口腔种植学精品教学（中山大学）003种植外科-1.pptVIP

Sinus lift surgery With a residual bone height of less than 5?mm, the survival rate of implant decreases substantially. Comprehensive assessment of sinus septa, sinus pathology, and bone quality and quantity using three-dimensional cone beam computed tomography radiographs is important before placing implants in posterior maxilla. Sinus lift procedure has increasingly become a common practice especially when the insufficient heights of residual bone prevent the placement of dental implants in maxillary posterior alveolar ridge. Sinus lift procedure is usually indicated, whenever the residual bone reveals a height of 10?mm or less in posterior maxilla.The two surgical approaches that have been contemporarily used to manage the atrophic posterior maxilla are lateral window/direct approach and osteotome transcrestal/indirect approach. Osteotome transcrestal approach A transalveolar elevation of the maxillary sinus floor is performed to provide easier surgical intervention, shorter surgical time, lesser complications, and slighter morbidity as well as greater patient satisfaction. The use of osteotome approach can produce an approximate increase in vertical bone height that ranges from 3 to 9?mm Lateral window approach A window opening is created surgically in the lateral sinus wall followed by elevating the Schneiderian membrane to allow placing implant(s) of appropriate length. The use of lateral approach can increase the vertical bone height greater than 9?mm, which is necessary when we have large bone shortages. Sinus lift surgery Intervention indicated height Residual bone height Required increase in bone Sinus lift procedure ≤10?mm 3?mm Osteotome approach 5?mm 3–9?mm Lateral approach ≤5?mm 9?mm Table1. Sinus Lift Procedures Indicated in Posterior Maxilla according to the Available Residual Bone Height and the Amount of Postsurgical Increase in Bone Height Needed Sinus lift surgery The perforation of Schneiderian membrane is one of the most common sinus lif