Lateral sinus lift - one stage

  • Lateral sinus lift - one stage
    Preparation of the lateral sinus window
  • Lateral sinus lift - one stage
  • Lateral sinus lift - one stage
    Socket filling with cerabone®
  • Lateral sinus lift - one stage
    Lateral window covering with collprotect® membrane
  • Lateral sinus lift - one stage
    Situation after healing
Sinus lift (also termed sinus floor augmentation) is a surgical technique that aims to thicken (augmentation) an atrophic sinus floor. According to the lateral approach, a flap is prepared to expose the lateral aspect of the maxillary sinus. Access to the sinus cavity is gained by preparing a window, preferably with a diamond burr or piezo instrument. Subsequently, a space between the membrane and the sinus floor is created by carefully detaching the Schneiderian membrane, which is then filled with a bone graft material (e.g., xenogenic, allogenic, or synthetic). If the residual bone height is sufficient to allow the insertion of the implants without affecting the primary stability, the augmentation and implantation may be performed simultaneously in a one-stage procedure.

Particle size

The use of large particles (e.g., cerabone® 1–2 mm, maxresorb® 0.8–1.5 mm) is recommended for the sinus lift technique. The increased space between the particles ensures a better vascularization and improves the regeneration of larger defects.

Schneiderian membrane perforation

If a small perforation (<5 mm) of the Schneiderian membrane occurs during the sinus floor elevation, a collagen membrane (e.g., Jason® membrane or collprotect® membrane) may be used to cover the perforation site. Please make sure that the patient does not sneeze for two weeks and prescribe antibiotics and swelling prophylaxis (e.g., xylometazoline). Do not continue the treatment or the sinus lift procedure in case of acute sinusitis with presence of pus.

One-stage sinus lift with cerabone® - Dr. V. Kalenchuk
Einzeitiger Sinuslift mit cerabone® - Dr. V. Kalenchuk

The reliability and high predictability of grafting materials for the sinus lift procedure are well documented. Among these, cerabone® is an excellent bovine grafting material. Its particles serve as an osteoconductive scaffold for osteoblasts and support new bone formation starting from the margins of the defect. Moreover, cerabone® particles integrate into the new bone with only minor superficial resorption over the years and therefore guarantee a long-term volume stability of the grafted site.

As an alternative, synthetic grafting material maxresorb® or the allogenic maxgraft® granules may be used; particularly suited for minor grafting procedures (<4 mm to augment), synthetic easy-to-apply paste maxresorb® inject is also a valid option.

Placement of a Jason® fleece prior to the application of relatively sharp bone graft granules can protect the Schneiderian membrane from damage and offers a cost effective alternative to a barrier membrane. If a smaller perforation of the Schneiderian (<5 mm) membrane is already present, then the use of a collagen membrane (e.g., collprotect® membrane) is recommended to seal the perforation.

Despite the scientific debate about the need for a barrier membrane, several studies have demonstrated that the use of a membrane to cover the sinus window results in a higher success rate for the sinus lift procedure. Thus, these study clearly indicate that a brarrier membrane should be applied to ensure an undisturbed healing. Particularly indicated for this purpose is the medium-term barrier function of collprotect® membrane. If an additional lateral augmentation is needed (for instance, due to a reduced ridge width), it is recommended to cover the augmentation site with a slowly resorbable membrane. The Jason® membrane, with its long-term barrier function, can stabilize the augmentation site for a sufficiently long period, thus ensuring an undisturbed osseous regeneration.

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