When Your Sinus Gets in the Way of Successful Implant Placement

When Your Sinus Gets in the Way of Successful Dental Implant Placement

Successful 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, 10mm of vertical bone is required for predictable implant success (Misch 1987) although success can be achieved with less than 20 mm (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.

Lateral Window Sinus Lift: A Sinus Augmentation Technique

Implant placement can be performed simultaneously with the sinus elevation procedure or following a healing period that can last

6-9 months. Immediate placement during sinus elevation reduces overall healing time and eliminates another surgical procedure, which can be desirable to patients. The decision to place an implant during sinus augmentation is dependent on the presence of adequate bone volume and quality to provide for initial stability of the implant. Rosen and colleagues (1999) recommended at least 5mm of native bone for immediate implant placement during sinus augmentation. However, more recent studies have found that implant stability can be achieved with less than 5mm (Peleg 2006).

Lateral Window Sinus Augmentation: The lateral approach involves a modified Caldwell-Luc operation to gain access to the sinus cavity. A bony window is created in the lateral maxillary wall, the Schneiderian membrane is elevated, and bone grafting material is a combination of autogenous bone and allograft. An absorbable collagen membrane is placed between the bone graft and the membrane as well as over the bony window.

This technique is usually the preferred method of sinus elevation in situations of poor bone quality and minimal residual bone height because it allows for direct visualization and accurate bone placement and volume at the position of the implant. Also, tearing of the membrane can be easily treated, minimizing contamination of the graft during healing.

For more information about Sinus Augmentation (Lift) procedures or Dental Implant Procedures, contact Joseph R. Nemeth, DDS and Associates at 248.357.3100 or via email at jodi@drnemeth.com. You may also want to visit the practice website at http://www.drnemeth.com.

Ridge Augmentation

Ridge Augmentation procedures are used to correct concavities in the jawbone where natural teeth are missing. They can correct depressions in your gum line that are unnatural looking and sometimes make you appear older that you are. They can be used to prevent the jawbone from collapsing following tooth extraction. Ridge augmentation is also used to even out replacement teeth that may seem too long compared to adjacent teeth.

If you would like to learn more about ridge augmentation or any other Michigan dental implants topic, call the office of Dr. Joseph Nemeth & Associates at 248.357.3100 or submit your questions online by clicking on this link www.drnemeth.com/asktheperiodontist.