Maxillary Implant Placement in a Limited Residual Bone Height

Authors

Calvin Kurnia, Department of Periodontics, Faculty of Dentistry, Maranatha Christian University, Bandung, 40164, IndonesiaFollow
Jane Amelia V. Wibisono, Department of Prosthodontics, Faculty of Dentistry, Maranatha Christian University, Bandung, 40164, Indonesia
Dominica Dian S. Sumantri, Department of Radiology, Faculty of Dentistry, Maranatha Christian University, Bandung, 40164, Indonesia

Abstract

The limitation of residual bone height (RBH) and vital structures such as sinuses in the maxillary often make the implant placement procedure becomes complicated. Clinicians may perform sinus elevation prior to implant placement to accommodate the length of the implant fixture. Sinus elevation is an invasive procedure and complication may occur during the surgery including the most frequent complication is perforation of Schneiderian membrane.

Objectives: To discuss a comprehensive management of implant placement and its complication step by step from surgical procedures to crown placement.

Case Report: 67-year-old female patient with partial edentulism in the right maxillary region, presence of sinus septum, and RBH was 4mm. The patient was planned to do sinus elevation surgery prior to implant placement, perforation of the Schneiderian membrane occurred while surgery performed and pericardium membrane was attached around the perforation site. Sinus re-entry and implant placement were performed after 3 months followed by prosthetics procedures in the next 6 month.

Conclusion: Dental implant is a complicated treatment and complication may occur during the placement, thus a comprehensive management is very essential to minimize the risk of complications.

References

1. Younes R, Nader N, Khoury G (Eds). Sinus grafting techniques: A step-by-step guide. Springer;2015.
2. Cardaropoli G. New predictable vertical ridge augmentation with a collagen membrane, bovine bone mineral, and fibrin fibronectic sealer system. Clin Oral Implants Res. 2017;28(S14):224-224.
3. Singh HS, Nagpal A, Sharma P, Hamid A, Singla A. Anatomical and clinical considerations in maxillary sinus floor elevation procedures. IP Ann Prosthodont Restor Dent. 2020;6(2):87-93.
4. Jensen OT, ed. The Sinus Bone Graft. 3rd ed. Quintessence Publishing;2019.
5. Sindel A, Özarslan MM, Özalp Ö. Management of the complications of maxillary sinus augmentation. In: Wang TC, ed. Challenging Issues on Paranasal Sinuses. Intech Open;2019:80603.
6. Rahpeyma A, Khajehahmadi S. Indications for palatal sinus lift: case series. J Indian Soc Periodontol. 2018;22(3):254-256.
7. Caudry S, Landzberg M. Lateral window sinus elevation technique: managing challenges and complications. J Can Dent Assoc. 2013; 79:d101.
8. Felice P, Pistilli R, Piattelli M, Soardi E, Barausse C, Esposito M. 1-stage versus 2-stage lateral sinus lift procedures: 1-year post-loading results of a multicentre randomised controlled trial. Eur J Oral Implantol. 2014;7(1):65-75.
9. Chiapasco M, Zaniboni M, Boisco M. Augmentation procedures for the rehabilitation of deficient edentulous ridges with oral implants. Clin Oral Implants Res. 2006 Oct;17 Suppl 2:136- 59.
10. Oktawati S , Neormansyah I , S upiaty. The relation of schneiderian membrane thickness and membrane perforation in sinus lift procedure: a systematic review. J Dentomaxillofac Sci. 2018;3(2):67-69.
11. Katranji A, Fotek P, Wang HL. Sinus augmentation complications: etiology and treatment. Implant Dent. 2008;17(3):339-49.
12. Chen L, Cha J, Chen HC, Lin HL. Sinus Perforation: Treatment and Classifications. J Implant Adv Clin Dent. 2011;3(1):19–30.
13. Yu HC, Kim YK. Fractures of implant fixtures: a r etrospective clinical s tudy. M axillofac Plast Reconstr Surg. 2020;42(1):13.
14. Yu Y, Jiang Q, Zhang Z, Yu X, Deng F. Influence of implant protrusion length on non-grafting osteotome sinus floor elevation with simultaneous implant: a 3- to 9-year retrospective study. Int J Implant Dent. 2021;7(22).
15. Kao SY, Lui MT, Cheng DH, Chen TW. Lateral trap-door window approach with maxillary sinus membrane lifting for dental implant placement in atrophied edentulous alveolar ridge. J Chin Med Assoc. 2015;78(2):85-8.
16. Cardoso CL, Curra C, Santos PL, Rodrigues MFM, Ferreira-Júnior O, de Carvalho PSP. Current considerations on bone substitutes in maxillary sinus lifting. Rev Clínica Periodoncia, Implantol y Rehabil Oral. 2016;9(2):102-107.
17. Bohner M, Santoni BLG, Döbelin N. β-tricalcium phosphate for bone substitution: Synthesis and properties. Acta Biomater. 2020;113:23-41.
18. Stiller M, Kluk E, Bohner M, Lopez-Heredia MA, Müller-Mai C, Knabe C. Performance of β-tricalcium phosphate granules and putty, bone grafting materials after bilateral sinus floor augmentation in humans. Biomaterials. 2014;35(10):3154-3163.
19. Pellicer-Chover H, Díaz-Sanchez M, Soto-Peñaloza D, Peñarrocha-Diago MA, Canullo L, Peñarrocha- Oltra D. Impact of crestal and subcrestal implant placement upon changes in marginal peri-implant bone level. A systematic review. Med Oral Patol Oral Cir Bucal. 2019;24(5):e673-e683.
20. Palacios-Garzón N, Velasco-Ortega E, López- López J. Bone loss in implants placed at subcrestal and crestal level: a systematic review and meta-analysis. Materials. 2019;12(1):154.
21. de Siqueira RAC, Savaget Gonçalves Junior R, Dos Santos PGF, de Mattias Sartori IA, Wang HL, Fontão FNGK. Effect of different implant placement depths on crestal bone levels and soft tissue behavior: a 5-year randomized clinical trial. Clin Oral Implants Res. 2020;31(3):282-293.
22. Lang NP, Lindhe J, eds. Clinical Periodontology and Implant Dentistry. 6th ed. Wiley-Blackwell;2015.
23. Atsuta I, Ayukawa Y, Kondo R, et al. Soft tissue sealing around dental implants based on histological interpretation. J Prosthodont Res. 2016;60(1):3-11.
24. Chai WL, Razali M, Ngeow WC. Dimension and structures of biological seal of peri-implant tissues. In: Dental Implantology and Biomaterial. Almasri MA, ed. Intech Open;2016:63950.
25. Böhm S, Weng D, Meyle J. Connective tissue grafts in periodontal surgery. Perio. 2006;3(2):129- 137.
26. Pandey KK. A beginner’s guide for implant impression: review article. Int J Oral Heal Med Res. 2017;4(1):91–93.
27. Linkevicius T. Zero Bone Loss Concepts. Quintessence Publishing;2019.

Recommended Citation

Kurnia, C., Wibisono, J. A., & Sumantri, D. D. Maxillary Implant Placement in a Limited Residual Bone Height. J Dent Indones. 2021;28(2): 118-123