ABSTRACT
Localized management of sinus floor (LMSF) achieves implant placement and sinus lifting simultaneously. LMSF is a further application of the principles of the edentulous ridge expansion (ERE) technique. It comprises the dissection of a partial-thickness flap, the buccal expansion of the residual alveolar bone, and the fracture and elevation of the sinus floor with simultaneous implant placement. Three hundred three patients were treated with 499 implants placed using the LMSF between April 1988 and December 1993. The selected patients, who showed no signs of sinus pathology, exhibited insufficient vertical alveolar bone dimensions for the placement of dental implants with the traditional technique. The minimal residual alveolar bone height was between 5 and 7 mm. Based on the criteria established by Albrektsson and his coworkers in 1986, the success rate of the 499 implants placed with the LMSF was 97.5%.
Subject(s)
Dental Implantation, Endosseous , Dental Implants , Maxilla/surgery , Maxillary Sinus/surgery , Alveolar Process/pathology , Alveoloplasty/methods , Bite Force , Bone Regeneration , Collagen/therapeutic use , Female , Follow-Up Studies , Humans , Jaw, Edentulous/rehabilitation , Jaw, Edentulous/surgery , Male , Maxilla/pathology , Middle Aged , Osteogenesis , Surgical Flaps/pathology , Treatment OutcomeABSTRACT
This study presents the clinical results of a surgical technique that expands a narrow ridge when its orofacial width precludes the placement of dental implants. In 170 people, 329 implants were placed in sites needing ridge enlargement using the endentulous ridge expansion procedure. This technique involves a partial-thickness flap, crestal and vertical intraosseous incisions into the ridge, and buccal displacement of the buccal cortical plate, including a portion of the underiying spongiosa. Implants were placed in the expanded ridge and allowed to heal for 4 to 5 months. When indicated, the implants were exposed during a second-stage surgery to allow visualization of the implant site. Occlusal loading was applied during the following 3 to 5 months by provisional prostheses. The final phase was the placement of the permanent prostheses. The results yielded a success rate of 98.8%.
Subject(s)
Alveolar Ridge Augmentation/methods , Dental Implantation, Endosseous/methods , Maxilla/surgery , Aluminum Oxide , Dental Implants , Humans , Surgical Flaps/methods , Treatment OutcomeABSTRACT
The edentulous ridge expansion (ERE) technique is a partial-thickness flap procedure for implant surgery that was developed in 1986. The ERE technique permits the use of osseointegrated implants at sites whose minimal orofacial dimensions are insufficient for traditional implant surgery. The present work is a histologic and ultrastructural study of hard tissue repair modalities at edentulous sites that were treated with the ERE technique in 20 humans. Biopsies were obtained from the tissue regenerating within the surgically created bone gap between the mobile buccal and nonmobile lingual or palatal bone-periosteum plates ("bone flaps") on days 40, 90, 120, 150, and 480 (day 0 = day of implant insertion). The results suggest that osteoblasts differentiate from preexisting mesenchymal cells located on the original fissure walls, with consequent deposition of new bone in the surgically created intrabony defect.