Maxillari sinus augmentation for implant rehabilitation
Başlık çevirisi mevcut değil.
- Tez No: 195305
- Danışmanlar: PROF. DR. KEMAL ŞENÇİFT
- Tez Türü: Yüksek Lisans
- Konular: Diş Hekimliği, Dentistry
- Anahtar Kelimeler: Belirtilmemiş.
- Yıl: 2007
- Dil: İngilizce
- Üniversite: Yeditepe Üniversitesi
- Enstitü: Sağlık Bilimleri Enstitüsü
- Ana Bilim Dalı: Belirtilmemiş.
- Bilim Dalı: Belirtilmemiş.
- Sayfa Sayısı: 93
Özet
The maxillary sinus grafting has become one of the most popular and successful bone grafting procedures undertaken in the maxillofacial region. Traditionally, the maxillary sinus has been an area that has been avoided by most dentists and augmentation surgery has been performed only when absolutely necessary. Philip Boyne (16) was the first to propose the use of bone grafting in the maxillary sinus for prosthetic purposes. When he started in the 1960s, grafting of the maxillary sinus was used to increase the bulk of bone for subsequent maxillary ridge reduction for optimal prosthodontic inter-arch distance. With the introduction of root-form titanium implants practitioners started utilizing sinus grafting for those sinuses that were deficient in bone height to hold this type of implants. Indications for maxillary sinus augmentation include loss of alveolar bone height, poor bone density, and strong occlusal forces. Contraindications include narrowing of the osteomeatal complex, malignancy, severe deformities of the maxillary sinus, scarring of the sinus mucosa from trauma, radiotherapy of the head and neck, sinusitis, inadequate oral hygiene, untreated periodontal disease, severe para-functional habits, fulminant mucosal disease, and severe xerostomia. Advances in grafting techniques have allowed simultaneous implant placement with maxillary sinus augmentation. Nevertheless, delayed implant placement after sinus grafting still gives better results than placing the implant simultaneously with sinus grafting (101). Complications of maxillary sinus augmentation include bleeding, buccal flap tear, infraorbital nerve injury, membrane perforation, incision line opening, barrier membrane exposure, graft loss or failure, implant failure, oroantral fistula, and implant migration (80). Alternatives to maxillary sinus augmentation are indicated when the operation is contraindicated. These alternatives include placing tilted implants to avoid the sinus, placing short implants, and zygomatic implants (2, 56, 69). However, all of these alternatives offer inferior results to the sinus augmentation option and must be used only if it is absolutely contraindicated to perform sinus augmentation. - 2 - The sinus floor, and to a smaller extent the elevated sinus membrane, offers an ideal environment for bone formation. Though it would seem intuitively counterproductive to bone graft healing, this area is remarkably forgiving of complication, infection, resorption, or rejection (34). The best grafting material to use is natural autogeneous bone, but this golden standard has been loosing the battle against new grafting materials that are xenogenic which proved to provide faster healing and regeneration capabilities when mixed with Platelets Rich Plasma. This thesis will underline the techniques used for maxillary sinus augmentation while reviewing the success rates of each technique. Indications and contraindications will be outlined together with the possible complications that might be encountered while attempting to graft the maxillary sinus. A comparison will be made between simultaneous and delayed implant placement protocols. Also various grafting material will be outlined. The aim is to provide a reference and act as a guideline for clinicians, and interested students, summarizing a great deal of the science and literature available on maxillary sinus augmentation up to the date that this thesis was finished
Özet (Çeviri)
The maxillary sinus grafting has become one of the most popular and successful bone grafting procedures undertaken in the maxillofacial region. Traditionally, the maxillary sinus has been an area that has been avoided by most dentists and augmentation surgery has been performed only when absolutely necessary. Philip Boyne (16) was the first to propose the use of bone grafting in the maxillary sinus for prosthetic purposes. When he started in the 1960s, grafting of the maxillary sinus was used to increase the bulk of bone for subsequent maxillary ridge reduction for optimal prosthodontic inter-arch distance. With the introduction of root-form titanium implants practitioners started utilizing sinus grafting for those sinuses that were deficient in bone height to hold this type of implants. Indications for maxillary sinus augmentation include loss of alveolar bone height, poor bone density, and strong occlusal forces. Contraindications include narrowing of the osteomeatal complex, malignancy, severe deformities of the maxillary sinus, scarring of the sinus mucosa from trauma, radiotherapy of the head and neck, sinusitis, inadequate oral hygiene, untreated periodontal disease, severe para-functional habits, fulminant mucosal disease, and severe xerostomia. Advances in grafting techniques have allowed simultaneous implant placement with maxillary sinus augmentation. Nevertheless, delayed implant placement after sinus grafting still gives better results than placing the implant simultaneously with sinus grafting (101). Complications of maxillary sinus augmentation include bleeding, buccal flap tear, infraorbital nerve injury, membrane perforation, incision line opening, barrier membrane exposure, graft loss or failure, implant failure, oroantral fistula, and implant migration (80). Alternatives to maxillary sinus augmentation are indicated when the operation is contraindicated. These alternatives include placing tilted implants to avoid the sinus, placing short implants, and zygomatic implants (2, 56, 69). However, all of these alternatives offer inferior results to the sinus augmentation option and must be used only if it is absolutely contraindicated to perform sinus augmentation. - 2 - The sinus floor, and to a smaller extent the elevated sinus membrane, offers an ideal environment for bone formation. Though it would seem intuitively counterproductive to bone graft healing, this area is remarkably forgiving of complication, infection, resorption, or rejection (34). The best grafting material to use is natural autogeneous bone, but this golden standard has been loosing the battle against new grafting materials that are xenogenic which proved to provide faster healing and regeneration capabilities when mixed with Platelets Rich Plasma. This thesis will underline the techniques used for maxillary sinus augmentation while reviewing the success rates of each technique. Indications and contraindications will be outlined together with the possible complications that might be encountered while attempting to graft the maxillary sinus. A comparison will be made between simultaneous and delayed implant placement protocols. Also various grafting material will be outlined. The aim is to provide a reference and act as a guideline for clinicians, and interested students, summarizing a great deal of the science and literature available on maxillary sinus augmentation up to the date that this thesis was finished
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