Sinus augmentation in a thin residual bone height of posterior maxilla with SLA Kit and CMI Implant: A staged approach

Dr. Thanasin Boonthavikoon (태국)

Author
Dr. Thanasin Bonnthavikoon DDS

- Doctor of Dental Surgery(DDS), Chulalongkorn University, Bangkok
- Higher graduated diploma in clinical science of oral and maxillofacial surgery, Mahidol University, Bangkok
- Higher graduated diploma in clinical science of periodontology, Chulalongkorn University, Bangkok
- Diplomated Thai Board of Periodontology
- Committee of Thai Association of Dental Implantology (TADI)
- Private Practice limited to Periodontics and Implantology, Bangkok, Thailand
Gender: Male
Age: 42
Medical history: Clinically healthy, absent of drug and allergy history
Dental history: Scaling, Filing, Extraction
Chief complaint: Tooth replacement in missing area of upper right region
Tooth #16 was extracted 2 years ago, no active inflammatory in oral cavity.
Good oral hygiene, overall periodontium was healthy
Normal mouth opening range
No limited space in area of 16
Diagnosis
Edentulous area #16 with severe pneumatization of maxillary sinus

Treatment planning
1. Lateral window sinus lift via staged approach area #16
2. Implant placement and conventional loading area #16
Fig4
Access was gained via full thickness flap with crestal and vertical incision in papilla-sparing manner.

Fig5
3-mm above marginal bone level, open antrostomy was created via ø6.5mm LS-reamer [SLA Kit, Neobiotech]

Fig6
Thin bone disk was completely created with LS-reamer

Fig7
Schneiderian membrane was detached via sinus curette no. 1,2,3[SLA Kit] without perforation.

Fig8
Schneiderian membrane was completely lifted without perforation or bleeding.

Fig9
Sinus cavity was grafted with deproteinized bovine bone mineral(DBBM).

Fig10
Resorbable native collagen membrane was trimmed and placed over the antrostomy site.

Fig11
Tension-free, water-tight seal, primary wound closure was done.

Fig12
13-mm of sinus lifting range was detected in immediate post-operative radiograph.

Fig13
7 months later, grafting material was fully incorporated with surrounding pristine bone without collapse of schneiderian membrane or any complication.

Fig14
CMI Implant (IS-III active) ø5.0 x 10mm was placed in correct 3D position with adequate primary stability.

Fig15
CMI Implant (IS-III active) ø5.0 x 10mm was placed in correct 3D position with adequate primary stability.

After 6 months of function, peri-implant mucosa was healthy with stable marginal bone level. Patient was satisfied with the treatment outcomes.

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This case presents smart sinus augmentation in a thin residual bone height of right posterior maxilla due to severe pneumatization of maxillary sinus. The procedures are detailed step-by-step with practical advice. 

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