Once a person loses the natural dentition, the short of occlusal forces gets guided to the alveolar bone. This action triggers a chain of bone remodeling procedures that result in a pressure threshold-regulated bone atrophy. Increased osteoclastic activity of the maxillary sinus floor results in enlargement of the size of sinus.
The major reasons for performing dental implant placements in maxillary areas are less than adequate height, density, and width of the alveolar process. Compromised quantity and quality of bone in the edentulous maxilla adversely affects the clinical results of dental implant treatments. It can lead to higher chances of failure and complications in implant procedure.
What can sinus floor elevation technique do?
For dental implant, the height of the bone has to be atleast 10.0 mm. This is a challenge for many people. To overcome this challenge, bone augmentation is done by way of the maxillary sinus floor elevation procedure. This is a surgical approach that dramatically increases the bone height for implant placement.
There are two major types of sinus floor elevation approaches explained by World Authority on Lateral Wall Sinus Grafting for dental implant placement. One is Indirect sinus grafting technique and the other one is direct sinus grafting method.
Indirect sinus grafting technique
This is basically a Trans-alveolar approach that is used to condense bone grafting materials under the Schneiderian membrane. This is done with at least 5 mm size of residual bone. This approach can lead to approximate gain of 3mm to 5.0 mm in bone height inside the sinus with a concurrent implant placement option.
Direct sinus grafting
This is a sinus lifting method that is done using a lateral window approach. This treatment is recommended in those cases where the bone height falls below 5.0 mm. Clinical outcomes as a result of this approach results in increased bone height that reaches above 5.0 mm in a period of six to nine months.
How indirect grafting technique overcomes the complications related to direct grafting technique?
Direct grafting technique overcomes the deficiency of vertical bone in edentulous posterior maxilla. This process results in a range of intra or post-operative or morbidities complications. Other forms of complications include severe bruising, pain, swelling, and risk of schneiderian membrane perforation. These complications would be observed due to the characteristic traumatic nature of this method.
To lessen the chances of complications linked with direct grafting method, a more conservative method called indirect method of elevation of the sinus membrane (without preparation of lateral window) is performed.
This procedure of sinus floor elevation is done in combination with addition of particles of allogic, autogenic, xenogenic bone grafts with the help of broad osteotomes. This helps in elevating the sinus floor. With this technique, the hydrostatic pressure can reduce the possibilities of perforation of Schneiderian membrane at the time of conducting the procedure.
Although the procedure of indirect sinus grafting by the means of simultaneous implant placement procedure can be a real success, it can present certain surgical problems as well. A discussion about the anatomy of the maxillary sinus and lateral wall augmentation method with the doctor results in effectively addressing and managing complications and challenges associated with it.