Topic

[Surgery]  Lateral Sinus Augmentation


Mark, 

This patient requires single tooth implant 16. I have 4-4.5 mm of vertical bone to the sinus.

The OMC is patent. The patient suffers from season allergies only (sinusitis) but no history of chronic sinus infection.

Can you review the radiographs attached, CT is very recent. If you require more xrays let me know.

Can you discuss flap for this case. Also comment on simulatenous implant placement.

The opacity in the sinus is likely fluid. During our course my patient had healthy sinuses so I am not sure CT wise what to 

avoid. I also understand from Dr. Storeys case in Toronto that the radiopacity may just be mucosa thickening or is it likely fluid or nothing at all?


Thanks 

Chad Denomme



by Chad Denomme at Fri, Oct 13, 2017 12:02 PM

1180 Views | 4 Replies | Avg Rating : 5.00

Attached Images


Replies


Likes : 0

Chad Denomme Replied at Mon, Oct 23, 2017 7:52 AM

Bernard thanks very much.


Do you incorporate any PRF into the CASK protocol.

I have done many CASK procedures, I would in this case prep to 3.1 parallel and place a 5x8.5.

Thoughts?



Likes : 1

Bernard Jin Replied at Thu, Oct 19, 2017 2:51 PM

Hi Chad,

I personally think the summers technique would not be advisable here, unless you are very confident & accustomed to this procedure (as in you perform it very often).  Based on the amount of residual bone, I believe there is a significant chance to perforate into the sinus antrum and tear the schneidarian membrane.

In my office, I'd probably approach this with a lateral window approach.  However, I have performed such cases with the CASK approach.

Bernard



Likes : 0

Chad Denomme Replied at Sat, Oct 14, 2017 7:58 AM

Bernard how about summers technique here?


chad



Likes : 1

Bernard Jin Replied at Sat, Oct 14, 2017 6:00 AM

Hi Chad

From what I see, looks like a case of thickened mucosa.  I would recommend having the patient perform daily nasal-sinus lavage for at least 3 weeks prior to sinus surgery.

I'm assuming the patient is a non-smoker? Panoramic rad. shows 16 present - so i assume it is an old image (how old?).  Have you checked the status of the adjacent dentition to rule out adjacent pathology of dental origin?  Going back to my last suggestion - have patient perform lavage for 3 weeks & then consider taking another panoramic rad.

:)  Bernard