Maxillary sinus elevation, followed by placement of a wide variety of grafting materials, has been the generally accepted surgical protocol for the development of bone in the sinus cavity. Over the years, various techniques have been proposed for maxillary sinus elevation, which differ in surgical approach, bone graft materials, and advanced technology application for hard tissue and soft tissue management. Dr. Kao and a team of experts begin by discussing anatomy, radiographic image applications and limitations, and then provide step-by-step clinical procedures for the lateral window technique, including piezosurgery, and the trans-alveolar methods, including balloon and controlled hydostatic sinus elevation. Also included are chapters on post-operative care and complication management.

While an oral surgery resident in training at the University of Michigan in 1977, I observed a strange phenomenon in a maxillary fracture patient. A unilateral ossification of the maxillary antrum occurred following a Le Fort III fracture that had been treated the year before. I wondered how trauma around the antrum due to an impacted maxilla and the inferiorly displaced orbital rim could lead to an ossified maxillary sinus. The trauma was bilateral, yet only one side responded by ossification. Furthermore, there appeared to be no functional impairment of the sinus. This unusual finding remained a mystery to me for many years. It wasn't until 1980, when Phil Boyne published the first paper on the sinus augmentation graft, that the mystery began to be solved. He found that preservation of the elevated sinus membrane created a confined space in which bone had the potential to form. Dr Boyne went on to show, in a primate study, that bone would readily form in the sinus floor, but that the newly formed bone would completely resorb over a period of a year unless dental implants were placed to help maintain the bone. Many other workers began to experiment with various bone-grafting materials, both in animals and clinically. Remarkably, most of the materials demonstrated new bone formation in the graft sites. Because dental implants were generally used as the measure of bone graft success and since there were very few implant failures reported in the literature, confusion resulted as to which grafting material to use. It seemed they all worked. To sort this out, a few patients with 5 to 7 mm of available bone were treated with sinus elevation and Gore-Tex over the lateral osteotomy site only. Despite no graft material be used, bone formed. As long as the sinus membrane remained intact, bone formed beneath the sinus membrane that had been tented up by simultaneously placed implants. The need to use any graft material at all appeared to be brought into question. At the same time, practitioners lined up in two camps: those who placed implants in delayed fashion after graft maturation and those who preferred simultaneous implant placement. Both approaches published a high level of success seeming to substantiate their protocols, but once again the measure of success was hampered by the lack of any human evidence for efficacy. A 5-year implant retrieval study was undertaken using standard titanium mini-implants that had been placed simultaneously with grafting. Interestingly, bone did not form well around these implants in this setting despite positive reviews in animal studies. Could we conclude that the delayed approach was preferred, or was there another factor, such as the implant surface, that could be important? Hydroxyapatite-coated, titanium plasma-sprayed, and acid-etched titanium implant surfaces seemed to do well in the grafted bone. Could this be the answer for implants placed into sinus bone grafts? As these developments are progressing, new interest is generated in jump-starting the natural inductive processes of bone formation through pharmacokinetics. Early results of human studies now appear to be favorable for using bone morphogenetic protein as a graft alternative that stands to modify all of the protocols in use to date. How these various approaches work toward definitive answers to the basic biologic and clinical questions is what this book is all about. The authors attempt to answer the how, why, when, and where of sinus grafting. It is hoped that the state of the art of sinus grafting will be elucidate for the reader in the ongoing quest for scientific knowledge and its clinical appilcation that will ultimately lead to excellence in patient care.

This completely revised and greatly expanded edition offers authoritative recommendations concerning all aspects of sinus bone grafting procedures for rehabilitation of the atrophic maxilla. Written for the uninitiated as well as the experienced clinician, this comprehensive clinical monograph also guides readers through the maze of new materials and techniques that have been introduced to improve upon or even supplant this procedure. It answers questions such as whether autogenous bone is necessary and where best to harvest it; which bone substitutes are most effective in regenerating bone and how safe they are to use; what contraindications exist, and what complications might be expected; what characteristics of size/shape/surface morphology are most important in choosing an implant; and many others. The last section of the book explores the future prospects for genetic engineering and other gene-based therapies that may one day eliminate the need for bone grafting.

Placement of endosseous implants in the posterior maxilla is often difficult because of a lack of supporting bone. Sinus augmentation procedures have therefore been extensively used for the treatment of the edentulous atrophic posterior maxilla prior to implant placement. This book describes in detail the most widely used sinus grafting techniques as well as some innovative variations, with full coverage of both lateral and crestal approaches. A key aim is to assist the practitioner in selecting the appropriate sinus grafting technique based on the evaluation of a number of parameters that are described in detail and codified in a simple and practical way. Up-to-date information is also provided on grafting materials and on potential complications of sinus augmentation procedures and their treatment.

Comprehensively describes bone augmentation techniques and their application to the different anatomical regions of the upper and lower jaws. Bone Augmentation by Anatomical Region is a unique, evidence-based guide focusing on each specific anatomical region – anterior maxilla, posterior maxilla, anterior mandible, and posterior mandible – in order to emphasize the correct implemented procedures needed to successfully perform oral osseous reconstruction. Numerous ridge augmentation techniques are covered, including: horizontal and vertical guided bone regeneration, autologous block transplantation, interpositional bone grafting, allogeneic blocks, sandwich technique, split-expansion ridge technique, and sinus floor grafting. Non-augmented approaches such as forced socket site extrusion and the installation of digitally printed implants are also presented and discussed. Guides readers on tackling bone augmentation via anatomical region of the jaws and their related surrounding muscles, vascularization and innervation Presents innovative augmentation techniques for the anterior maxilla, posterior maxilla, anterior mandible, and posterior mandible Includes clinical photographs in each section and a decision tree to help readers select the appropriate surgical modality Bone Augmentation by Anatomical Region is a specialist resource suitable for dentists who practice implant dentistry, oral surgeons, oral and maxillofacial surgeons, periodontists, and postgraduate dental students in the above-mentioned disciplines. Please note Due to recently developments, part of Chapter 2 Biologic Conditions for Bone Growth and Maintenance: Managing the Oxidative Stress has been amended which will be available in all future reprints. All electronic versions have been updated.

Diseases and Conditions in Dentistry: An Evidence-Based Reference is the ideal, one-stop guide for dentistry clinicians to keep at their side. Provides a quick reference for the busy clinician covering diseases and conditions in endodontics, periodontics, prosthodontics and restorative dentistry Offers identically formatted chapters following the same clear and concise layout with detailed clinical cases and evidence-based discussions Features a companion website with additional clinical photographs, radiographs, and case notes

This book explores the potential of bone grafting techniques to rehabilitate the maxilla through the placement of dental implants. As implant dentistry becomes increasingly well established and sophisticated, this book will help experienced surgeons to involve implant solutions as part of more challenging reconstructions in the upper jaw. Starting with a recap on principles of bone biology, the book then considers implant integration in normal bone and with bone grafts. Grafting procedures are presented depicting a variety of bone harvest sites, followed by onlay and inlay grafting techniques. Approaches to sinus lifting, segmental osteotomy and distraction osteogenesis for augmentation protocols are provided.