March 11, 2015
Investigators reviewed the scientific literature to identify optimal treatment methods for rehabilitation of edentulous regions in the posterior maxilla. The authors propose guidelines to improve predictability of the success of various techniques for the insertion of implants in the atrophic posterior maxilla.
Researchers from Bluestone Center for Clinical Research and the New York University College of Dentistry (NYUCD) published “Treatment Options for the Atrophic Posterior Maxilla” in Actualidad Médica.
Rehabilitation of edentulous regions in the posterior maxilla frequently poses restorative challenges due to inadequate alveolar ridge bone and poor bone quality. Maxillary sinus augmentation procedure (SAP) is a highly predictable pre-prosthetic surgical method to enhance bone volume for implant placement. Various techniques may be used, including Lateral Wall Sinus Floor Elevation (LWSFE), Bone Added Osteotome Sinus Floor Elevation (BAOSFE), and Osteotome-Assisted Sinus Augmentation (OASA).
A literature search was performed for articles related to SAP in human subjects. Fifteen articles were included in the analysis. Crestal bone height (RBH) and anatomical characteristics of the sinus cavity were identified as key of case selection criteria for SAP. The authors suggest the following guidelines for SAP: sinus augmentation using LWSFE is recommended when RBH is 4mm or less in cases requiring single or multiple implant placement; in cases presenting with 4-7mm of RBH, OASA is recommended for single implants and LWSFE is recommended for multiple implant placements; in cases presenting with more than 7mm of RBH, BAOSFE can be performed with single or multiple implant placements. . Simultaneous implant placement is recommended whenever primary stability can be obtained. (Primary stability is achieved most often in patients with a V-shaped sinus.)
The article was authored by Ismael Khouly, DDS, MS, PhD, Associate Director of Periodontology & Implant Dentistry at the Bluestone Center for Clinical Research, Clinical Assistant Professor in the Department of Oral & Maxillofacial Surgery; Stuart J Froum, DDS, clinical professor and Director of Clinical Research in the Department of Periodontology and Implant Dentistry, NYUCD; Diego Gallego Rivero, DDS, Department of Periodontology and Implant Dentistry at NYUCD; Alejandro Perez, DDS, Department of Periodontology and Implant Dentistry at NYUCD; Sang-Choon Cho, DDS, Department of Periodontology and Implant Dentistry at NYUCD, and Said Khouly, DDS, MS, private practice in Spain.