The posterior part of the maxilla poses new problems for implants due to the presence of the maxillary sinus. During a person’s lifetime, the maxillary sinus continues to pneumatize and expand, and the maxillary sinus continues to enlarge, which makes the distance between the top of the maxillary alveolar ridge and the bottom wall of the maxillary sinus smaller, and the bone becomes more lax. Clinicians often see the poor condition of the maxillary sinus area and are too intimidated to go for implants for fear of various complications. Insufficient vertical bone volume and poor bone quality have become the most challenging clinical problem for implantation of missing teeth in the posterior maxillary sinus. Maxillary sinus lift (sinus lifting) Maxillary sinus lift (open maxillary sinus lift) A window is opened in the lateral wall of the maxillary sinus, the mucosa of the maxillary sinus floor is stripped and pushed upward and inward under direct vision, and bone graft material is placed between the mucosa of the maxillary sinus floor and the maxillary sinus floor to increase the amount of bone from the maxillary sinus floor to the top of the alveolar ridge. Basic principles: (1) If the remaining bone volume is greater than 5 mm and less than 8 mm, an external lift can be done to place the implant at the same time. (2) If the remaining bone volume is greater than 2 mm and less than 5 mm, implants can be placed at the same time as the external lift. It is also possible to place the implant in the first stage and wait for the second surgery for more than 6 months to place the implant. (3) If the remaining bone volume is less than 2mm, bone grafting material should be placed first to increase the bone volume from the floor of the maxillary sinus to the top of the alveolar ridge, and then implants should be placed after the completion of the 9-month osteogenesis period to ensure the initial stability of the dental implant. Methods: First, open the window, remove the buccal bone plate and reset it after surgery. Second, push the buccal bone plate into the maxillary sinus. Third, the buccal lateral bone plate is removed by grinding method and maxillary sinus lift is performed. The external maxillary sinus lift has a larger lift space distance than the internal lift, a clear surgical view, less chance of mucosal perforation of the maxillary sinus, and even if it occurs, it can be repaired in time, which is especially suitable for patients with a severe lack of vertical distance in the posterior maxilla. Maxillary sinus lift is one of the most challenging problems for clinicians, and the development of the external maxillary sinus lift technique will undoubtedly expand your indications for implantation and improve your skills, as well as bring benefits to your patients.
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