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Elevation in the presence of an antral pseudocyst and simultaneous implant placement

Prof. Yong-Dae Kwon
Seoul, South Korea

  

Clinical Challenge

A middle-aged male came to the clinic for dental implant placement. The panoramic radiography showed a hazy shadow in the right maxillary sinus. A CBCT scan was taken for further evaluation and revealed a dome-shaped radiopacity. The radiographic impression was an antral pseudocyst. In the region of the 1st molar the residual bone height was enough to avoid a lateral window approach. But the morphology of the residual ridge in the 1st molar area and the presence of an antral pseudocyst were not favorable indicators for a transcrestral sinus floor elevation.

  

Clinical outcome at a glance

Objectives

  • Lateral sinus floor elevation using Geistlich Bio-Oss Pen® and Geistlich Bio-Gide®.
  • Augmentation is simultaneous with implant placement in sites 16 and 17.
  • Aspiration of a small systic lesion in the sinus cavity.

Conclusions 

  • One-stage sinus floor elevation treatment.
  • Very promising clinical outcome with the use of Geistlich Bio-Oss Pen® and Geistlich Bio-Gide®.
  • Geistlich Bio-Gide® is very suitable for repairing a perforated Schneiderian membrane.

Aim / Approach

In order to ensure that the radiopacity would be nothing but a non-symptomatic antral pseduocyst, sinus floor elevation via the lateral window technique was planned. After opening up a bony window, I was able to aspirate the small cystic lesion with yellowish mucus. During the procedure, a perforation was found and successfully repaired with a Geistlich Bio-Gide®.

Conclusion

Geistlich Bio-Gide® is because of its easy manipulation and its good adhesion to the Schneiderian membrane a great product for the perforation repair and should be properly trimmed and placed to ensure it spreads sufficiently to completely cover the perforation.