Simultaneous Sinus-Lift and Implantation Using Microthreaded Implants and Leukocyte- and Platelet-Rich Fibrin as Sole Grafting Material: A Six-Year Experience

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Published: Tuesday, 17 March 2015 13:05 Written by 

Sinus-lift for implant placement is a very predictable and reproducible surgery.1,2 The choice of the technique, either lateral using a Caldwell-Luc osteotomy or axial with the Summers osteotomy,3 is mainly dependent on the residual bone height of the alveolar ridges, and both techniques show similar results.2,4 One key question that remains is to define the best filling material for the subsinus cavity after lifting the sinus membrane. The consensualapproach is to consider that most materials are efficient for this surgery, considering the high osteogenic potential of the Schneiderian membrane and its periosteum-like behavior.5,6 However, the choice of material or association of materials will influence the waiting period before adequate healing and remodeling of the grafted material, implant placement, and functional loading. Many materials are potentially usable in this clinical situation7: autogenous bone graft (parietal, iliac, chin, retromolar, etc), xenograft (bovine, swine, etc), and allograft or synthetic (!-tricalcium phosphate, hydroxyapatite, etc). Recently, the possibility of sinus-lift without any grafted material is hotly debated, following the concepts of guided bone regeneration. Indeed, in a closed cavity such as a lifted sinus, the osteogenic potential of the bone and the sinus membrane is highly protected and efficient. This concept of limited grafting was first developed with the Summers osteotomy, using no grafting material even in thin residual bone height.4,8 And, recently, authors have shown that a full sinus-lift can be performed using the lateral approach with whole blood as sole filling material.9,10 The key point of this new guided bone regeneration strategy is to maintain the Schneiderian membrane in the highest possible position, using simultaneous

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