Friday, 4 May 2018

Advanced Bone Augmentation Technique

Direct sinus lift:

Generally, Sinus floor elevation is used where alveolar bone resorption leads to insufficient bone height for the dental implant placement. Direct Sinus Lift (or) Lateral Wall Sinus Elevation is performed when the bone is found to be severely deficient.

Caldwell-Luc Procedure:

It is the Lateral Window Sinus Augmentation. A bony window is created in the lateral maxillary wall to access the sinus cavity and then the Schneiderian membrane is elevated.

The allograft method is used for bone grafting. An absorbable collagen membrane divides the bony window and bone graft. A direct bone visualization, accurate placement and implant positioning are allowed in this technique. Collagen membrane helps in treating any tear in the membrane.

Antral Balloon Sinus lift Procedure

In this procedure, Sinus membrane is raised with the help of a rubber (or) antral balloon instead manual tools. In this technique, membrane perforation will have the least chance.

Indirect sinus lift:

It is essential to perform a sinus lift procedure to raise the bone height, density in the posterior maxilla. This Subantral Augmentation is an effective procedure in elevating the bone height with the help of the following techniques.
  • The Crestal approach (Indirect sinus lift) or Osteotome sinus floor elevation procedure
  • The direct sinus lift procedure or lateral approach
  • One step antrostomy

Indirect sinus lift Procedure

The doctor completely pre-evaluates the implant site with detailed X-rays. The soft & hard tissues are entirely scrutinized and the diagnostic information is collected before performing the surgery.
  • There is an assessment done for gingival health. 
  • Color, texture, depth of the pocket is examined
  • A bone topography elevation is required to enable ridge mapping
The following measurements are noted out:
  • Height between alveolar and sinus floor
  • A Bucco-lingual width and mesiodistal of edentulous spacing, CT dental scan and OPG
  • Greater palatine nerve, an infraorbital nerve, and posterior superior alveolar nerve blocks are administered with the help of sensorcaine. 2% lignocaine HCL is used for local infiltration.
  • An Incision about 2-3 cm is made on the palatal side of the ridge crest
  • Full-thickened mucoperiosteal flap reflected and then retracted
  • A surgical stent is introduced into the site
  • With a round bur, the implant position is marked
  • Implant bed is prepared with a Pilot drill
  • With the help of osteotome, the sinus floor is broken
  • The mobilized bone at the sinus floor is elevated with the osteotome
  • The implant is placed at its prepared site
  • Titanium cover screw is introduced on the implant
  • Finally, the mucoperiosteal flap is repositioned & sutured
Dr. Sudhakar Reddy, an expert Oral & Maxillo Facial surgeon & Implantologist who has been successfully doing direct sinus lift surgery in Bangalore and dental bone grafting in Bangalore. This expert dentist won many awards for his exceptional service in dental care.
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