Surgery and Restoration of the Pneumatized Partially Edentulous Maxilla

Clinical Assistant Professor, NYU
Private Practice
New York, NY U.S.A.




The presenter, a general dentist, will present a case report involving a change in treatment plan. Originally a natural tooth and implant-borne posterior cantilever prosthesis was chosen. With the advent of sinus grafting, the restoration was changed to one of being totally fixutre retained without sacrifice of tooth structure. Concepts presented include: first and second state surgical technique, graft selection, biomechanics, wide diameter fixtures, cement vs. screw retention and progressive loading.

In 1990 a patient presented for fixed prosthetic rehabilitation of an edentulous posterior quadrant. Available bone and patient resistance to sinus surgery led to the placement of only TPS hexed cylindrical implant which successfully integrated. Easily tolerated surgery and a reluctance to traumatization of the canine finally persuaded the patient to agree to sinus grafting. A sinus lift and simultaneous placement of two more TPS cylinders was commenced. Clinical and didactic elements will jointly be presented through case completion.

A favorable result was obtained by adhering to basic tenents and proper case selection. The technique as developed by Tatum in 1976 has shown clinical promise and it is only in the 1990's that it has become a mainstream modality. Controlled multicenter studies and a greater understanding of bone physiology are needed to insure higher predicability of this procedure.

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