Osteotomy in direct sinus lift. A comparative study of the rotary technique and ultrasound

María Peñarrocha-Diago, Miguel Peñarrocha-Diago, Cristina Sanchez-Recio, David Peñarrocha-Oltra, Javier Romero-Millán, María Peñarrocha-Diago, Miguel Peñarrocha-Diago, Cristina Sanchez-Recio, David Peñarrocha-Oltra, Javier Romero-Millán

Abstract

Purpose: The present study investigates sinus membrane rupture in direct maxillary sinus lift with the rotary technique and with ultrasound, examining the survival of implants placed after sinus augmentation, and analyzing the bone gain obtained after the operation and 12 months after placement of the prosthetic restoration.

Materials and methods: A retrospective study was made of 45 patients requiring maxillary sinus lift or augmentation for implant-prosthetic rehabilitation. Use was made of the handpiece and ostectomy drills for the rotary technique, and of specific tips for ultrasound. The implant success criteria were based on those developed by Buser. The bone gain obtained as a result of sinus lift was calculated from the postoperative panoramic X-rays.

Results: A total of 57 direct elevations of the maxillary sinus were carried out: 32 with the rotary technique and 25 with ultrasound. Perforations of Schneider's membrane with the rotary technique and ultrasound occurred in 7% and 1.7% of the cases, respectively, with membrane integrity being preserved in 91.2%. Of the 100 implants placed, 5 failed after one year of follow-up in the rotary technique group, while one implant failed in the ultrasound group. The rotary technique in turn afforded a bone gain of 5.9 mm, versus 6.7 mm with ultrasound.

Conclusions: Perforations of the membrane sinusal in direct lift were more frequent with the rotary technique (7%) than with ultrasound (1.7%). Implant survival and bone gain were both greater when ultrasound was used.

Figures

Figure 1
Figure 1
Preoperative panoramic X-ray view.
Figure 2
Figure 2
Postoperative panoramic X-ray view.
Figure 3
Figure 3
Postoperative panoramic X-ray view. Measurement of bone gain. A. Length of the implant. B. Occlusal line of the alveolar crest. C. Lower margin of the maxillary sinus before grafting. a. Radiological alveolar crest height before grafting. D. Lower margin of the maxillary sinus after grafting. b. Radiological alveolar crest height after grafting. Note the increase in height at the level of each of the implants. c. The bone gain (in green) is obtained by subtracting the radiological alveolar crest height before grafting from the height after grafting (c=b-a).
Figure 4
Figure 4
Postoperative panoramic X-ray view. Measurement of bone loss after prosthetic loading.

References

    1. Sorní M, Guarinós J, García O, Peñarrocha M. Implant rehabilitation of the atrophic upper jaw: a review of the literature since 1999. Med Oral Patol Oral Cir Bucal. 2005 ;10 Suppl 1:E45–E56.
    1. Shlomi B, Horowitz I, Kahn A, Dobriyan A, Chaushu G. The effect of sinus membrane perforation and repair with Lambone on the outcome of maxillary sinus floor augmentation: a radiographic assessment. Int J Oral Maxillofac Implants. 2004;19:559–562.
    1. Schwartz-Arad D, Herzberg R, Dolev E. The prevalence of surgical complicationsof the sinus graft procedure and their impact on implant survival. J Periodontol. 2004;75:511–516.
    1. Vercellotti T, De Paoli S, Nevins M. The piezoelectric bony window osteotomy and sinus membrane elevation: introduction of a new technique for simplification of the sinus augmentation procedure. Int J Periodontics Restorative Dent. 2001;21:561–7.
    1. Vercellotti T, Nevins ML, Kim DM, Nevins M, Wada K, Schenk RK. Osseous response following respective therapy with piezosurgery. Int J Periodontics Restorative Dent. 2005;25:543–9.
    1. Torrella F, Pitarch J, Cabanes G, Anitua E. Ultrasonic ostectomy for the surgical approach of the maxillary sinus: a technical note. Int J Oral Maxillofac Implants. 1998;13:697–700.
    1. Stübinger S, Kuttenberger J, Filippi A, Sader R, Zeilhofer HF. Intraoral piezosurgery: preliminary results of a new technique. J Oral Maxillofac Surg. 2005;63:1283–7.
    1. Barone A, Santini S, Sbordone L, Crespi R, Covani U. A clinical study of the outcomes and complications associated with maxillary sinus augmentation. Int J Oral Maxillofac Implants. 2006;21:81–5.
    1. Buser D, Mericske-stern R, Dula K, Lang NP. Clinical experience with one stage, non-submerged dental implants. Adv Dent Res. 1999;13:153–61.
    1. Boronat A, Peñarrocha M, Carrillo C, Marti E. Marginal bone loss in dental implants subjected to early loading (6 to 8 weeks postplacement) with a retrospective short-term follow-up. J Oral Maxillofac Surg. 2008;66:246–50.
    1. Sánchez-Recio C, Peñarrocha-Diago M, Peñarrocha-Diago M, Peñarrocha-Oltra D. Maxillary sinus lift performed using ultrasound. Evaluation of 21 patients. Med Oral Patol Oral Cir Bucal. 2010 ;15:e371–4.
    1. Thor A, Sennerby L, Hirsch JM, Rasmusson L. Bone formation at the maxillary sinus floor following simultaneous elevation of the mucosal lining and implant installation without graft material: an evaluation of 20 patients treated with 44 Astra Tech implants. J Oral Maxillofac Surg. 2007;65:64–72.
    1. Hernández-Alfaro F, Torradeflot MM, Marti C. Prevalence and management of Schneiderian membrane perforations during sinuslift procedures. Clin Oral Implants Res. 2008;19:91–8.
    1. 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.

Source: PubMed

Szponzorok és közreműködők

Egészségi állapot

Kábítószer-beavatkozások

3
Iratkozz fel