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Progressive immediate loading of a perforated maxillary sinus dental implant: a case report.

Al-Juboori MJ - Clin Cosmet Investig Dent (2015)

Bottom Line: The displacement of a dental implant into the maxillary sinus may lead to implant failure due to exposure of the apical third or the tip of the implant beyond the bone, resulting in soft tissue growth.This case report discusses dental implant placement in the upper first molar area with maxillary sinus involvement of approximately 2 mm.Follow-up was performed with resonance frequency analysis and compared with an implant placed adjacent in the upper second premolar area using a conventional delayed loading protocol.

View Article: PubMed Central - PubMed

Affiliation: Department of Oral Surgery, MAHSA University, Kuala Lumpur, Malaysia.

ABSTRACT
The displacement of a dental implant into the maxillary sinus may lead to implant failure due to exposure of the apical third or the tip of the implant beyond the bone, resulting in soft tissue growth. This case report discusses dental implant placement in the upper first molar area with maxillary sinus involvement of approximately 2 mm. A new technique for progressive implant loading was used, involving immediately loaded implants with maxillary sinus perforation and low primary stability. Follow-up was performed with resonance frequency analysis and compared with an implant placed adjacent in the upper second premolar area using a conventional delayed loading protocol. Implants with maxillary sinus involvement showed increasing stability during the healing period. We found that progressive implant loading may be a safe technique for the placement of immediately loaded implants with maxillary sinus involvement.

No MeSH data available.


Related in: MedlinePlus

Temporary abutment and crown installed into the 26-position implant and torque before flap closure. Cover screw used for the 25-position implant, which was placed with the submerged technique and left to heal for 2 months before re-entry.
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f3-ccide-7-025: Temporary abutment and crown installed into the 26-position implant and torque before flap closure. Cover screw used for the 25-position implant, which was placed with the submerged technique and left to heal for 2 months before re-entry.

Mentions: The patient was a 52-year-old woman with no history of systemic disease or parafunctional occlusion. The patient presented to our facility with a main request to replace her missing maxillary left second premolar and first molar with implants. An orthopantomogram was taken (Figure 1), and after clinical and radiographic examination, a taper implant with a 4.0 mm width and a 10 mm length was selected for replacement of both teeth. Using local anesthesia, a crestal incision was performed without vertical extension. The bone was then exposed and prepared according to the manufacturer’s recommendations. During preparation of the first molar socket, the resistance to drilling decreased, indicating sinus floor penetration. Because the bone density was poor, the final drill was inserted halfway, and two implants with a diameter of 4.0 mm and length of 10 mm were placed, replacing the first molar and second premolar. The implant design was a tapered, modified surface (sand-blasted, large grit, acid-etched [SLA]) that was threaded to the top (Superline™, Dentium, Cypress, CA, USA) to achieve better implant stability and increase the implant surface area in contact with the surrounding bone. Implants were placed approximately 1 mm subcrestally, and resonance frequency analysis (RFA) measurements were taken for both implants (Table 1). The reading for the second premolar implant was 73 ISQ (implant stability quotient) in all four directions, and for the first molar implant, the reading was 69 ISQ in all directions except for the buccolingual direction, which was 64 ISQ. A cover screw was placed on the second premolar implant and covered with gingival tissue to obtain primary closure and allow healing using the submerged technique. The first molar implant was immediately loaded with a temporary plastic abutment, and a crown was fabricated from a light-cured composite resin material (Figure 2). At this stage, the crown was out of occlusion, with a narrow occlusal table and no interproximal contact (Figures 3 and 4). The tissue flap was adapted to the temporary crown, and the gingiva was sutured around it (Figure 5). A periapical radiograph was taken postoperatively for both implants and was considered a basic radiograph (Figure 6). The radiograph shows the implant in the molar area penetrating the maxillary sinus approximately 2–3 mm.


Progressive immediate loading of a perforated maxillary sinus dental implant: a case report.

Al-Juboori MJ - Clin Cosmet Investig Dent (2015)

Temporary abutment and crown installed into the 26-position implant and torque before flap closure. Cover screw used for the 25-position implant, which was placed with the submerged technique and left to heal for 2 months before re-entry.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4317063&req=5

f3-ccide-7-025: Temporary abutment and crown installed into the 26-position implant and torque before flap closure. Cover screw used for the 25-position implant, which was placed with the submerged technique and left to heal for 2 months before re-entry.
Mentions: The patient was a 52-year-old woman with no history of systemic disease or parafunctional occlusion. The patient presented to our facility with a main request to replace her missing maxillary left second premolar and first molar with implants. An orthopantomogram was taken (Figure 1), and after clinical and radiographic examination, a taper implant with a 4.0 mm width and a 10 mm length was selected for replacement of both teeth. Using local anesthesia, a crestal incision was performed without vertical extension. The bone was then exposed and prepared according to the manufacturer’s recommendations. During preparation of the first molar socket, the resistance to drilling decreased, indicating sinus floor penetration. Because the bone density was poor, the final drill was inserted halfway, and two implants with a diameter of 4.0 mm and length of 10 mm were placed, replacing the first molar and second premolar. The implant design was a tapered, modified surface (sand-blasted, large grit, acid-etched [SLA]) that was threaded to the top (Superline™, Dentium, Cypress, CA, USA) to achieve better implant stability and increase the implant surface area in contact with the surrounding bone. Implants were placed approximately 1 mm subcrestally, and resonance frequency analysis (RFA) measurements were taken for both implants (Table 1). The reading for the second premolar implant was 73 ISQ (implant stability quotient) in all four directions, and for the first molar implant, the reading was 69 ISQ in all directions except for the buccolingual direction, which was 64 ISQ. A cover screw was placed on the second premolar implant and covered with gingival tissue to obtain primary closure and allow healing using the submerged technique. The first molar implant was immediately loaded with a temporary plastic abutment, and a crown was fabricated from a light-cured composite resin material (Figure 2). At this stage, the crown was out of occlusion, with a narrow occlusal table and no interproximal contact (Figures 3 and 4). The tissue flap was adapted to the temporary crown, and the gingiva was sutured around it (Figure 5). A periapical radiograph was taken postoperatively for both implants and was considered a basic radiograph (Figure 6). The radiograph shows the implant in the molar area penetrating the maxillary sinus approximately 2–3 mm.

Bottom Line: The displacement of a dental implant into the maxillary sinus may lead to implant failure due to exposure of the apical third or the tip of the implant beyond the bone, resulting in soft tissue growth.This case report discusses dental implant placement in the upper first molar area with maxillary sinus involvement of approximately 2 mm.Follow-up was performed with resonance frequency analysis and compared with an implant placed adjacent in the upper second premolar area using a conventional delayed loading protocol.

View Article: PubMed Central - PubMed

Affiliation: Department of Oral Surgery, MAHSA University, Kuala Lumpur, Malaysia.

ABSTRACT
The displacement of a dental implant into the maxillary sinus may lead to implant failure due to exposure of the apical third or the tip of the implant beyond the bone, resulting in soft tissue growth. This case report discusses dental implant placement in the upper first molar area with maxillary sinus involvement of approximately 2 mm. A new technique for progressive implant loading was used, involving immediately loaded implants with maxillary sinus perforation and low primary stability. Follow-up was performed with resonance frequency analysis and compared with an implant placed adjacent in the upper second premolar area using a conventional delayed loading protocol. Implants with maxillary sinus involvement showed increasing stability during the healing period. We found that progressive implant loading may be a safe technique for the placement of immediately loaded implants with maxillary sinus involvement.

No MeSH data available.


Related in: MedlinePlus