case presentation
feature
Drs. W. Stephen Barnes and Michael J. Hoffman
In our office, we frequently are called upon to replace
missing posterior maxillary teeth using dental implants. The
sinus cavity can often be a limiting factor in the ability to place
implants in the posterior maxilla. When teeth are removed, the
sinus will often pneumatize or enlarge, decreasing the available
bone to support dental implants. When the available height is
less than the length of our required implant length, additional
surgery must be done to "re-establish" lost alveolar height.
Classically there have been two well-accepted methods of
performing sinus lift grafts for posterior maxillary implants. An
external sinus lift involves a lateral maxillary osteotomy, followed by gentle elevation of the Schneiderian membrane. This
58
JULY 2014 » dentaltown.com
allows entrance into the created space below the antrum and
subsequent graft placement. The alternative approach is an
internal (Sommers) sinus lift. This involves in-fracture of the
bone at the apex of the implant osteotomy in a superior direction to "push" the sinus lining superiorly. This is followed by
graft placement and the implant is placed thereafter. In our
experience, the Sommers lift is highly predictable and can
accommodate a 4mm superior lift predictably and sometimes up
to 6mm. Any implant requiring more than 4-6mm of lift, in our
hands, is best accomplished with an open sinus lift. The open
sinus lift is a procedure that we perform regularly and predictably in our office.
http://www.dentaltown.com
Table of Contents for the Digital Edition of Dentaltown July 2014