الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Due to the inadequate alveolar bone height in the posterior maxilla, or due to increased pneumatization of the maxillary sinus, the rehabilitation of this area through dental implants brings several difficulties.
The present study included 7 implants placed in 7 patients both males and females with atrophied posterior maxillary region and/or excessively pneumatized maxillary sinus. All the patients were free from any systemic disease that might complicate the surgical procedure or the bone healing around implants.
All patients were evaluated pre-operatively, clinically and radiographically through panoramic x-ray and CBCT to evaluate the residual bone width and height in respect to the maxillary sinus.
All patients were subjected to ENT consultation to exclude maxillary sinus pathology. They were informed with the procedure, and a written consent was taken. Also, they were given premedication prior to surgery.
Sinus elevation was carried out through an osteotomy performed on the lateral wall of the sinus using piezosurgery. Implants were placed and PRF was prepared according to Choukron’s method by using a table centrifuge.
Instead of placing autogenous bone or allogeneic bone substitute into the sinus space as fillers, we tented the elevated sinus membrane using the implant fixtures to maintain the elevated sinus space then, the PRF was introduced into the sinus cavity between the implants and the membrane as a sole filling material
Follow up using periapical radiographic examination was carried out immediate, and at 1 and 4 months. CBCT was carried out immediately and at 6 months postoperatively. Implants were loaded at 4 month post-operatively.
In all 7 implants wound healing was uneventful and no patients developed any complications leading to implant loss following the sinus lifting with simultaneous implant placement.
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Also, there was a significant increase in bone height, which ranged from 10.40 mm to 11.90 mm (Mean ± SD, 11.35 ± 0.56 mm) with a mean percentage of change of 97.05%. In addition, the density of the new bone formed around implants after 6 post-operative months ranged from 250.0 to 798 HU (Mean ± SD, 507.0 ± 191.24 HU).
Bone density around the implants after 6 post-operative months also increases significantly and ranged from 245.0 HU to 803 HU (Mean ± SD, 547.71 ± 188.42 HU), with a mean percentage of change 88.79%.
Marginal ridge resorption at 6 month postoperatively ranged from 0.48–1.20 mm (Mean ± SD, 0.82 ± 0.25 mm).
Thus, the combined use of PRF and piezosurgery during lateral sinus lifting procedure with simultaneous implant placement is considered a reliable option for maxillary sinus augmentation.