Bilateral Maxillary Sinus Lift

1
Bilateral Maxillary Sinus Lift

• Right side is planned as a staged sinus lift
  procedure with the surgical removal of the second
  bicuspid
• Left side planned for sectioning of fixed bridge,
  removal of fractured premolar, left antral graft
  and immediate placement of three osseointegrated
  tapered screw vent implants

2
First Surgical Procedure Right Side

• This is a 40 year old patient scheduled for
  prosthetic reconstruction of maxillary arch
• Opposing fixed mandibular bridge work
• No posterior maxillary dentition
• Our goal was to place 2, long, tapered screw vent
  implants on the right side (13mm)
• Implant length is important in younger patients
  to insure long term, proper function against
  opposing fixed bridgework

3
Staged Sinus Lift

• The right side was staged due to the lack of bone
  and the desire to augment the right antrum with
  8-10mm of bone
• As with all of our bone grafting procedures, the
  grafts are augmented using platelet concentrate

4
Second Surgery bilateral procedure

• 2 tapered screw vent implants are placed into the
  right antral graft
• On the left side we sectioned the fixed bridge
  distil to the maxillary left canine
• The left first bicuspid was surgically removed
• 3 tapered screw vent implants were placed in the
  left quadrant
• The anterior implant was immediately placed in
  the extraction site of the first bicuspid
• An antral sinus lift was performed on the left
  side for the posterior implant
• 11.5mm implant placed immediately into left
  antral graft

5
Surgical Notes

• Notice complete osseous healing of buccal window
  4 months after staged antral graft on the right
  side
• The right sinus lift graft enabled the placement
  of a 4.7, 13mm 3.7, 13mm implants into the
  second bicuspid and first molar sites

6
Surgical Notes

• Note buccal defect associated with anterior
  implant placed immediately into the first
  bicuspid extraction site
• Sinus window and schneiderian membrane visible
  with parallel pin in distil implant site
• Graft applied to left antrum as well as buccal
  defect
• Note the neat isolation and containment of graft
  material due to the use of platelet rich plasma

7
Final Notes

• Note radiopaque areas in the right and left sinus
  cavities indicating organization and ossification
  of sinus grafts
• This patient was treated in 2 efficiently planned
  surgical procedures with the aid of general
  anesthesia