الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
This study was conducted on 14 implants placed in 13 patients (10 females and 3 males) selected from the Outpatient Clinic of the Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Alexandria University. Patients had missing maxillary posterior teeth (premolars and molars) indicated for transcrestal sinus lifting and implant placement. The selected patients age ranged from 23- 47 years old with mean of 35.92 ± 8.61 years old.
This work aimed to evaluate clinically and radiographically the simultaneous implant placement after Schneiderian membrane elevation using the maxillary sinus balloon technique and DASK drills and grafting with synthetic bone graft.
All patients were operated under local anesthesia. The surgical template was checked for proper seating. Full thickness incision down to the bone with blade no.15, 2 to 3 mm on the palatal side of the crest of the ridge at the planned surgical site. The osteotomy was performed with a customized drilling sequence according to manufacture’s instructions to the preplanned depth 1 mm away from the Schneiderian membrane.
The remaining subantral bone of 1 mm was removed using DSAK drills of the appropriate size and the sinus floor is carefully approached under light apical pressure. When the sinus floor is yielded, the drill was removed. The balloon was inserted in the sub antral space, performing progressive, slow and controlled insufflations with saline solution.
The grafting material (GUIDOR calc-i-oss CRYSTAL) of 0.25 ml was introduced and pressed into each implant site. The selected implant was placed into the osteotomy site. The definitive restoration was delivered to all patients after 6 months.
Clinical results revealed mild pain among five patients and moderate pain among three patients that lasted for 1-3 days. Four patients suffered from trace edema which subsided by the 2nd postoperative day and two patients suffered from mild edema which was resolved on the 4th day postoperatively. One patient presented with tearing of the sinus membrane during inflation of the balloon which was discovered by Valsalva maneuver.
In the sixth month, the mean peri-implant bone density was 771.1 ± 239.1 HU with a minimum recorded value of 403.3 and a maximum recorded value of 1205.8 HU. These differences were statistically significant (p <0.001). While, the mean vertical bone height value was 10.45 ± 1.56 mm with a minimum recorded value of 7.64 mm and a maximum recorded value of 13.15 mm. These differences were statistically significant (p <0.001).
Based on the above results we can concluded that transcrestal sinus lift using the sinus balloon technique is a minimally invasive procedure involving few intraoperative complications and with a 100% implant success rate 6 months postoperatively.