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The introduction of sinus elevators into clinical practice significantly expanded the indications for the possibility of implant prosthetics in patients with complex topographic and anatomical relationships between the elements of the upper jaw and maxillary sinus.

Over the last ten years this surgery has been significantly augmented by various technical methods and techniques, mainly by using different variants of bone grafting, in particular autoplasty with the most frequent use of transplants taken from the chin. Other materials are also widely used, most often in the form of various forms of hydroxyapatite, silicon-based corundum ceramics, etc.

When prescribing a sinus elevator surgery, the patient’s psycho-emotional state should be taken into account:

– The patient must know that existing alternative treatments are unacceptable in his or her case;

– The patient must be clearly informed about the risks of the surgery and its possible complications;

– the patient should be informed about the necessity of performing obligatory hygienic manipulations in the postoperative period and eliminating solid food from the diet for six months.

Contraindications to sinus elevator surgery are:

– mental illness;

– Chronic decompensated diseases;

– HIV infection, hepatitis, sexually transmitted diseases;

– Coagulation and hemostasis disorders;

– tuberculosis, cancer;

– endocrine and hematopoietic system disorders.

The algorithm for sinus elevator surgery includes the following steps.

1. Incision up to the bone, passing along the ridge of the alveolar process in the mesiodistal direction with additional vertical dissection of tissues near the teeth delimiting the defect.

2. Detachment of the mucosal-periosteal flap and skeletonization of the anterolateral sinus wall.

3. Formation of a semi-oval or trapezoidal bone fragment in the area of the anterolateral wall. The bone is prepared to its thickness without damaging the mucosa.

4. Displacement of the bone fragment by breaking it up and separating the mucosa of the sinus from the floor and walls. Continued displacement of the fragment backwards and upwards leads to formation of an additional cavity in the lower part of the sinus, the upper border (wall) of which is the displaced bone fragment.

 

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