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Sinus Lift Procedure of the Maxilla in Patients with Inadequate Bone for Dental Implants

Radiographic Appearance

James J. Abrahams1, Michael W. Hayt and Reuben Rock

1 All authors: Department of Diagnostic Radiology SP2-123, Yale University School of Medicine, 333 Cedar St., P.O. Box 208042, New Haven, CT 06520-8042.



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  		Fig. 1A. —Sinus lift procedure. (Reprinted from [7]) Drawing shows that, after incision, soft tissue in anterior maxilla has been reflected back to expose overlying maxillary sinus (arrowheads). Note osteotomy (arrows) in bone.

 


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  		Fig. 1B. —Sinus lift procedure. (Reprinted from [7]) Drawing shows cross-sectional (lateral) view of maxillary sinus. Note that bone flap created by osteotomy has been pushed inward with maxillary sinus membrane, creating space that is packed with bone-graft material as shown in C and D.

 


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  		Fig. 1C. —Sinus lift procedure. (Reprinted from [7]) Drawing shows osteotomy and sinus membrane displaced inward and space packed with bone graft.

 


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  		Fig. 1D. —Sinus lift procedure. (Reprinted from [7]) Drawing shows cross-sectional view of maxillary sinus. Bone graft fills space created by inward displacement of osteotomy and sinus membrane.

 


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  		Fig. 2A. —67-year-old man who underwent sinus lift procedure to treat alveolar atrophy. Axial CT scan through maxillary antrum shows bone graft appearing as irregular dense mass (arrowheads) in center of sinus. Note scanty soft-tissue density (arrow) between graft and wall of sinus.

 


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  		Fig. 2B. —67-year-old man who underwent sinus lift procedure to treat alveolar atrophy. Axial CT scan slightly caudad to A shows slight concavity at osteotomy site (arrow). Note more graft material is seen in caudad portion of sinus than in cephalad portion.

 


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  		Fig. 2C. —67-year-old man who underwent sinus lift procedure to treat alveolar atrophy. Panoramic (C) and sagittal oblique (D) DentaScans (General Electric Medical Systems, Milwaukee, WI) show position of graft (large arrow, C) adjacent to alveolar ridge (small arrows, C) in caudad aspect of sinus better than in the axial scans, A and B. Note convex border of graft where it bulges through osteotomy in anterior maxillary wall (arrowheads, D). S = nasal septum, T = turbinate, M = maxillary sinus, A = anterior, I = inferior.

 


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  		Fig. 2D. —67-year-old man who underwent sinus lift procedure to treat alveolar atrophy. Panoramic (C) and sagittal oblique (D) DentaScans (General Electric Medical Systems, Milwaukee, WI) show position of graft (large arrow, C) adjacent to alveolar ridge (small arrows, C) in caudad aspect of sinus better than in the axial scans, A and B. Note convex border of graft where it bulges through osteotomy in anterior maxillary wall (arrowheads, D). S = nasal septum, T = turbinate, M = maxillary sinus, A = anterior, I = inferior.

 


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  		Fig. 2E. —67-year-old man who underwent sinus lift procedure to treat alveolar atrophy. Panoramic DentaScan obtained before surgery shows atrophy of alveolar ridge (arrowheads) and lack of soft tissue in sinus. M = maxillary sinus.

 


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  		Fig. 3. —53-year-old man who underwent sinus lift procedure and developed postoperative infection. Coronal CT scan shows opacified left maxillary sinus (white arrow). Note bone graft is more diffusely disbursed on left (arrowheads) and absent on right. Also note osteotomies (black arrows).

 

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