Sinus Lift and Immediate Implant Placement, using LAS kit and TS3 implants. Presentation by Dr Nicola Baldini DDS http://www.dentalevo.it/dentistry-materials/sinus-lift-big-buccal-window/ http://www.dentalevo.it/dentistry-materials/sinus-lift-small-buccal-window/

1. Sinus lift and immediate implant placement
using LAS kit and TS3 implants
Dr Nicola Baldini DDS
University of Florence and Siena, Italy

4. Maxillary sinus vascularization
1 = Maxillary a.
!
2 = Infraorbital a.
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3 = Alveolar Post Sup a.
!
4 = anastomosis 2+3
Green area: Infraorbital a.+ Alveolar Post Sup a.
!
Blue area: Palatal Mayor a.
!
Red area: Nasal Lateral a.

5. Maxillary sinus vascularization
Anastomosis between arteria alveolar superior posterior
artery and infraorbital artery

6. Maxillary sinus vascularization
• Present in100% of tested patients
!
• 47% infrabony position
!
• 55% diameter less than 1 mm, 40% between 1 and 2mm, 5% between 2 and
3mm
Rosano G, Taschieri S, Gaudy JF, Weinstein T, Del Fabbro M. Maxillary sinus vascular anatomy and its relation to sinus
lift surgery. Clin Oral Implants Res. 2011 Jul;22(7):711-5. Epub 2010 Dec 9.
!

7. • Pjetursson BE, Tan WC, Zwahlen M, Lang NP. A systematic review of the success of sinus floor elevation and survival of
implants inserted in combination with sinus floor elevation. Part I: Lateral approach. J Clin Periodontol 2008; 35 (Suppl.
8): 216–240.
• Canullo L, Patacchia O, Sisti A, Heinemann F. Implant Restoration 3 Months after One Stage Sinus Lift Surgery in
Severely Resorbed Maxillae: 2-Year Results of a Multicenter Prospective Clinical Study. Clinical Implant Dentistry and
Related Research, Volume *, Number *, 2010.
• Stern A, Green J. Sinus lift procedures: an overview of current techniques. North Am. 2012 Jan;56(1):219-33.
• Rickert D, Slater JJ, Meijer HJ, Vissink A, Raghoebar GM. Maxillary sinus lift with solely autogenous bone compared to a
combination of autogenous bone and growth factors or (solely) bone substitutes. A systematic review. J Oral Maxillofac
Surg. 2012 Feb;41(2):160-7. Epub 2011 Nov 17.
• Esposito M, Grusovin MG, Rees J, Karasoulos D, Felice P, Alissa R, Worthington H, Coulthard P Effectiveness of sinus lift
procedures for dental implant rehabilitation: a Cochrane systematic review. J Oral Implantol. 2010 Spring;3(1):7-26.
!
!

8. Which is the right x-ray exam?
• Opt
!
• CT Dentalscan
!
• CT Cone Beam
Temmerman A, Hertele ́ S, Teughels W, Dekeyser C, Jacobs R, Quirynen M. Are panoramic
images reliable in planning sinus augmentation procedures?
Clin. Oral Impl. Res. 22, 2011; 189–194.

9. Buccal bone thickness
Sinus width
Residual alveolar bone height
Cronical sinusitis

10. Cronical sinusitis
• Sinus evaluation
!
!
• Maxillary sinus ostium
ENT specialist collaboration?
Carmeli G, Artzi Z, Kozlovsky A, Segev Y, Landsberg R. Antral computerized tomography pre-operative evaluation: relationship between
mucosal thickening and maxillary sinus function.
Clin. Oral Impl. Res. 22, 2011; 78–82.

11. Septa within the sinus
• present in 21-29% of the patients
• bilateral 8,4%
• 24% premolar area, 55% molar area, 21%
retromolar area
!
Pommer B, Ulm C, Lorenzoni M, Palmer R, Watzek G, Zechner W.
Prevalence, location and morphology of maxillary sinus septa: systematic review and meta-analysis.
J Clin Periodontol. 2012 Aug;39(8):769-73. doi: 10.1111/j.1600-051X.2012.01897.x. Epub 2012 May 24.

12. Septa within the sinus

13. Evolution of a surgical technique
• More performing
• Faster
• Safer
• Less invasive

14. Wallace SS, Tarnow DP, Froum SJ, Cho SC, Zadeh HH, Stoupel J, Fabbro MD, Testori T.
Maxillary sinus elevation by lateral window approach: evolution of technology and technique.
J Evid Based Dent Pract. 2012 Sep;12(3 Suppl):161-71. doi: 10.1016/S1532-3382(12)70030-1.
• bone substitutes
!
• collagen membrane covering bony window
!
• implants with rough surface
!
• piezosurgical devices

15. What is more invasive?

16. One stage approach

17. One stage approach

18. One stage approach

19. One stage approach

20. One stage approach

21. One stage approach

22. One stage approach

24. One stage approach
Day 0 Day 14

25. 2 months

26. After 3 months...

27. Conclusions

28. baldini.nicola@gmail.com
Thank you