Minimally Invasive Sinus Augmentation Procedure Using a Sinus Crestal Approach: A Prospective Case Series Study on Radiologic Outcomes

doi:10.13701/j.cnki.kqyxyj.2020.07.018

Abstract

Abstract: Objective: To evaluate radiologic outcomes and morphology of a novel device that allows simultaneous hydraulic sinus membrane elevation, bone grafting, and implant placement. Methods: 56 patients with 68 lost teeth in the posterior maxilla with 4 to 9 mm of residual crestal height were operated by minimally invasive Sinus Crestal Approach (SCA) technology. They were analyzed by cone beam computed tomography (CBCT) pre and immediately post operation, three months post-operation, and one year post-operation. The parameters were measured: pre-operative bone height (H0), immediately post-operative bone height (H1), three-month post-operative height (H2), 1 year post-operative height (H3), lift Height H'=H1-H0, three months of osteogenic height H1'=H2-H0, 1 year post-operative osteogenesis height H2'= H3-H0, and post-operative bone tip height H3'. Sinus floor morphology was assessed one year post-operation. Marginal bone lost was measured. Results: The mean heights pre (H0) and immediately post-operation (H1) were (6.34 ±1.15) mm and (11.57±1.28) mm (P<0.01). The post-operative lift height (H') was (5.23±1.33) mm, and the 1 year post-operative lift height (H2') was (4.66±1.36) mm (P<0.05). According to the post-operative CBCT sagittal images, the morphology was divided into four types, 47 cases of type A (69.1%), 11 cases of type B (16.2%), 4 cases of type C (5.9%), and 6 cases of type D (8.8%). A total of 3 cases had perforation, with perforation rate at 4.4%. MBL was (0.65±0.20) mm. Conclusion: The SCA technique was simple and easy to master, which achieved excellent results and low incidence of complications. Long-term clinical studies are needed to confirm these preliminary results.

Key words: crestal sinus lift procedure, implant, minimally invasive

WANG Zhi, ZOU Lidong. Minimally Invasive Sinus Augmentation Procedure Using a Sinus Crestal Approach: A Prospective Case Series Study on Radiologic Outcomes[J]. Journal of Oral Science Research, 2020, 36(7): 688-692.

References

[1] Tatum H Jr. Maxillary and sinus implant reconstructions[J]. Dent Clin North Am, 1986, 30(2): 207-229.
[2] Summers RB. A new concept in maxillary implant surgery: The osteotome technique[J]. Compendium, 1994, 15(2): 152,154-156.
[3] Cosci F, Luccioli M. A new sinus lift technique in conjunction with placement of 265 implants: a 6-year retrospective study[J]. Implant Dent, 2000, 9(4): 363-367.
[4] Arab HR, Moeintaghavi A, Shiezadeh F, et al. Crestal sinus floor elevation with autogenous press-fit dowel bone harvested using trephine drills: a new method[J]. J Long Term Eff Med Implants, 2018, 28(3): 209-214.
[5] Tallarico M, Meloni SM, Xhanari E,et al. Minimally invasive sinus augmentation procedure using a dedicated hydraulic sinus lift Implant device: a prospective case series study on clinical, radiologic, and patient-centered outcomes[J]. Int J Periodontics Restorative Dent, 2017, 37(1): 125-135.
[6] López-Quiles J, Melero-Alarcón C, Cano-Duran JA,et al. Maxillary sinus balloon lifting and deferred implantation of 50 osseointegrated implants: a prospective, observational, non-controlled study[J]. Int J Oral Maxillofac Surg, 2018, 47(10): 1343-1349.
[7] Heo YK. Minimally Invasive Sinus Surgery[M]. Seoul: WELL Publishing inc, 2017: 60-79.
[8] 周贤,胡秀莲. 经牙槽嵴顶入路微创上颌窦内提升植骨同期种植技术[J]. 中国实用口腔科杂志, 2018, 11(1): 5-11.
[9] Bruschi GB, Crespi R, Capparè P, et al. Transcrestal sinus floor elevation: A retrospective study of 46 patients up to 16 years[J]. Clin Implant Dent Relat Res, 2012, 14(5): 759-767.
[10] Pjetursson BE, Tan WC, Zwahlen M, et al. A systematic review of the success of sinus floor elevation and survival of implants inserted in combination with sinus floor elevation[J]. J Clin Periodontol, 2008, 35(8 Suppl): 216-240.
[11] Shanbhag S, Karnik P, Shirke P, et al. Cone-beam computed tomographic analysis of sinus membrane thickness, ostium patency, and residual ridge heights in the posterior maxilla:Implications for sinus floor elevation[J]. Clin Oral Implants Res, 2014, 25(6): 755-870.
[12] Kirmeier R, Payer M, Wehrschuetz M, et al. Evaluation of three-dimensional changes after sinus floor augmentation with different grafting materials[J]. Clin Oral Implants Res, 2008, 19(4): 366-372.
[13] Sorní M, Guarinos J, Peñarrocha M. Implants in anatomical buttresses of the upper jaw[J]. Med Oral Patol Oral Cir Bucal, 2005, 10(2): 163-168.
[14] 周磊,徐淑兰,徐世同,等.Summer's骨凿提升上颌窦的临床应用[J].华西口腔医学杂志,2008,26(3): 296-298.
[15] Renouard F, Nisand D. Short implants in the severely resorbed maxilla: A 2-year retrospective clinical study[J]. Clin Implant Dent Relat Res, 2005, 7(Suppl 1): S104-S110.
[16] Esposito M, Cannizzaro G, Barausse C, et al. Cosci versus Summers technique for crestal sinus lift: 3-year results from a randomised controlled trial[J]. Eur J Oral Implantol, 2014, 7(2): 129-137.
[17] 王倩,李丹,唐志辉. 上颌窦底内提升术同期种植窦内成骨的临床效果[J]. 北京大学学报(医学版), 2019, 51(5): 925-930.
[18] Better H, Slavescu D, Barbu H, et al. Minimally invasive sinus lift implant device: A multicenter safety and efficacy trial preliminary results[J]. Clin Implant Dent Relat Res, 2014, 16(4): 520-526.
[19] 高巍,李良玉,张峰. 经牙槽嵴顶入路两种微创上颌窦提升方法的应用及3~5年临床观察[J]. 口腔医学研究, 2016, 32(6): 643-647.
[20] Rios HF, Avila G, Galindo P, et al. The influence of remaining alveolar bone upon lateral window sinus augmentation implant survival[J]. Implant Dent, 2009, 18(5): 402-412.
[21] Schwartz-Arad D, Herzberg R, Dolev E. The prevalence of surgical complications of the sinus graft procedure and their impact on implant survival[J]. J Periodontol, 2004, 75(4): 511-516.
[22] Trombelli L, Franceschetti G, Rizzi A, et al. Minimally invasive transcrestal sinus floor elevation with graft biomaterials. A randomized clinical trial[J]. Clin Oral Implants Res, 2012, 23(4): 424-432.
[23] Berengo M, Sivolella S, Majzoub Z, et al. Endoscopic evaluation of the bone-added osteotome sinus floor elevation procedure[J]. Int J Oral Maxillofac Surg, 2004, 33(2): 189-194.
[24] Katranji A, Fotek P, Wang HL. Sinus augmentation complications: etiology and treatment[J]. Implant Dent, 2008, 17(3): 339-349.