الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
The purpose of this research was to determine the effectiveness of Lateral Antrostomy Sinus Lifting Technique with Simultaneous Implant Placement without Bone Graft. A total of 7 patients has been chosen from the outpatient clinic of the Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Alexandria University with missing maxillary posterior teeth (Kennedy Classification: Class 1 or Class 2) who met the inclusion and exclusion criteria. The selected patients’ age was ranged between 38-50 years with a mean of 42.86 years. A total of 12 implants were placed.
Preoperative CBCT x-rays were performed on each patient on which the sinus dimensions and anatomy were studied. The operative procedure has been performed through raising a full-thickness mucoperiosteal flap, accessing the maxillary sinus area for lifting through a piezoelectric window osteotomy followed by collagen membrane placement, and simultaneous implant insertion, and After 6 months, implant stability was measured again followed by placement of a fixed prosthesis.
Clinical results revealed that all pain scores were limited to mild with a statistically significant decrease in the pain from the 1st to the 7th day. All patients showed signs of mild edema, which is edema confined to the surgical site. None of the participants encountered any postoperative complications. Implant stability was measured immediately postoperative and after 6 months showing an average increase of 16.66 ± 3.3 in ISQ values. Radiographic evaluation showed a statistically significant amount of vertical bone height gain after 6 months with an average of 10.03 ± 0.73 mm. The preoperative mean bone volume was found to be 1.098 ±0.147 cm3 and it was increased significantly to 1.644 ± 0.192 cm3 after 6 months. The mean bone density value was found to be 410.00 ± 55.07 HU immediately after the procedure and 577.00 ± 226.51 HU after six months. This was found to be a statistically insignificant difference. The average marginal bone loss was found to be 0.93 ± 0.37 mm with a minimum value of 0.52 mm and a maximum value of 1.70 mm.
6.2 Conclusion
After conduction of the study, the following could be concluded:
● Graftless sinus lifting through lateral window displayed successful outcomes in regards to safety and effectiveness.
● It was found that new bone was observed radiographically formed directly on and around the placed implants dispensing using any grafting material.
● With the aid of the piezoelectric device, lateral window osteotomy became possible with less incidence of sinus membrane tearing.
● Dispensing the use of bone substitutes meaning that the morbidity of harvesting donor site for graft collection can now be avoided also less surgical time, which led to decreased postoperative pain, edema and liability to infection.
● The lateral window position facilitates sinus membrane visibility and detachment, and also decreases the intraoperative and postoperative complications.