Clinical Maxillary Sinus Elevation Surgery (eBook)

Dr. Daniel W.K. Kao is the CEO of Washington Dental Group and also a clinical assistant professor of periodontics at University of Pennsylvania School of Dental Medicine. Dr. Kao is also a Diplomate of the American Board of Periodontology. His research interests include the clinical applications of growth factors (BMP, PDGFs), the relationship of systemic disease and periodontal disease, and dental implant studies. Dr. Kao lectures at dentistry conferences both nationally and internationally.

Clinical Maxillary Sinus Elevation Surgery 5
Copyright 6
Contents 7
Contributors 9
Acknowledgments 11
Introduction 13
References 17
Chapter 1 Anatomy and Physiology of the Maxillary Sinus 19
Anatomy of the maxillary sinus 19
Ostium 21
Microscopic anatomy 22
Nerves and blood vessels 23
Pathophysiology of the maxillary sinus 25
References 25
Chapter 2 The Applications and Limitations of Conventional Radiographic Imaging Techniques 27
Introduction 27
Periapical radiography 27
Clinical applications 28
Limitations 34
Panoramic radiography 36
Clinical applications 37
Limitations 41
Conclusion 42
References 43
Chapter 3 The Applications and Limitations of Advanced (3-Dimensional) Radiographic Imaging Techniques 49
Introduction 49
Conventional cross-sectional tomography 50
Clinical application 50
Limitations 51
Medical-grade CT and CBCT 51
Clinical applications 53
Limitations 67
Conclusion 68
References 69
Chapter 4 Conventional Instruments Preparation and Preclinical Training of the Lateral Window Technique 75
Introduction to the lateral window technique 75
Suture materials and technique 78
Preclinical training on a hen’s egg and sinus model 79
Part I: preclinical training on a hen’s egg shell 79
Part II: preclinical training on a sinus model 81
References 83
Chapter 5 Clinical Procedures of the Lateral Window Technique 85
Anesthesia 85
Incision (flap design) 85
Hard tissue management 86
Outline of the bony window 86
Preparation of the bony window 86
Handle the bone island 89
Elevate the sinus membrane 89
Bone graft materials and barrier membrane 92
References 95
Chapter 6 Avoiding and Managing Complications for the Lateral Window Technique 97
Introduction 97
Problems to be avoided 100
The medical history 100
Radiographic examination 102
Septa 105
Prevention of hemorrhage 106
Summary, presurgical prevention of complications 107
Complications during the surgical procedure 107
Flap care 107
Trauma during retraction 107
Inadvertent tears/perforations of the flap 108
Schneiderian membrane tear or perforation 109
Grafting material into sinus 111
Dislodgement of an implant into the sinus 113
Contamination of site or graft material 113
Trauma to adjacent teeth with disruption of apical blood supply 113
Excessive bleeding 114
Incomplete elevation of the sinus membrane 114
Postoperative instructions to help avoid postoperative complications 116
Appendix A 117
Medical preoperative conditions 117
Preoperative sinus conditions 117
Preoperative dental conditions 117
Appendix B 118
Preoperative instructions 118
Postoperative instructions 118
References 119
Chapter 7 Advanced Techniques of the Lateral Window Technique 123
Background of piezosurgical techonology (piezoelectric bone surgery) 123
The applications of piezosurgical technology in lateral window procedures 124
Surgical steps 126
Step 1 126
Step 2: bony window osteotomy 127
Step 3: sinus membrane separation 127
Step 4: sinus membrane elevation by noncutting elevator EL1, EL2, and EL 3 127
Step 5: sinus membrane elevation by hand instruments 128
Step 6: bone graft and barrier membrane placed 128
Step 7: suture and postop instruction 128
References 129
Chapter 8 Basic Instruments and Materials of the Transalveolar Approach: Osteotome Technique 131
Background 131
Instrument preparation for the transalveolar approach: osteotome technique 132
References 134
Chapter 9 Clinical Procedures of the Transalveolar Osteotome Approach 135
Incision design 135
Step 1 135
Step 2 136
Step 3 136
Step 4 138
Step 5 138
Step 6 139
Step 7 140
Step 8 140
Step 9 141
Step 10 141
References 143
Chapter 10 Postoperation Management of the Transalveolar Osteotome Approach 145
Postoperative instruction 146
Complications in the sinus elevation surgery 147
Inadequate primary stability 147
Infection 148
Sinus membrane perforations 149
References 152
Chapter 11 Advanced Techniques of the Transalveolar Approach 153
Clinical procedures 154
Step 1 (to create access) 154
Step 2 (to insert the sinus lift balloon) 154
Step 3 (to detach the sinus membrane) 154
Step 4 (bone grafting material placement) 154
Step 5 (dental implant placement) 155
Other surgical techniques 155
Surgical protocol 158
Surgical step 1 (to create access) 158
Step 2 (initial detachment of the sinus membrane) 159
Step 3 159
Step 4 160
Step 5 160
Clinical case 160
References 164
Chapter 12 Decision Tree for Maxillary Sinus Elevation Options 167
References 174
Chapter 13 Choices of Bone Graft Materials 175
Bone grafting materials overview 175
Tissue engineering materials 176
References 181
Chapter 14 Review of Dental Implant Success and Survival Rates 183
Success and survival criteria 184
Success and survival rates 184
Success and survival rates of the lateral approach 184
Success and survival rates of the transalveolar approach 186
Factors that could affect the success and survival rates 187
References 191
Additional relevant works 193
Index 197