Edition V06N03 | Year 2012 | Editorial Pergunte a um Expert | Pages 26 to 31
Sinus floor elevation surgery
The bone resorption that occurs after extraction of maxillary posterior teeth may result in severe vertical and/or horizontal bone loss, compromising the planning of rehab with implants in that region. Numerous grafting techniques have been described and used aiming to restore adequate bone volume for posterior implants installation. The most used technique to restore the anatomy of this region is the procedure of maxillary sinus floor augmentation. The maxillary sinus elevation surgery was initially described by Tatum,1 in 1986, being also reported by Boyne and James,2 and Wood and Moore.3 In this procedure the access to maxillary sinus is obtained through making a bone window on the lateral sinus wall, using a spherical diamond drill number 6-8, maintaining the sinus membrane integrity. The sinus membrane is then carefully lifted with the aid of specific curettes. This mobilization is performed with the bone window adhered to the membrane and displaced to the maxillary sinus roof. Created the desired space, the material chosen for grafting is then inserted.4 In 1994, Summer5 described an alternative surgical technique to increase the bone volume in the posterior maxilla on which the access to the maxillary sinus floor was performed through the alveolar bone crest using osteotomies of varied diameters aiming to surgically make an alveolus. The sinus mucosa was lifted and a grafting material was inserted, preceding the concomitant installation of a titanium implant. The referred technique has as main recommendation the necessity of gain of height on the maxillary sinus floor of at most 2 to 3mm. It is considered a less invasive alternative, especially for regions that did not need great sinus mucosa lifting.