Geistlich - Indication sheets S1 -Sinus Floor Augmentation | Page 2

6.6.2006 8:03 Uhr Seite 2 Indication sheet S1 31166.2/0601/e wallkamm e Sinus Floor Augmentation Sources of supply Implant tray Sinus instrument tray A13 Cavity is filled with Bio-Oss® or the Bio-Oss® – bone mixture. A fine periosteal elevator is used to insert it. The material adheres very well to the instrument when mixed with blood. A14 The implant is inserted. A15 Lateral fenestration is covered with the Bio-Gide® membrane. Safescraper® / Micross® A16 Suture: a monofilament 7 – 0 suture (Seralene) is used for the releasing incision. The incision on the ridge is closed with 6 – 0, also monofilament Tissucol Clinical procedure of Dr. Beat Wallkamm, private practice, Langenthal CH A17 Healing after ten days > Sinus floor augmentation with lateral access and simultaneous implantation > Problems with sinus membrane and septum A18 Radiological check 4. Surgical aftercare Medications Follow-up appointments Opening and taking the impression - Rinse with 0.1% chlorhexidine for 4 weeks - Antibiotic therapy: amoxycillin / clavulanic acid 1000 mg twice a day for 3 days if penicillin allergic: Zithromax (azithromycin) 500 mg once a day for 3 days - Paracetamol 500 mg or ibuprofen 600 mg for pain - Local cooling - Week 1 (for suture removal) / Week 2 / Week 6 - Week 14 1. Deciding criteria according to Beat Wallkamm Augmentation technique depending on residual bone thickness Alternative An occasional side effect is a haematoma in the cheek that can extend to below the eye. (case D) Standard implantation without augmentation: > 8 mm residual bone thickness Osteotome technique: 6 – 7 mm residual bone thickness x One-stage, lateral access: 4 – 5 mm residual bone thickness Two-stage, lateral access: < 4 mm residual bone thickness Addition of autologous bone 5. Long-term results > The long-term prognosis for implants in an augmented sinus is very good (3, 10 – 13). x yes no References 1 Boyne P.J., James R.A. Grafting of the maxillary sinus floor with autogenous marrow and bone. J. Oral Surg. 1980, 38, 613–616 2 Tatum H., Jr. Maxillary and sinus implant reconstructions. Dent Clin. North Am. 1986, 30, 207–229 3 Valentini P., Abensur DJ. Maxillary sinus grafting with anorganic bovine bone: A clinical report of long-term results. J Oral Maxillofac Implants 2003, 18, 556-560. 4 Hallman M., Sennerby L., Lundgren S. A clinical and histologic evaluation of implant integration in the posterior maxilla after sinus floor augmentation with autogenous bone, bovine hydroxyapatite, or a 20:80 mixture. J Oral Maxillofac Implants 2002, 17, 635-643. 5 Artzi Z., Kozlovsky A., Nemcovsky CE., Weinreb M. The amount of newly formed bone in sinus grafting procedures depends on tissue depth as well as the type and residual amount of the grafted material. J Clin Periodontol 2005; 32:193-199. 6 John HD., Wenz B. Histomorphometric analysis of natural bone mineral for maxillary sinus augmentation. Int J Oral Maxillofac Implants 2004, 19, 199-207 7 Jensen J., Sindet-Petersen S.l., Oliver A.J. Varying treatment strategies for reconstruction of maxillary atrophy with implants: Results in 98 patients. J. Oral Maxillofac Surg. 1994, 52, 210 - 216 8 Mazor Z., Peleg M., Gross M. Sinus augmentation for single-tooth replacement in the posterior maxilla: A 3 year follow up clinical report. Int. J. Oral Maxillofac Implants 1999, 14, 55-60 9 Proussaefs P., Lozada J. The «Loma Linda Pouch»: A technique for repairing the perforated sinus membrane. Int. J. Periodontics Restorative Dent. 2003, 23, 593-597 10 Scarano A., Pecora G., Piattelli M., Piattelli A. Osseointegration in a sinus augmented with bovine porous bone mineral: Histological results in an implant retrieved 4 years after insertion. A case report. J Periodontol 2004; 75:1161-1166 11 Sartori S., Silvestri M., Forni F., Icaro Cornaglia A., Tesei P., Cattaneo V. Ten-year follow-up in a maxillary sinus augmentation using anorganic bovine bone (Bio-Oss®). A case report with histomorphometric evaluation. Clin Oral Impl Res. 2003, 14, 369-372. 12 Valentini P., Abensur D., Wenz B., Peetz M., Schenk R. Sinus grafting with porous bone mineral (Bio-Oss®) for implant placement: A 5-year study on 15 patients. Int. J. Periodontics Restorative Dent. 2000, 20, 245-252 13 Piatelli M., Favero G., Scarano A., Orsini G., Piatelli A. Bone reactions to anorganic bovine bone (Bio-Oss®) used in sinus augmentation procedures: a histologic long-term report of 20 cases in humans. Int J Oral Maxillofac Implants 1999, 14, 835-840 2 months after augmentation and implantation x 4 months after augmentation and implantation 6 months after augmentation and implantation Implant loading Alternative This case shows the radiological appearance 7.5 years after bilateral sinus lift. The probing depths around the implants are 2 – 4 mm. The patient was a risk patient, a smoker with loss of maxillary teeth because of periodontitis. The periodontitis in the mandible is under control. Fixed restoration is planned there too at a later stage. (case E) 5 Seralene suture 6 – 0 / 7– 0 1 Hu-Friedy Mfg. Co., Inc. Rudolf-Diesel-Straße 8, D– 69181 Leimen Tel. [phone] / 97 00-0 | Fax [phone] / 97 00-98 www.hu-friedy.com | E-Mail: [email protected] A Helmut Zepf Medizintechnik GmbH Obere Hauptstrasse 16 - 22, D – 78606 Seitingen-Oberflacht Tel.: +49/ (0) 7464 / 98 88 -0 | Fax: +49/ (0) 7464 / 98 88 - 88 www.zepf-dental.com | E-Mail: [email protected] B FRIADENT GmbH Steinzeugstr. 50, D – 68229 Mannheim www.friadent.com | Tel: [phone] Meta Via E. Villa n.7, 42100 Reggio Emilia, Italy www.metahosp.it | Tel: [phone] | Fax [phone] Baxter One Baxter Parkway, Deerfield, IL 60015-4625, USA, www.baxter.com SERAG-WIESSNER KG D – 95119 Naila, Zum Kugelfang 8-12 www.serag-wiessner.com | Tel [phone] | Fax [phone] Geistlich Pharma AG Division Biomaterials CH - 6110 Wolhusen, Switzerland phone ++ 41- 41 - 49 25 -630 fax ++ 41- 41 - 49 25 -639 www.geistlich.com 6