Restoration of the Pneumatized Partially Edentulous Maxilla
FREDERICK J. NAU, D.D.S.
Clinical Assistant Professor, NYU
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.