Abstract:
Summary.
Purpose: Dental implant installation in
the posterior maxilla depends fundamentally
on the presence of an adequate bone quantity.
Tooth loss in the posterior maxilla is followed
by extensive loss of the alveolar ridge and increased maxillary sinus pneumatization that
often makes implant installation difficult to
achieve.
Maxillary sinus floor augmentation is traditionally the common surgical technique to
overcome this situation. When the deficiency
in the vertical dimension relates more to severe ridge resorption, crestal ridge augmentation should also be considered. Posterior maxillary sandwich osteotomy combined with
sinus augmentation, using inter–positional
bone graft might be a viable option to address
this problem. This study describes a successful implementation of this technique to solve
a severe vertical osseous ridge defect under
the sinus floor.
Material and Methods: A two–stage lateral wall sinus floor augmentation combined
with inter–positional sandwich osteotomy
followed by the insertion of dental implants
with adequate length and diameter was performed. Deproteinized natural bovine bone
mineral (DBBM) covered by a resorbable
collagen membrane were used. Rehabilitation
of this area was completed by a standard prosthetic protocol.
Results: As a result of completing the
above procedure favourable bone mass and
form was created to enable implant placement in positions that are optimal from a
prosthetic and esthetic point of view in terms
of reshaping the alveolar crest and normalizing the interocclusal distance improving the
crown–implant ratio. Conclusion: This case
demonstrates a step–by–step illustration of
an innovative technique for overcoming a
vertical ridge defect combined with increased maxillary sinus pneumatization. It can
be concluded that this novel technique is recommended to meet the dimensional requirements of bone augmentation both crestal
and intrasinusal in severe atrophic posterior
maxilla to achieve an improved alveolar plane, equalized crown–to–implant ratios, and a
more favourable gingival shape.
