maxillary sinus floor bone grafting

Clinically, some patients have sufficient bone mass due to individual differences, and implants with shorter specifications can be implanted by direct implantation in the maxillary molar region. However, when the maxillary molar is implanted, the special anatomical and physiological signs of the maxillary sinus are very close to the alveolar ridge of the maxillary molar. Especially in patients with extremely atrophic alveolar ridge, the average from the maxillary sinus floor to the alveolar ridge is about 5mm. The bone volume is limited. It is easy to wear through the sinus cavity when implanting a long implant, and there is not enough support bone, which brings certain difficulties to the implant surgery. The maxillary molars, especially the distance from the maxillary sinus floor to the alveolar ridge, are too small. When there is insufficient bone tissue support, the maxillary sinus floor implants are generally used to solve the problem of not being able to grow due to insufficient bone mass, but the operation is complicated. More should be cautious. Treating diseases: dental disease Indication (1) The molars, the premolars are missing, and the alveolar ridge is extremely atrophied. The bone mass between the maxillary sinus floor and the alveolar ridge is less than 10 mm and the implant implant is required in this area. (2) The distance between the maxillary and alveolar sockets is within the allowable range of denture repair. If the distance between the jaws is too long, the alveolar bone should be implanted. If the distance between the jaws is too long and the maxillary retraction is reversed, then le- The forti type bone graft is lowered - forward, and the bone is planted in the gap. (3) The whole mouth is missing, and the patient cannot tolerate the active denture base. Preoperative preparation 1. General preparation (1) Prepare a temporary dental prosthesis for the missing teeth in advance, preferably for more than one month, so that during the first-month period from the first operation to the second operation (before the implant denture), the chewing is not affected by the missing teeth. Beautiful. (2) If tooth extraction and orthodontic surgery are performed, the bone defect should be restored after three months, and the x-ray shows that the quality and shape of the alveolar bone are satisfactory before considering the implantation operation. (3) When performing implant surgery, you should ensure your health. Do routine blood tests, patients with mild hypertension, blood pressure should return to normal, women should avoid menstrual periods. (4) The oral cavity should be kept clean before surgery, and the teeth should be cleaned beforehand to cure oral inflammation and diseases. (5) The patient can provide pre-dental dentures and pre-dental photos for the reference of the repairing doctor, so that the implanted dentures are more natural and realistic in the arrangement and color of the teeth. 2. Take the x-ray surface tomogram and calculate the distance from the base of the maxillary sinus to the alveolar ridge according to its magnification. 3, regular oral cleaning. Surgical procedure (1) Incision: From the maxillary canine to the first molar, the incision is made in the cheek groove. The mucosa and periosteum are incision, and the periosteal flap is separated and the bone surface of the maxillary sinus is exposed. Do not injure the infraorbital nerve. (2) Drill a rectangular window with a 2 mm diameter ball on the bone surface according to the size of the sinus cavity. When drilling, only penetrate the bone wall, do not damage the mucosa. Except for the upper boundary of the window, the other three sides are connected by a small osteotome or a micro bone saw. (3) Separate the upper bone mucosal flap from the maxillary sinus floor, use a suitable nasal mucosa stripper to adhere to the bone wall carefully, push up the sinus mucosa until the height of the bone graft, generally up 1.5cm, remember not to punch through Maxillary sinus mucosa. (4) Repair the tissue under the bone wall so that the bone graft can be placed in place. (5) Take half of the autologous humerus or allogeneic bone, which is trimmed to conform to the bone graft and implanted into the maxillary sinus floor, so that it should be tightly connected without gaps. (6) Separate the periosteal flap along the incision of the buccal sulcus to the temporal side, expose the alveolar surface of the alveolar bone, and drill holes in the designed position. At the same time, use your fingers to force the bone graft to make it pass through at the same time. The implant is screwed into place and acts as a fixed bone. If it is delayed planting, it is fixed by fine steel wire, or the bone graft is fixed in the non-planting area with titanium screws. After one year, the hole is drilled from the alveolar ridge and the implant is implanted.