Dentaltown February 2016 - (Page 26)

oral surgery feature AN OVERVIEW OF Sinus Augmentation PROCEDURES by Dr. Veerendra Darakh Dr. Veerendra Darakh graduated from Government Dental College, Mumbai in 1990 and is currently in private practice. His practice emphasizes endodontics and implantology. Darakh lectures on various dental topics in a wide array of dental meetings and has written many articles for dental publications. His passion is dental continuing education and he is very active in CE activities. Darakh organizes lectures and seminars in India, featuring speakers from all over the globe. He can be reached at darakh@vsnl.com. Introduction The sinus-lift technique was introduced by Dr. Oscar Hilt Tatum Jr. in 1975, and was first published by Drs. Philip Boyne and R. A. James in 1980. Initially the technique was used for achieving an optimal intercrestal distance needed for dentures. In 1980, Boyne and James started to place implants in the newly created bone. By 1990, a modification of Tatum's original technique had become a standard clinical procedure. This procedure has contributed considerably to the expansion of implantology. Others in the field have developed several modifications to the original surgical approach, and the procedure is constantly evolving. In the past, LeFort I osteotomies with interpositional bone onlays, using rib or iliac crest, were also used. However, these techniques are only applicable when there is sufficient interarch distance. In addition, significant postoperative morbidity is associated with these approaches. Anatomy The maxillary sinus usually presents as a single chamber with five walls forming a quadrilateral pyramid shape, with its apex pointing laterally in the zygomatic process. Adult dimensions are approximately 2.5cm wide, 3.75cm high, 3cm deep, bounded by the orbital roof superiorly, the 26 FEBRUARY 2016 // dentaltown.com hard palate, alveolus and dental portion of the maxilla inferiorly, and the zygomatic process laterally, and finally, a thin plate of bone separating the cavity from the infratemporal and pterygopalatine fossa posteriorly. Its large, flat, quadrangular base supports both the median and lateral walls of the nasal cavity. The Schneiderian membrane covering the sinus floor contains multilayered columnar cells, basal cells, beaker cells, an underlying basal membrane and the tunica propria. It is a pseudostratified ciliated epithelium that functions by removing debris and bacteria from the sinus. Surgical techniques Reconstruction of the edentulous posterior maxilla presents a number of challenges. The area is frequently characterized by post-extraction buccolingual and apicoocclusal ridge atrophy (caused by involutional absorption of alveolar bone due to a lack of trophic stimulus), pneumatization of the sinuses, low bone density, and the highest occlusal loads. Presence of periodontal disease before tooth loss also leads to extensive bone resorption. The residual alveolar ridge may be of such morphology and position in relation to the opposing arch as to preclude ideal positioning of implants, and is often type IV in quality. Such sparsely trabeculated, poor-quality bone is a significant contributing factor to greater failure rates in a number of studies. http://www.dentaltown.com

Table of Contents for the Digital Edition of Dentaltown February 2016

On Dentaltown.com
HOWARD SPEAKS: There Ain’t No Silver Bullet in Business
PROFESSIONAL COURTESY: A Magical Meeting Experience
Continuing Education Update
Reverse Prep
An Overview of Sinus Augmentation Procedures
Figuring Out This Marketing Thing
OFFICE VISIT: Doing Dentistry in the Desert
Make Work-Life Balance Work for You
Pulpotomy Materials: An Update
Diligence: How to Successfully Purchase a Dental Practice
Parents Who Fool Themselves About Sugar in Kids’ Diets
Seven Easy Ways to Boost Treatment Compliance
You Should Know: ZendyHealth
Product Profile: DENTSPLY Caulk
Poll
Intraoral Scanning: A Great Resource in Today’s Dentistry
Must Haves for 2016
Product Profile: GC America
Simplifying Everyday Direct Posterior Restorations
Augmentation of Keratinized Gingiva
Industry News
Ad Index
Product Profile: United Business Funding
New Products
Product Profile: TCS
Top Three Strategies to Triple New Patient Numbers
Oral Diseases Associated with Women
Dentally Incorrect

Dentaltown February 2016