Simultaneous Sinus Lifting and Alveolar Distraction of a Severely Atrophic Posterior Maxilla for Oral Rehabilitation with Dental Implants

Abstract

We retrospectively reviewed a new preimplantation regenerative augmentation technique for a severely atrophic posterior maxilla using sinus lifting with simultaneous alveolar distraction, together with long-term oral rehabilitation with implants. We also analyzed the regenerated bone histomorphologically. This study included 25 maxillary sinus sites in 17 patients. The technique consisted of alveolar osteotomy combined with simultaneous sinus lifting. After sufficient sinus lifting, a track-type vertical alveolar distractor was placed. Following a latent period, patient self-distraction was started. After the required augmentation was achieved, the distractor was left in place to allow consolidation. The distractor was then removed, and osseointegrated implants (average of 3.2 implants per sinus site, 80 implants) were placed. Bone for histomorphometric analysis was sampled from six patients and compared with samples collected after sinus lifting alone as controls (n = 4). A sufficient alveolus was regenerated, and all patients achieved stable oral rehabilitation. The implant survival rate was 96.3% (77/80) after an average postloading followup of 47.5 months. Good bone regeneration was observed in a morphological study, with no significant difference in the rate of bone formation compared with control samples. This new regenerative technique could be a useful option for a severely atrophic maxilla requiring implant rehabilitation.

Distraction Osteogenesis in Implantology for Ridge Augmentation - A Systematic Review

“…50 Kanno et al [44] 80 alternative to correct vertical deficits of edentulous ridges resulting from atrophy, trauma, congenital malformation, and the resection of benign or malignant tumors [29]. These results have been confirmed by other studies [23,30].…”

“…a change in the contour of a severely atrophic resorbed maxillary alveolus, thereby regenerating adequate bone on both the alveolar side and inside the maxillary sinus. This along with simultaneous sinus lifting proves to be a useful technique for patients with a severely atrophic maxilla requiring dental implant rehabilitation [44].…”

Biological characterization of implant surfaces - in vitro study

“…Reestablishment of esthetic and chewing functions of the stomatognathic system using osseointegrated dental implants has become the new paradigm in oral and maxillofacial rehabilitation of edentulous individuals 1 . Tissue and cellular responses to the composition of the implant surface, specifically to the physical and chemical characteristics, have determined the clinical success of the procedures performed [2][3][4] .…”

Partially Biodegradable Distraction Implant to Replace Conventional Implants in Alveolar Bone of Insufficient Height: A Preliminary Study in Dogs

“…With reliable long‐term functional and aesthetic results, dental rehabilitation with implants has become a common practice and has been widely accepted by dentists and patients in the last few decades. However, appropriate implant positioning can be compromised by insufficient bone volume and surrounding soft tissue conditions of the residual alveolus . Different reconstructive surgical techniques, including onlay or sandwich bone grafting, guided bone regeneration, and distraction osteogenesis, are proposed to improve the condition of local bone.…”

“…ADO has been clinically applied to reconstruct alveolar defects and to prepare enough bone volume to accommodate implant placements . ADO has gained acceptance as an effective, predictable, and reliable preimplant augmentation method, as it avoids donor site morbidity and provides predictable gain of hard and soft tissues simultaneously …”