Crestal Sinus Lift with Thick Mucosal Lining: thoughts?

Last Updated: Mar 03, 2016

51y/o old Male patient with edentulous maxilla wants implant supported overdenture.
I need to install implant in the posterior for A-P spread. CBCT shows thickening of mucosal lining of the sinus and mucosal retention cyst ( possible ) in the right side. There is 8mm bone ht need to do crestal lift ( CAS kit ) by another 2mm to install 4.2 x 10mm implant. Pt has no sinusitis symptoms. Do I need clearance from ENT??. or I can have pt take Augmentin 825mg/125mg 1 tab bid starting 1 day prior to surgery and
continue for 5 days. How should I proceed? Appreciate your expert opinions.

11 Comments on Crestal Sinus Lift with Thick Mucosal Lining: thoughts?

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pascal valentini

03/08/2016

I would use short implants .

Alejandro Berg

03/08/2016

A sinus lift is completely possible and a thick sinus membrane will almost ensure no tearing. A few extra things, first I would use levofloxacin 500mg e/24h x10d starting 2 days before surgery, second i would irrigate copiously the osteotomy and the elevated area prior to installation with metronidazol 500mg i/v solution and third, that curvature and membrane thickness means more work so patience and extra time for the procedure. cheers

PeterFairbairn

03/08/2016

Agree 8 mm will be fine , but with this small amount of thickening ( which varies at any moment ) there should be less chance of a tear anyway when doing internal with these systems ... Peter

PeterFairbairn

03/08/2016

Haha Alejandro we were writing at same time ...... how are you

valentini

03/08/2016

levoflaxin is a dangerous antibiotic because of the high risk of fracture for the Achille tendon. Anyway in that case there is no indication for sinus lift crystal or lateral

valentini

03/08/2016

levoflaxin is a dangerous antibiotic because of the high risk of fracture for the Achille tendon.

Dr Gilani

03/08/2016

I don't see any problem with your planning as long as 4.2 mm implant is the diameter. BTW Augmentin is a bit of overkill for this surgery, while the use of AB in implant surgery is controversial in the first place.

sbmnath

03/09/2016

you can use 8mm length implant and avoid sinus lift

Kaz

03/13/2016

There was a ENT at the last AAID meeting that spoke and he said that unless there is generalized inflammation ( thickened membrane around the whole periphery of the sinus) and you did not risk occluding the meatus by elevating the membrane too high, you do not need an ent clearance.

Kaz

03/13/2016

Sorry, ENT consult

Namita Dutta

03/13/2016

THANKS for all your comments. I ended up using short 4.2x8 implants .They had 45+ insertion torque. Appreciate you all..... Namita

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