title: Minimally invasive antral membrane balloon elevation followed by maxillary bone augmentation and implant fixation.
abstract: The posterior maxillary segment frequently suffers from insufficient bone mass to support dental implants. Current bone augmentation methods, including the lateral maxillary approach (ie, hinge osteotomy) and sinus elevation by osteotome, have many shortcomings. The objective of our study was to assess the safety and efficacy of minimally invasive antral membrane balloon elevation (MIAMBE) followed by bone augmentation and implant fixation (executed during the same procedure). Alveolar crest exposure and implant osteotomy were followed by sequential balloon inflations yielding > 10 mm MIAMBE. A mix of autologous fibrin and bone particles with bone speckles was injected beneath the antral membrane. Implants were fixated into the osteotomies, and primary closure was performed during the same sitting. A total of 24 patients were enrolled. Successful conclusion of this procedure was accomplished in 91.6% of the initial 12 patients and 100% in the second dozen cases without significant complications. Patient discomfort was minimal. Long-term follow up revealed satisfactory bone formation, resulting in adequate implant stability. We conclude that the protocol of MIAMBE results in an excellent success rate, low complication rate, minimal discomfort, and long-term safety and durability. Because it requires only basic equipment and a short learning curve, this clinical approach should be widely employed.
authors.affiliation: Dental Clinic, Hanesihim Street 40, Petah-Tikvah, Israel.
authors.forename: Efraim
authors.initials: E
authors.lastname: Kfir
authors.forename: Vered
authors.initials: V
authors.lastname: Kfir
authors.forename: Eitan
authors.initials: E
authors.lastname: Mijiritsky
authors.forename: Ronen
authors.initials: R
authors.lastname: Rafaeloff
authors.forename: Edo
authors.initials: E
authors.lastname: Kaluski
mesh_terms: D000328:Adult; D000540:Alveolar Ridge Augmentation / Q000379:methods*; D018786:Bone Substitutes / Q000627:therapeutic use; D016025:Bone Transplantation / Q000379:methods; D002404:Catheterization / Q000295:instrumentation / Q000379:methods*; D003029:Coagulants / Q000627:therapeutic use; D003758:Dental Implantation, Endosseous / Q000379:methods; D015921:Dental Implants; D005260:Female; D005337:Fibrin / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008437:Maxilla / Q000000981:diagnostic imaging / Q000601:surgery*; D008443:Maxillary Sinus / Q000000981:diagnostic imaging / Q000601:surgery*; D019060:Minimally Invasive Surgical Procedures; D009092:Mucous Membrane / Q000000981:diagnostic imaging / Q000601:surgery; D010012:Osteogenesis / Q000502:physiology; D010027:Osteotomy / Q000379:methods; D017060:Patient Satisfaction; D011859:Radiography; D012449:Safety; D016896:Treatment Outcome
chemical_list: D018786:Bone Substitutes; D003029:Coagulants; D015921:Dental Implants; D005337:Fibrin