Two-stage crestal sinus elevation by sequential drills in less than 4 mm of residual ridge height: a clinical and histologic case report

Implant Dent. 2014 Aug;23(4):378-86. doi: 10.1097/ID.0000000000000120.

Abstract

Purpose: The aim of this work, the first human histologic case report of this technique, was a clinical and histologic evaluation of implant placed in a severely atrophic maxilla using a 2-stage crestal sinus elevation.

Case presentation: A 52-year-old woman required rehabilitation of an atrophic maxilla with a fixed implant-supported prosthesis. At the first surgery, a crestal sinus lift was performed using beta-tricalcium phosphate (β-TCP), as radiographic tracer, and mineralized human bone allograft (MHBA) as grafting material. After 6 months, a bone core biopsy was taken, and 2 implants were placed in the augmented sites. Four months later, implants were exposed, and 2 splinted gold-porcelain crowns were delivered. Histology highlighted basal bone disappearance, replaced by a wide composite network (∼50% vol/vol) of MHBA granules connected by newly formed bone, and osteoblastic activities.

Conclusion: This case report demonstrates the possibility of executing a staged transcrestal sinus lift in atrophic situations. MHBA evidenced usefulness in maintaining bone volume. Histologic analyses confirmed the sound outcome of the graft augmentation. Additional studies would be beneficial to confirm or refute the reliability of this technique.

Publication types

  • Case Reports

MeSH terms

  • Alveolar Process / diagnostic imaging
  • Alveolar Process / surgery*
  • Cone-Beam Computed Tomography
  • Female
  • Humans
  • Middle Aged