title: Palatal versus vestibular piezoelectric window osteotomy for maxillary sinus elevation: a comparative clinical study of two surgical techniques.
abstract: OBJECTIVE
  The goal of this study was to compare the surgical advantages and disadvantages of a new palatal access osteotomy for sinus elevation with a conventional lateral approach.
  
  
  METHODS
  In 32 patients, either a palatal (n = 16) or a lateral (n = 16) osteotomy to the maxillary sinus was performed under local anesthesia. The palatal access included a circular paramarginal incision and elevation of a palatal mucosal flap based on a median pedicle. The lateral access was performed by vestibular standard incision and development of a mucoperiosteal flap with a vestibular and superior basis. For all osteotomies a piezoelectric device was used. The sinus cavity was augmented with synthetic nanostructured hydroxyapatite graft material.
  
  
  RESULTS
  Intraoperative complications during both procedures were minimal and wound healing was uneventful. Membrane perforation occurred in 19% of the palatal group and in 19% of the lateral group. Soft tissue management of the palatal technique was superior to that of the lateral approach, because the vestibular anatomy was not altered and consequently no disharmonious soft tissue scarring and no postoperative swelling occurred.
  
  
  CONCLUSIONS
  The palatal approach permitted higher postoperative comfort, especially for edentulous patients, because full dentures could be incorporated directly after surgery with almost perfect fit.
authors.affiliation: Hightech Research Center of Craniomaxillofacial Surgery, University of Basel, Basel, Switzerland. sstuebinger@uhbs.ch
authors.forename: Stefan
authors.initials: S
authors.lastname: Stübinger
authors.forename: Belma
authors.initials: B
authors.lastname: Saldamli
authors.forename: Oliver
authors.initials: O
authors.lastname: Seitz
authors.forename: Robert
authors.initials: R
authors.lastname: Sader
authors.forename: Constantin A
authors.initials: CA
authors.lastname: Landes
mesh_terms: D000328:Adult; D000368:Aged; D018786:Bone Substitutes; D003758:Dental Implantation, Endosseous; D017886:Durapatite; D005260:Female; D006801:Humans; D008297:Male; D008443:Maxillary Sinus / Q000601:surgery*; D008875:Middle Aged; D009061:Mouth Mucosa / Q000601:surgery; D013516:Oral Surgical Procedures, Preprosthetic / Q000295:instrumentation / Q000379:methods*; D010027:Osteotomy / Q000295:instrumentation / Q000379:methods; D021362:Palate, Hard / Q000601:surgery*; D013524:Surgical Flaps; D014464:Ultrasonic Therapy / Q000379:methods*; D055815:Young Adult
chemical_list: D018786:Bone Substitutes; D017886:Durapatite