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Placement of posterior maxillary implants in partially edentulous patients with severe bone deficiency using CAD/CAM guidance to avoid sinus grafting: a clinical report of procedure.
Int J Oral Maxillofac Implants. 2009 Jan-Feb; 24(1):96-102.IJ

Abstract

PURPOSE

To provide a detailed presentation of computer-aided design/computer-assisted manufacture guidance in severely resorbed posterior maxillae to place implants in a very limited amount of bone, thus avoiding sinus grafting.

MATERIALS AND METHODS

Based on computerized tomography (CT) axial images, implant positions are planned using imaging software. A surgical template is fabricated and drilled with a numerically controlled machine to transfer the planned positions to bone with high accuracy. To avoid sinus grafting, implants can be planned in the anterior or posterior wall and in the septa of the sinus as well as in the palatal curvature. Recipient site preparation is done transgingivally with a drill or with a dedicated bone spreader to increase the amount of bone when necessary.

RESULTS

Fifteen resorbed posterior maxillae were treated with a fixed prosthesis supported by a combination of 42 upright and tilted implants. In all cases, implants were placed as planned. Seventeen implants were tilted at a 20- to 35-degree angle with the line perpendicular to the axial CT images. Seven implants were placed in the palatal curvature, 11 implants were close to the anterior wall, and two of them in combination with the palatal curvature. Only one implant was placed close to the posterior wall and two were placed in septa. All patients attended scheduled follow-up visits. During the 4-year observation period, no complications were recorded, no implants were lost, and there was no infection or inflammation.

CONCLUSION

This proof-of-concept study suggests that the use of an image-guided system associated with bone spreading for oral implant placement in the atrophic posterior maxilla can be an alternative to sinus grafting.

Authors+Show Affiliations

Department of Oral Surgery, Dental University of Lyon, France. Thomas.fortin@rockefeller.univ-lyon1.frNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19344031

Citation

Fortin, Thomas, et al. "Placement of Posterior Maxillary Implants in Partially Edentulous Patients With Severe Bone Deficiency Using CAD/CAM Guidance to Avoid Sinus Grafting: a Clinical Report of Procedure." The International Journal of Oral & Maxillofacial Implants, vol. 24, no. 1, 2009, pp. 96-102.
Fortin T, Isidori M, Bouchet H. Placement of posterior maxillary implants in partially edentulous patients with severe bone deficiency using CAD/CAM guidance to avoid sinus grafting: a clinical report of procedure. Int J Oral Maxillofac Implants. 2009;24(1):96-102.
Fortin, T., Isidori, M., & Bouchet, H. (2009). Placement of posterior maxillary implants in partially edentulous patients with severe bone deficiency using CAD/CAM guidance to avoid sinus grafting: a clinical report of procedure. The International Journal of Oral & Maxillofacial Implants, 24(1), 96-102.
Fortin T, Isidori M, Bouchet H. Placement of Posterior Maxillary Implants in Partially Edentulous Patients With Severe Bone Deficiency Using CAD/CAM Guidance to Avoid Sinus Grafting: a Clinical Report of Procedure. Int J Oral Maxillofac Implants. 2009 Jan-Feb;24(1):96-102. PubMed PMID: 19344031.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Placement of posterior maxillary implants in partially edentulous patients with severe bone deficiency using CAD/CAM guidance to avoid sinus grafting: a clinical report of procedure. AU - Fortin,Thomas, AU - Isidori,Michel, AU - Bouchet,Hervé, PY - 2009/4/7/entrez PY - 2009/4/7/pubmed PY - 2009/6/26/medline SP - 96 EP - 102 JF - The International journal of oral & maxillofacial implants JO - Int J Oral Maxillofac Implants VL - 24 IS - 1 N2 - PURPOSE: To provide a detailed presentation of computer-aided design/computer-assisted manufacture guidance in severely resorbed posterior maxillae to place implants in a very limited amount of bone, thus avoiding sinus grafting. MATERIALS AND METHODS: Based on computerized tomography (CT) axial images, implant positions are planned using imaging software. A surgical template is fabricated and drilled with a numerically controlled machine to transfer the planned positions to bone with high accuracy. To avoid sinus grafting, implants can be planned in the anterior or posterior wall and in the septa of the sinus as well as in the palatal curvature. Recipient site preparation is done transgingivally with a drill or with a dedicated bone spreader to increase the amount of bone when necessary. RESULTS: Fifteen resorbed posterior maxillae were treated with a fixed prosthesis supported by a combination of 42 upright and tilted implants. In all cases, implants were placed as planned. Seventeen implants were tilted at a 20- to 35-degree angle with the line perpendicular to the axial CT images. Seven implants were placed in the palatal curvature, 11 implants were close to the anterior wall, and two of them in combination with the palatal curvature. Only one implant was placed close to the posterior wall and two were placed in septa. All patients attended scheduled follow-up visits. During the 4-year observation period, no complications were recorded, no implants were lost, and there was no infection or inflammation. CONCLUSION: This proof-of-concept study suggests that the use of an image-guided system associated with bone spreading for oral implant placement in the atrophic posterior maxilla can be an alternative to sinus grafting. SN - 0882-2786 UR - https://www.unboundmedicine.com/medline/citation/19344031/Placement_of_posterior_maxillary_implants_in_partially_edentulous_patients_with_severe_bone_deficiency_using_CAD/CAM_guidance_to_avoid_sinus_grafting:_a_clinical_report_of_procedure_ DB - PRIME DP - Unbound Medicine ER -