2.01.23 Liana_Sinus augmentation

Question 1

What sinus conditions / diseases require ENT consult before sinus augmentation?

Answer 1

[Add table here]

Question 2

What are the average dimensions of the maxillary sinus?

Answer 2

2.5cm wide x 3cm deep x 3.75 cm height

Question 3

What vessels supply the maxillary sinus?

Answer 3

Rosano 2011
Posterior superior Alveolar and Infraorbital arteries
* 100% will anastomose intraosseously
* in addition, 44% will anastomose extraosseously
* 47% are visible in the CBCT
* Vessel diameters:
* < 1mm = 55.3%
* 1-2mm = 40.4%
* 2-3mm = 4.3%

Question 4

What is the prevalence of sinus septa?

Answer 4

Pommer 2012
* Prevalence = overall 28.4%

➡molar = 55%

➡premolar = 24%
➡retromolar = 21%

➡ Edentulous > dentate

• Orientation of septa
  ➡transverse = 88%,
  ➡sagittal = 11%
  ➡horizontal =1.3%
• Septa height = mean 7.5 mm.

Question 5

Where to place the sinus access window?

Answer 5

3-5 mm above the sinus floor
3-5 mm behind the anterior tooth (or anterior sinus)
Height: 10-15mm
Width: 10-15mm

Question 6

Usually, how much bone graft is needed for lateral sinus aug?

Answer 6

1-3 CC, usually
Dr. Wang: Mix 2 CC small particle with 1 CC cortical (which is usually larger particle)

Crest to lift height: lift to about ~15 mm
Then, place 13 mm implants (not 10mm! - Dr. Wang says, if you’re doing lateral sinus, why would you place only 10 mm implants)

Question 7

Should a membrane be placed over a graft (before closing) for a lateral sinus aug?

Answer 7

(according to Liana) = No - most studies show NSSD
(acc. to Dr. Wang) = Yes, “studies show better bone and more vital bone, and less problems”

Right after elevating, you should add a membrane before packing the graft (to help avoid perforation)

Question 8

Should patients fly after having a sinus lift?

Answer 8

Dr. Saleh had a patient fly 2 weeks after & it was fine
Dr. Wang says: Usually it is fine if there is no perforation
If there is, usually 4 wks is better