Sinus floor elevation and vertical application of biomaterials

Case provided by prof. dr. Anton Friedman (Chair and Head Department of Periodontology, School of Dentistry, Faculty of Health, University of Witten, Germany).

History of hopeless maxillary molars

  • Residual subantral bone ≈ 2 mm
  • Lateral window approach ≈ 6 months following tooth loss

Sinus floor elevation and vertical application of biomaterials

  • Xenograft (Smartgraft®) hydrated with high weight hyaluronic acid (hyaDENT BG)
  • OSSIX®Plus membrane in place covers full extension of the grafted area
  • Separate membrane fixation unnecessary

Coronally advanced flap (CAF) and suture

  • Coronal advancement of the buccal flap (CAF)
  • Complete tension free closure of the site with PTFE and monocryl sutures
  • Suture removal ≈ 12 days post-op

surgery – re-entry and tissue sampling 8 months after SFE

  • Periapical x-ray displays gain in mineralized tissue at the sinus and supracrestally (arrows)
  • Soft tissue and ridge dimension at stage 2
  • Macroscopically mature crestal bone across the ridge

implant placement 8 months later

  • Ridge dimension achieved 8 months after SFE and lateral/vertical augmentation
  • WNI (Straumann SP/WN/10 mm length) in place
  • Gingiva former in place for transmucosal healing