Indirect Maxillary Sinus Lift for Single Tooth Implant: A Clinical Study

Purpose: Tooth replacement with dental implant has been most challenging in maxillary posterior region due to pneumatization of maxillary sinus. Indirect maxillary sinus floor augmentation is one of the methods to overcome this problem so a clinical study was performed in institute and patients treated with indirect maxillary sinus lift and simultaneous implant placement. Aim: The aim of this study is to evaluate clinically and radiographically the long - term success of one-stage indirect (crestal approach) sinus lift procedure using alloplastic bone graft material and bioabsorbable membrane in conjunction with two-stage implant placement in atrophic partially edentulous posterior maxilla. Materials and Methods: One-stage indirect maxillary sinus lift in conjunction with two-stage implant placement was carried out in six patients at six sites. All the patients were partially edentulous with posterior maxillary alveolar ridge height of >5 mm and were in the age group of 20-50 years. Bioactive glass putty, bioabsorbable collagen membrane and 3.75 mm x 11.5 mm implants were used. Patients were evaluated clinically and radiographically for 18 months after placement of implants at intervals of 6 months to assess increase in residual ridge height, peri-implant condition (marginal bone loss, plaque and gingival index) and implant stability. Results: Maxillary first molar was the most common site (71.42%) for sinus lift and implant placement. Caries was the most common cause (83.33%) for loss of tooth. Increase in residual ridge height ranged from 71.43% to 133.33%) as measured by denta-scan. Implant survival rate was 100%. Marginal bone loss ranged from 0.6 to 1.2 mm. Implant stability was measured by periotest (2-6). Only one patient had perforation of the sinus membrane, but it was sealed satisfactorily by bioabsorable membrane. Conclusion: One-stage crestal approach sinus lift procedure with alloplastic bone graft material in combination with two- stage implant placement has a predictable outcome in patients with severe resorption of the posterior maxilla.