or a combination with the allograft or alloplast was grafted into sinus. Sinus floor elevation was combined with vertical/horizontal onlay bone grafts to reconstruct the defect of alveolar ridge. Results The average preoperative height of the maxillary alveolar bone was 5.78mm(range: 0.4mm~12.5mm). 14 implants failed during the healing period(lateral approach: 4, trans-crestal approach: 10) and 3 implant failed after prosthetic loading(lateral approach: 2, trans-crestal approach: 1). The cumulative survival rate of implants after 6 years was 97.6%. Trans-crestal approach(97.4%) and lateral approach(97.9%) had similar survival rates. Conclusion The results indicate that the trans-crestal approach and lateral approach for maxillary sinus elevation is a acceptable method at atrophic maxillary posterior area.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.34 no.3
• /
• pp.341-349
• /
• 2008

Purpose: The purpose of this study was to evaluate the $Osstem^{(R)}$ implants (US II/SS II implants) through the retrospective study for the clinical success rate during the installation of the $Osstem^{(R)}$ implants (US II/SS II implants) by using of the procedures of maxillary sinus floor elevation. Materials and methods: The current study was researched in the 6 medical institutions: Chonnam National University, Chosun University, Pusan DaeDong Hospital, Bundang Seoul National University Hospital, Ap-Seon Clinic, and All Clinic. Based on the total number of 116 patients whose treatment was the installation of the US II/SS II implants with the procedures of the maxillary sinus floor elevation, they were conferred on the dental records of the patients under the joint consultation of the 6 medical institutions. On the dental recording charts, there were included in as the following; the name of the institutions, gender, age, with or without smoking or drinking, with or without the generalized diseases, the height of the alveolar bone on the operational sites, elapsed edentulous state period, the state of the opposed or adjacent teeth, the methods of the maxillary sinus floor elevation, secondary time period for surgery, the lengths, types, and diameters of implants, with or without bone transplantation or the types of bone, postoperative current bone height, current adjacent soft tissue state of the implants, with or without the success of the installations of the implants. We have done our survey with the clinical and radiolographical examinations and dental questionaries. The success and survival rate of the implants was evaluated. Results 1. Total number of the patients with the installation of the US II implants were 62. The 252 numbers of US II implants were installed on the 89 maxillary sinuses. The patient's mean age was 54.1 years old and there were 36 men and 27 women. 2. Total number of patients with the installation of SS II implant were 57. The 165 numbers of SS II implants were planted on the 80 maxillary sinuses. Their mean age was 48.7 years old and there were 37 men and 20 women. 3. The follow-up period was 30.7 months(21-49 mon) on average. The vertical bone loss of installed implants after the procedures of the maxillary sinus elevation was 1.1 mm on average in SS II and 1.3 mm on average in US II. There existed no statistical significance on each group. The mean enlarged bone height after the maxillary sinus floor elevation was 8.2 mm. 4. For the procedures of the maxillary sinus elevation, the Lateral approach technique occupied 87.1%, which was the most used one. In addition, the most frequently used transplanted bone was autogenous bone only which was 72.7% during the maxillary sinus floor elevation. 5. The complication of maxillary sinus floor elevation were perforation of sinus membrane, disesthesia on doner site, exposure of cover screw and exposure of maxillar bone. 6. The survival rate of US II and SS II after maxillary sinus floor elevation was 99.2% and 95.8%, respectively. And the success rate of US II and SS II after maxillary sinus floor elevation was 97.6% and 89.7%, respectively. Conclusion : On the evaluation of the analysis of our study, both US II and SS II implants showed the excellent clinical results by use of the procedures of maxillary sinus floor elevation.

• Journal of Periodontal and Implant Science
• /
• v.39 no.3
• /
• pp.293-301
• /
• 2009

Purpose: The purpose of this study is to show the total survival rate of implants with maxillary sinus floor elevation and the effects that reach the survival rate by classifying types of graft materials, implant surface, operation method, bone height. Methods: In a total of 131 patients, 251 implants with sinus floor elevation were installed simultaneously or after regular healing. Various bone grafts (autograft, xonograft, allograft, alloplast) and implant surface (MTX-HA implant, chemical etching implant, Titanium oxide surface implant, resorbable blasting media implant, resorbable blast texturing implant, HA-coated implant) were used. All implants were investigated clinically and radiographically, being with 1 to 5 years follow-up period after installation. Results: The survival rate of 251 implants with maxillary sinus floor elevation was 94%. The types of implant, surface, graft material, bone height have no statistically signi-ficant differencies. Conclusions: It can be suggested that maxillary sinus floor elevation may have predictable result with various bone graft materials and implant surface.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.36 no.4
• /
• pp.146-153
• /
• 2014

Purpose: This study compares and evaluates the efficacy of graft materials after maxillary sinus bone grafts with autogenous tooth bone graft material (AutoBT), demineralized freeze-dried bone allograft (DFDBA) and deproteinized bovine bone mineral (DBBM). Methods: The study involved 30 sinuses in 26 patients who visited the Division of Oral and Maxillofacial Surgery, Department of Dentistry in Ajou University Hospital and received either AutoBT, DFDBA or DBBM with sinus elevation using the lateral window technique. Sinus graft height was measured before, immediately after, and six months after bone graft with panoramic radiography and the height changes of the sinus floor was compared according to the graft materials. Results: After six months, the decrease ratio of graft heights were 13.57% for AutoBT group, 14.30% for DFDBA group, and 11.92% for DBBM group. There was no statistically significant difference. Conclusion: The new maxillary sinus floor formed by the upper border of bone graft material, can repneumatize after the maxillary sinus elevation. Thus, long-term stability of sinus graft height represents an important factor for implant success. We found that the three graft materials for sinus elevation do not differ significantly and all three graft materials showed excellent resistance to maxillary sinus repneumatization. However, due to the special circumstances of the maxillary sinus and small sample, the actual difference between the three graft materials may not have been detectable. Therefore further study needs to be conducted for more reliable study results.

• The Journal of the Korean dental association
• /
• v.54 no.10
• /
• pp.771-779
• /
• 2016

Purpose: Antral pseudocyst is a common benign lesion that exists in the maxillary sinus. Because of this possible complication, controversy remains with respect to sinus floor elevation operations. The purpose of this study was to analyze the antral pseudocyst related to maxillary sinus augmentation. Patients and Methods: The radiographs of 268 patients who visited Chosun University Dental Hospital from 2008 to 2010 and underwent the maxillary bone grafting procedure were examined. Results: Of the 268 patients who underwent the maxillary bone grafting procedure, 5 patients (1.86%) were diagnosed with antral pseudocysts. In all cases, maxillary sinus floor elevation was performed without aspiration, biopsy or extraction of the antral pseudocyst. Conclusion: Antral pseudocysts are not considered a contraindication for maxillary sinus bone grafting procedure.

• Journal of Periodontal and Implant Science
• /
• v.35 no.4
• /
• pp.813-822
• /
• 2005

The predictable outcome of implant placement in the atrophic maxilla with sinus floor elevation procedure(osteotome sinus floor elevation technique and window opening technique) is well documented. Aim of this study was to evaluate the efficacy of $Br{\aa}nemark$ Ti-Unite implant system and ITI SLA implant system placed in the atrophic posterior maxilla with sinus floor elevation procedure. Eighty patients received placement of $Br{\aa}nemark$ Ti-Unite implants(195 implants) in their atrophic posterior Maxilla with sinus floor elevation procedure(153 osteotome sinus floor elevation technique and 42 window opening procedure). Fifty patients received placement of ITI SLA implants(83 implants) in their atrophic posterior Maxilla with sinus floor elevation procedure(77 osteotome sinus floor elevation technique and 6 window opening procedure). Chart review were taken from each patient. The total failed implants were seven and the total implant survival rate was 96.4% in $Br{\aa}nemark$ Ti-Unite system. The total failed implants were one and the total implant survival rate was 98.8% in ITI SLA system. The implant survival rate with osteotome technique was 96% and 97.6% with window opening in $Br{\aa}nemark$ Ti-Unite system. The implant survival rate with osteotome technique was 98.7% and 100% with window opening. The implant survival rate with osteotome technique was 96% and 97.6% with window opening in ITI SLA system. The results of this evaluation show that the placement of $Br{\aa}nemark$ Ti-Unite system as well as ITI SLA system is a reasonable treatment option for patients with the atrophic posterior maxillary area.

• Journal of Periodontal and Implant Science
• /
• v.44 no.2
• /
• pp.50-56
• /
• 2014

Purpose: The aims of this study were to measure the distance of the intraosseous vascular anastomosis in the anterolateral wall of the maxillary sinus from different reference points, and to correlate the location of the intraosseous vascular anastomosis with the tooth position and the residual bone height of the maxilla. Methods: Computed tomography (CT) images were taken from 283 patients undergoing dental implants placement in the posterior maxilla. Three horizontal lines were drawn at the ridge crest, maxillary sinus floor, and the position of the anastomosis. A vertical second line at the center of each tooth was drawn perpendicular to the horizontal lines. The distance from the ridge crest to the maxillary sinus floor and the distance from the maxillary sinus floor to the bony canal were measured from the intersections of the horizontal and vertical lines. The residual alveolar bone height was used to categorize three groups: group 1,<4 mm; group 2, between 4 and 8 mm; and group 3, >8 mm. Results: The residual bone height values of different tooth positions were significantly different (P=0.0002). The distance from the maxillary sinus floor to the intraosseous vascular anastomosis was significantly different between groups 1 and 3 (P=0.0039). At the molar sites, a moderate negative correlation was found between the residual bone height and the distance from the maxillary sinus floor to the intraosseous anastomosis. The distances of the alveolar ridge crest and the maxillary sinus from the intraosseous vascular anastomosis were not significantly different between sexes. Conclusions: Within the limitations of this study, sites with a higher residual bone height in the molar regions were at a relatively high risk of artery damage during window osteotomy preparation; therefore, we recommend taking more precautions when using a lateral approach for sinus elevation.