Sinus Lift (Socket Lift)
Vertical and horizontal Augmentation
Lee, Myung Ho, D.D.S.
Member of Korean Implant Association
Member of Korean Prosthetic Academy
Member of Korean Esthetic Academy
Myung In Dental Clinic
CheonJu, Cheonrabukdo, South Korea
This 61 years old female patient visited dental office to restore maxillary left first and second molar area. Treatment approach chosen for this patient was implanted prosthesis. Oral and radiographic examination revealed insufficient alveolar ridge height with crestal bony defect.
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This patient needs Sinus graft (approach through implant prepared site) and crestal vertical augmentation procedure. Ti-oss® (100% Bovine cancellous bone substitute, Chiyewon co. Korea) and PRP technique were chosen for this purpose.
Vertical releasing incision mesial to second premolar and crestal incision distal to the second molar was designed to open the area
Tissue reflection revealed a significant amount of ridge defect (more than 5mm defect) was found in the second molar area. PRP and Ti-oss® mixture was made and was used for vertical build up. Through implant prepared site, Ti-oss® and PRP mixture was inserted into the sinus cavity after sinus membrane preparation by water pressure technique.
Tissue closure was done with two horizontal matrix suture and interrupted suture. The postoperative panoramic radiograph showed well-covered implants with Ti-oss® and slight opaque image of Ti-oss® can be observed in the sinus.
The periapical and panoramic radiograph one month after surgery showed increased density of Ti-oss® mass and the image of sinus floor began to disappear. This is the proof of graft integration into the sinus cavity. Crestal graft also well stabilized around the implant.
Periapical radiograph after 3 months showed well densified and stabilized Ti-oss® graft and this is the proof of osteoconductivity of Ti-oss®.
The second surgery was done after 7 months and healing abutments were connected. All graft was well densified to sustain the functional load. CT images verified three-dimensional augmented ridge form and sinus graft.
Panoramic radiograph after 7 months and 1 year and 6 months after surgery proved well maintained grafted areas in the sinus and ridge area.
Clinical oral image was excellent and periapical radiograph also proved well maintained creatal ridge contour after 21 months after surgery.
Radiograph 3 months after surgery is a kind of proof of biocompatibility and safety of Ti-oss®. Multiporosity, osteoblast preferred surface of Ti-oss® are contributing factors to this success. Almost 2 years follow up backed up the clinical reliability.