Lateral sinus floor elevation with a bony fenestration of the sinus floor
Clinical Challenge
The patient described here is a 56-year old non-smoker and in good general health. She reported a history of dental extraction in right side of the posterior maxillary region about 3 months earlier. The treatment plan envisages a fixed prosthetic restoration, and to achieve this goal, a surgical procedure of sinus augmentation prior to implant placement was performed.
Preoperative picture of the area intended to be treated.
Application of the Geistlich Bio-Gide® to seal bone fenestration in sinus floor.
Covering bony defect on the sinus floor with Geistlich Bio-Gide®.
Closing bony defect on the sinus floor with Geistlich Bio-Gide® before filling the sinus floor cavity.
Sinus floor augmentation using Geistlich Bio-Oss®.
Lateral window to the sinus cavity is covered with Geistlich Bio-Gide®.
Panoramic radiography view after a follow-up time of 8 months prior to reentry and implant placement.
Clinical situation and bone volume at the augmented site after 8 months.
Implant placement at the augmented sinus floor.
4 months after implant placement the final restoration was performed with a three-unit bridge prosthesis (Dr. Álvaro Martins/Goiânia, Brazil).
Final periapical radiography after 12 months.
Clinical outcome at a glance
Objectives
- Sinus floor elevation with lateral window approach.
- Fixed prosthetic restoration in the posterior maxilla.
- Sinus floor elevation prior to implant placement.
Conclusions
- Two-stage sinus floor elevation treatment.
- This clinical case shows excellent osteoconductive behavior of Geistlich Bio-Oss® and uneventful healing of Geistlich Bio-Gide®.
- Good prosthetic results due to excellent osseointegration of the implant in the augmented site.
Aim / Approach
A full-thickness flap was raised to expose the lateral wall of the sinus. After osteotomy was performed, the sinus membrane was carefully elevated and space was created for the bonegraft under the sinus membrane. Then a cut out part of Geistlich Bio-Gide® was used to obliterate the fenestration in the lower osseous wall of the sinus. The grafting material Geistlich Bio-Oss®was gently packed into the sinus cavity, followed by placement of Geistlich Bio-Gide® shaped and positioned to cover the antrostomy window. After 8 months, a dental implant was inserted into the grafted site. The prosthetic rehabilitation was performed 4 months after installing the implant.
Conclusion
This clinical case, with 12-month follow-up, showed the employment of Geistlich Bio-Oss® and Geistlich Bio-Gide® in sinus floor elevation for the purpose of rehabilitation with dental implants. The good prosthetic result achieved confirms the excellent osteocondutive properties for osseointegration.
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