wang, wendy; shu-wei kuo; amma boateng; shalin ......arthur ashman department of periodontology and...
TRANSCRIPT
This Presentation was Sponsored by New York University Department of Implant Dentistry Alumni Association (NYUDIDAA) and the Office for International Programs
INTRODUCTION Insufficient alveolar bone height and proximity to the sinus floor are o9en limita:ons for implant placement in the posterior maxilla. Maxillary sinus augmenta:on has demonstrated a high success rate and is rou:nely used to enable implant placement. Despite its predictability, the technique has poten:al to develop complica:ons jeopardizing the final outcomes . Perfora:on of the Schneiderian membrane is the most frequently reported complica:on with incidence rate ranging from 10 to 44%. Several protocols have been described to repair sinus membrane perfora:ons. However, these procedures are technique sensi:ve and likely to increase surgical and healing :me. The purpose of this case series with histological reports is to present a simple novel technique to treat large perfora:ons of the sinus membrane during lateral window sinus floor eleva:on with a collagen sponge, associate with a re-‐entry procedure 3-‐6 weeks following the repair. MATERIALS AND METHODS Retrospec:ve data on consecu:ve pa:ents who had received sinus augmenta:on using the lateral window approach technique, and in whom large Schneiderian membrane perfora:ons occurred (>10 mm) were included. A total of 15 pa:ents (15 sinuses, 8 female, 7 males) were included, age ranged from 35 to 75 years (mean: 53.5 years).
RESULTS Clinical assessment of the healed membranes revealed complete closure and significant membrane thickening in 80% of the cases. Although the remaining 20% showed small residual perfora:ons, an increase in the membrane thickness was recorded in all cases. Histology finding showed connec:ve :ssue forma:on with li\le inflammatory responses. CONCLUSIONS Two years follow-‐up of 15 pa:ents demonstrated 100% implant success rate. Thickening of the Schneiderian membrane lead to an easier procedure and a reduc:on in the :me between repair and re-‐entry surgery. Within the limita:ons of this case series, the presented protocol appeared to be a simple and reliable alterna:ve to treat large sinus membrane perfora:ons. More cases and clinical comparisons are necessary to validate the result of the study.
1. Kandasamy S, Goonewardene M, Tennant M. Changes in interdental papillae heights following alignment of anterior teeth. Aust Orthod J. 2007 May;23(1):16-‐23.
2. Fu JH, Lee A, Wang HL. Influence of :ssue biotype on implant esthe:cs. Int J Oral Maxillofac Implants. 2011 May-‐Jun;26(3):499-‐508.
3. Wennström JL. Mucogingival considera:ons in orthodon:c treatment. Semin Orthod. 1996 Mar;2(1):46-‐54.
4. Su H, Gonzalez-‐Mar:n O, Weisgold A, Lee E. Considera:ons of implant abutment and
crown contour: cri:calcontour and subcri:cal contour. Int J Periodon:cs Restora:ve Dent. 2010 Aug;30(4):335-‐43.
5. Grunder U, Gracis S, Capelli M. Influence of the 3-‐D bone-‐to-‐implant rela:onship on esthe:cs. Int J Periodon:cs Restora:ve Dent. 2005 Apr;25(2):113-‐9.
6. Small PN, Tarnow DP. Gingival recession around implants: a 1-‐year longitudinal prospec:ve study. Int J Oral Maxillofac Implants 2000 Jul-‐Aug;15(4):527-‐32.
Wang, Wendy; Shu-Wei Kuo; Amma Boateng; Shalin Vinayak; Paul Yung Cheng Yu
Arthur Ashman Department of Periodontology and Implant Dentistry New York University College of Dentistry