Jean-Francois Matern MD, Presenter: Nothing to Disclose

Francis P. Veillon MD, Abstract Co-Author: Nothing to Disclose

Thomas Bridonneau, Abstract Co-Author: Nothing to Disclose

Jean Carvahlo MD, Abstract Co-Author: Nothing to Disclose

Pierre Keller DMD, MSc, Abstract Co-Author: Nothing to Disclose

Implant therapy has become an excellent treatment modality since its inception into the modern era of dentistry. However, when patients present with advanced atrophy of the maxilla ridge, the procedure of choice to restore the anatomic bone deficiency is surgical maxillary sinus floor elevation. The purpose of this study is to describe the CT-scan guided sinus lift technique and to prove the minimal invasive aspect of this new radiological procedure.

For this prospective study, 17 cadaver heads were analyzed by cone beam CT (CBCT) and panoramic to response to our inclusion criterions (maxillary edentulous posterior sector and bone height inferior to 5mm). For each step, procedure was controlled by CT-scan and sinusal endoscopy. The radiological sinus lift technique consists of the following 4 stages: 1. Approach. A 14.5 G OstyCut needle was inserted mesial to the canine eminence and manually drilling was performed in parallel direction to the sinus floor. 2. Osteotomy. Inner obturator was introduced to compress bone and to create an osseous window opened to the submucosal space. 3. Lifting. The sinus lift was performed by hydrodissection with diluted iodinated contrast media agent. 4. Filing. The submucosal space filing was performed by injection of diluted collagen. A dome shape visualized in the maxillary alveolar recess defines the success of the radiological sinus lift procedure. All radiological maxillary sinus floor elevations were scanned postoperatively with panoramic and maxillary CBCT.

Twelve maxillary sinuses were included to radiological sinus floor elevation procedure. Dome shape of the Schneiderian membrane performed in 8 maxillary sinuses (66,7%). All failures (n=4) were caused by mucosal perforation at the time of maxillary sinus osteotomy. Mean elevated membrane height was 12.0mm for a mean intervention time of 45 minutes. Radiological exposures were 79.0 mGy.cm DLP and 22.8 mGy CTDIv.

The present experimental study reports a new minimally radiological procedure to maxillary sinus floor elevation. This study proposes a radiological interventional alternative to classic surgical approach with an equivalent success rate according to the literature.

The radiological sinus lift will provide less tissue injury, a more physiological approach to more homogenous maxillary sinus membrane elevation and less failure over surgical procedure.

Matern, J, Veillon, F, Bridonneau, T, Carvahlo, J, Keller, P, Radiological Sinus Lift: A New Minimally Invasive CT-scan Guided Procedure to Maxillary Sinus Floor Elevation in Implant Dentistry.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13014926.html