title: Management of combined ridge defect and osteotome sinus floor elevation with simultaneous implant placement--a 36-month follow-up case report.
abstract: This report demonstrated the management of combined ridge defect and maxillary sinus pneumatization with simultaneous implant placement. One case with vertical and horizontal ridge deficiency and sinus pneumatization in the maxillary premolar area was indicated for ridge augmentation and sinus elevation before implant placement. Implant osteotomy was enlarged using a ridge expansion osteotome to 1 mm short of the sinus floor; sinus elevation was performed using sinus lift osteotomes; the implant was placed; bone graft and resorbable membrane were used to augment the remaining defect. The second stage was done after 6 months, followed by final restoration. The patient was reevaluated for 36 months following the final prosthesis. The surgical site healed without complication following implant placement. During the second stage, the implant was completely surrounded by bone, with bone covering the buccal aspect of the cover screw. The X-ray showed a 5 mm apical shift of the sinus floor at 6 months post surgery. At 12 months post loading, crestal bone loss to the level of the first thread was noted; no changes were observed at the sinus or surrounding teeth. Pocket depth ranged from 3-4 mm. No further bone loss or soft tissue contour change was noted at 18, 24, 30, and 36 months post loading. The combination of these three techniques with simultaneous implant placement as described in this report seems to be successful. Further research is needed to evaluate whether the combination of these techniques with simultaneous implant placement offers similar results when compared with the stage approach.
authors.affiliation: Periodontic Division, Department of Oral Basic and Clinical Sciences, King Abdulaziz University, Faculty of Dentistry, Jeddah, Saudi Arabia. dr_thafeed@hotmail.com
authors.forename: Ali Saad Thafeed
authors.initials: AS
authors.lastname: AlGhamdi
mesh_terms: D016301:Alveolar Bone Loss / Q000601:surgery; D000540:Alveolar Ridge Augmentation / Q000379:methods; D001861:Bone Regeneration; D016025:Bone Transplantation; D003442:Crowns; D003758:Dental Implantation, Endosseous / Q000379:methods*; D019250:Dental Implants, Single-Tooth; D019094:Dental Prosthesis, Implant-Supported; D005260:Female; D005500:Follow-Up Studies; D016557:Guided Tissue Regeneration, Periodontal / Q000379:methods*; D006801:Humans; D008443:Maxillary Sinus / Q000601:surgery*; D008875:Middle Aged; D013516:Oral Surgical Procedures, Preprosthetic / Q000379:methods*; D010027:Osteotomy