Bilateral simultaneous augmentation of the maxillary sinus floor with particulated mandible. Report of a technique and preliminary results

This paper describes a surgical technique that permits the achievement of bilateral simultaneous augmentation of the maxillary sinus floor with the use of autologous bone harvested from the mandibular symphysis alone. Out of a group of 26 partially edentulous patients consecutively treated for sinus augmentation in an 18-month period, eight needed a bilateral procedure and were treated with the same surgical protocol. None of the patients had residual molar teeth, crestal bone height was reduced to 4 mm or less. Bone was harvested from the chin in blocks with a trephine bur, 11 or 9 mm in diameter it was then particulated with a bone mill. Sinus augmentation and implant placement were done simultaneously in both sides of the maxilla. Implant-supported fixed partial dentures were inserted 6 months after the procedure. 44 ITI solid screw implants were placed in the grafted sinuses with a mean of 2.75 implants on each side. Mean follow-up was 19 months. In all patients needing a bilateral sinus lift, the procedure could be successfully completed. All implants were stable at abutment connection. All implants are stable at the latest follow-up, and all prosthesis are still working. In all implants, a clear bone-to-implant contact was visible. No peri-implant radiolucency has been noticed so far. It is concluded that bilateral augmentation of maxillary sinus floor with particulated mandible associated with simultaneous ITI implant insertion is feasible. It is a safe and effective procedure that can be accomplished in an out-patient environment with only minor discomfort for the patient.