ShareThisSuccessful placement of implants in the posterior maxilla could potentially be compromised by the lack of vertical dimension between the alveolar crest and the floor of the maxillary sinus. Typically, 10 mm of vertical bone is required for predictable implant success (Misch, 1987) although success can be achieved with less than 10mm (Fugazzoto 2007). Moreover, bone density in the posterior maxilla is often poor, which could lead to complications during implant fixation. To address these problems, maxillary sinus elevation surgery was developed to increase the amount of bone available for implant placement.
Anatomy of the Maxillary Sinus
The maxillary sinus is pyramidal in shape and borders the nasal wall, floor of the orbit, and alveolar processes. The maxillary ostium, a non-physiologic drainage port, lies high on the medial wall and opens into the nasal cavity between the middle and lower nasal conchae. The average volume of a fully dev
eloped sinus is about 15ml, but the volume expands with age as the sinus pneumatizes. The sinus is lined with pseudostratified ciliated columnar epithelium that covers a loose, highly vascular, connective tissue. Beneath the connective tissue lies the periostium, which tightly approximates the bony wall. These structures - epithelium, connective tissue, and periosteum - are collectively referreced to as the Schneiderian membrane.
Indications and Contraindications for Sinus Augmentation
Prior to tooth loss, the sinus membrane maintains its position above the roots of the posterior maxillary teeth. Upon extraction, the sinus pneumatizes or expands unimpeded, reducing the over-all bone volume in the area. If less than 10mm of bone height remains after tooth loss, sinus augmentation should be considered to prevent implant placement from extending through the Schneiderian membrane. Contraindications may include uncontolled medical conditions, sinus pathology, acute or chronic sinusitis, heavy smoking, history of radiation therapy, and blood disorders. These patients may be at high risk of complication such as delayed wound healing or graft infection.
When used appropriately, sinus augmentation is an important tool for implant planning in the posterior maxilla. Predictable implant placement and restoration is possible for patients with minimal bone height, allowing for ideal treatment.
Interested in learning more about sinus augmentation? Contact the author of this article, Southfield Periodontist and Dental Implant Specialist, Dr. Amar Katranji at 248.357.3100 or visit Joseph R. Nemeth, DDS & Associates on the web at http://www.drnemeth.com/.
If you are a dentist and would like information about the Michigan Implant Study Club or any upcoming continuing education courses sponsored by Joseph R. Nemeth, DDS & Associates, visit the for dental professionals page of the website at http://www.drnemeth.com/forprofessionals.html.
Anatomy of the Maxillary Sinus
The maxillary sinus is pyramidal in shape and borders the nasal wall, floor of the orbit, and alveolar processes. The maxillary ostium, a non-physiologic drainage port, lies high on the medial wall and opens into the nasal cavity between the middle and lower nasal conchae. The average volume of a fully dev
eloped sinus is about 15ml, but the volume expands with age as the sinus pneumatizes. The sinus is lined with pseudostratified ciliated columnar epithelium that covers a loose, highly vascular, connective tissue. Beneath the connective tissue lies the periostium, which tightly approximates the bony wall. These structures - epithelium, connective tissue, and periosteum - are collectively referreced to as the Schneiderian membrane.Indications and Contraindications for Sinus Augmentation
Prior to tooth loss, the sinus membrane maintains its position above the roots of the posterior maxillary teeth. Upon extraction, the sinus pneumatizes or expands unimpeded, reducing the over-all bone volume in the area. If less than 10mm of bone height remains after tooth loss, sinus augmentation should be considered to prevent implant placement from extending through the Schneiderian membrane. Contraindications may include uncontolled medical conditions, sinus pathology, acute or chronic sinusitis, heavy smoking, history of radiation therapy, and blood disorders. These patients may be at high risk of complication such as delayed wound healing or graft infection.
When used appropriately, sinus augmentation is an important tool for implant planning in the posterior maxilla. Predictable implant placement and restoration is possible for patients with minimal bone height, allowing for ideal treatment.
Interested in learning more about sinus augmentation? Contact the author of this article, Southfield Periodontist and Dental Implant Specialist, Dr. Amar Katranji at 248.357.3100 or visit Joseph R. Nemeth, DDS & Associates on the web at http://www.drnemeth.com/.
If you are a dentist and would like information about the Michigan Implant Study Club or any upcoming continuing education courses sponsored by Joseph R. Nemeth, DDS & Associates, visit the for dental professionals page of the website at http://www.drnemeth.com/forprofessionals.html.
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