Simultaneous implant placement with sinus augmentation using a modified lateral approach in the pneumatized posterior maxilla: A Case Report

Sun,  Yoo-Kyung; Cha,  Jae-Kook; Lee,  Jung-Seok; Jung,  Ui-Won

doi:2018.56.3.142

J Korean Dent Assoc > Volume 56(3); 2018 > Article

The Journal of The Korean Dental Association 2018;56(3):142-150.
DOI: https://doi.org/10.22974/jkda.2018.56.3.002 Published online March 31, 2018.

함기화된 상악 구치부에서 변형 측방 접근법을 이용한 상악동 거상술과 임플란트 동시식립에 대한 증례보고

선유경¹, 차재국², 이중석³, 정의원⁴

^¹연세대학교 치과대학 치주과학교실, 치주조직재생연구소
^²연세대학교 치과대학 치주과학교실, 치주조직재생연구소
^³연세대학교 치과대학 치주과학교실, 치주조직재생연구소
^⁴연세대학교 치과대학 치주과학교실, 치주조직재생연구소

Simultaneous implant placement with sinus augmentation using a modified lateral approach in the pneumatized posterior maxilla: A Case Report

Yoo-Kyung Sun¹, Jae-Kook Cha², Jung-Seok Lee³, Ui-Won Jung⁴

¹Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry
²Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry
³Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry
⁴Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry

Abstract

In the posterior maxillary area, due to resorption of the ridge after extraction and pneumatization of the maxillary sinus, the height of the alveolar ridge may not be sufficient for placement of implants. To solve this problem, sinus augmentation using both crestal and lateral approaches have been widely used. Jung et al. (2010) introduced the modified lateral approach technique, which is a simplified technique that combines the advantages of crestal and lateral approaches. The purpose of this case report is to report two cases in the posterior maxilla in which simultaneous implant placement with maxillary sinus augmentation has been performed using the modified lateral approach technique. In two female patients, 67 and 74 years old, respectively, simultaneous implant placement was performed using the modified lateral approach technique on the left maxillary second premolar and the first molar. In both patients, the residual bone height on the distal side of the maxillary second premolar was measured to be approximately 5 mm, and the residual bone height of the first molar was measured to be 2-3 mm. After flap elevation, osteotomy of the lateral window was performed in the form of a mesiodistally extended slot above the sinus floor and the Schneiderian membrane was elevated. Sequenced drilling was performed while protecting the membrane with a periosteal elevator. Bone graft and implant placement was performed after preparation of the implant site. Sufficient primary stability was achieved for each implant and sinus membrane was not perforated. After four and five months respectively, implant second surgery was performed. Clinically, the implants were observed to be stable. Implants and surrounding peri-implant mucosa were well maintained after prosthodontic treatment. In conclusion, the modified lateral approach could be a predictable and efficient technique for implant placement in the atrophied posterior maxilla.

Key Words: sinus graft;dental implant;modified lateral approach;pneumatization;