The Sinus Bone Graft

This completely revised and greatly expanded edition offers authoritative recommendations concerning all aspects of sinus bone grafting procedures for rehabilitation of the atrophic maxilla. Written for the uninitiated as well as the experienced clinician, this comprehensive clinical monograph also guides readers through the maze of new materials and techniques that have been introduced to improve upon or even supplant this procedure. It answers questions such as whether autogenous bone is necessary and where best to harvest it; which bone substitutes are most effective in regenerating bone and how safe they are to use; what contraindications exist, and what complications might be expected; what characteristics of size/shape/surface morphology are most important in choosing an implant; and many others. The last section of the book explores the future prospects for genetic engineering and other gene-based therapies that may one day eliminate the need for bone grafting

Table of Contents

Section I Biologic, Biomechanical, and Prosthetic Considerations
1. History of Maxillary Sinus Grafting - Philip J. Boyne
2. Biologic Basis of Sinus Grafting - Georg Watzek, Gabor Fürst, and Reinhard Gruber
3. Vital Biomechanics of Bone and Bone Grafts - Harold M. Frost and Ole T. Jensen
4. Indications for and Classification of Sinus Bone Grafts - Carl E. Misch, Matteo Chiapasco, and Ole T. Jensen
5. Sinus Floor Augmentation: Simultaneous Versus Delayed Implant Placement - Ronald M. Achong and Michael S. Block
6. Sinus Floor Augmentation at the Time of Tooth Removal - Paul A. Fugazzotto and Ole T. Jensen
7. Prosthetic Management of the Sinus Graft Patient - Ira D. Zinner, Stanley A. Small, and Lloyd S. Landa
8. Contraindications for Sinus Graft Procedures - Matteo Chiapasco, Joel L. Rosenlicht, Salvatore L. Ruggiero, and Ronald E. Schneider
9. Complications of Maxillary Sinus Augmentation - Michael A. Pikos
10. Sinus Reactions to Invasive Surgery - Chantal Malevez

Section II Graft Sources and Materials
11. Maxillofacial Donor Sites for Sinus Floor and Alveolar Reconstruction - Craig M. Misch
12. Tibia Bone Grafting for Sinus Augmentation - Robert E. Marx
13. Sinus Augmentation with Bone Harvested from the Ilium - R. Gilbert Triplett and Sterling R. Schow
14. Sinus Augmentation with Bone Harvested from the Calvarium - Jean F. Tulasne
15. Safety and Efficacy of Bone Allograft for Sinus Grafting - Laureen Langer, Burton Langer, and James T. Mellonig
16. Use of Alloplasts for Sinus Floor Grafting - Ole T. Jensen, Giuliano Garlini, Dieter Bilk, and Fabian Peters
17. Use of Xenografts for Sinus Augmentation - Stuart J. Froum, Stephen S. Wallace, Sang-Choon Cho, and Dennis P. Tarnow

Section III Technical Variations and Auxiliary Procedures
18. Effect of Surface Morphology on Implant Survival in the Grafted Maxillary Sinus - Dennis P. Tarnow, Sang-Choon Cho, Stephen S. Wallace, and Stuart J. Froum
19. Use of Barrier Membranes in Sinus Augmentation - Stephen S. Wallace, Stuart J. Froum, and Dennis P. Tarnow
20. Le Fort I Downgraft with Sinus Elevation - Ole T. Jensen and Richard Branca
21. Trans-Alveolar Sinus Elevation Combined with Ridge Expansion - Daniel R. Cullum and Ole T. Jensen
22. Osteotome Technique for Site Development and Sinus Floor Augmentation - Robert B. Summers
23. Piezoelectric Bone Surgery for Sinus Bone Grafting - Tomaso Vercellotti, Myron Nevins, and Ole T. Jensen
24. Le Fort I and Alveolar Distraction Osteogenesis with Sinus Bone Grafting - Ole T. Jensen and Zvi Laster
25. PRP and BMP: A Comparison of Their Use and Efficacy in Sinus Grafting - Robert E. Marx
26. Zygomatic Implants: A Viable Alternative to the Sinus Bone Graft - Steven M. Sullivan, Chantal Malevez, and Daniel Henrichson
27. Graftless Rehabilitation of the Atrophied Maxilla Using Tilted and Short Implants and Immediate Function - Bo Rangert, Carlos Aparicio, Chantal Malevez, Edmond Bedrossian, Franck Renouard, Paul Maló, and Roberto Calendriello

Section IV Looking to the Future
28. Stromal Stem Cell Preparation from Iliac Bone Marrow Aspirate for Sinus Bone Grafting - Ole T. Jensen
29. Tissue Engineering for Maxillary Sinus Augmentation - Ronald Schimming and Rainer Schmelzeisen
30. Use of Tissue-Engineered Bone Cells for Sinus Augmentation with Simultaneous Implant Placement - Minoru Ueda, Yoichi Yamada, Morimich Ohya, and Hideharu Hibi
31. Gene Therapy of Growth Factors for Tissue Engineering and Regenerative Medicine - William V. Giannobile, Brent Y. Kimball, and Li-Xing Man

Preface

Inveni quod deficiens. . . .

Despite its relatively brief history, the sinus bone graft today constitutes one of the most popular and successful bone-grafting procedures undertaken in the maxillofacial region. Moreover, the maxillary sinus serves as the subject of more research, both in animal and clinical trials, than any other single bone-grafting site, culminating in a variety of modifications to the procedure and hence its role as the graft site most often used to establish efficacy for emerging dental implant technologies.

The sinus floor, and to a smaller extent the elevated sinus membrane, offers an ideal environment for bone formation. Though it would seem intuitively counterproductive to bone graft healing, especially if the sinus membrane becomes perforated during the course of graft placement, this area is instead remarkably forgiving of complication, infection, resorption, or rejection.

As we enter a new era and contemplate the likely reality of avoiding bone grafts altogether with CAT scan– derived treatment plans based on available bone, or the use of zygomaticus implants, or a return to cantilever prosthetics, one cannot help but wonder how the story of the history of sinus grafting will end.

This second edition subscribes to the concept inveni quod deficiens, “recover what is lost.” The restorative dentist’s charge is to reconstruct lost bone and restore lost function.

The as-yet unknowable potential of exogenous recombinants, cell-based therapies, gene-transfer technology, and, ultimately, tooth-germ transplantation will likely be pursued beneath elevated sinus membrane. The sinus floor in “end times” will host bioengineered dental lamina; in place of polished titanium, gleaming enamel will re-emerge through gingiva.

To this end, I would like to acknowledge Dr Hilt Tatum for teaching me how to do a sinus graft, and Dr Per-Ingvar Brånemark for showing me how to do an implant. A book of this complexity and magnitude would not have been possible without the excellent work and diligent care of Lisa Bywaters, who helped edit and organize the manuscript into a coherent book.

I also express appreciation to Karen Shoop, my implant coordinator, the heart and soul of this 2-year experience.

I must also acknowledge my surgical assistants, Cindy Formaneck, Anna Dykes, and Kristin Stifflear, who during the course of this work assisted with both surgery and photographic documentation.

Research assistants who contributed to the book include Steve Tanberg, David Baer, and Brent Kimball.

Though section editors were avoided, I give special thanks to Drs Phil Boyne and Bo Rangert, who informally advised me at critical stages of the book.

And of course I must thank my family as well: my wife Marty, my sons Sverre and Trygve, and my daughter Autumn—even my grandchildren, Abigail, Sierra, and Ole Tait, for whom it is I work.

Edited by Ole T. Jensen, DDs, MS
Private Practice
Oral and Maxillofacial Surgery
Denver, Colorado