Maxillofacial rehabilitation of the atrophic maxilla, whether with or without maxillary sinus pneumatisation, often presents a challenge due to limited bone availability. Consequently, vertical and horizontal bone augmentation becomes necessary. The conventional and widely employed approach involves maxillary sinus augmentation using various techniques, which may or may not cause a rupture of the sinus membrane. However, such membrane rupture increases the risk of acute and chronic contamination, affecting the graft, implant, and the maxillary sinus itself.

The surgical procedure for maxillary sinus autograft

Typically entails three stages. First, the autograft is removed, followed by the preparation of the bone site for the graft. The third stage, frequently added, involves the placement of Osseo integrated implants, as it was previously unfeasible to conduct this simultaneously with graft surgery. Presenting a novel advancement, a bioactive kinetic screw (BKS) bone implant model has been introduced, streamlining the process by enabling autogenous grafting, sinus augmentation, and implant fixation in a single step.

1. What is Sinus lifting?

Sinus lifting, also known as maxillary sinus augmentation, is a surgical procedure performed in oral maxillofacial rehabilitation to address limited bone availability in the atrophic maxilla, particularly in cases where the maxillary sinuses have experienced pneumatisation. This technique aims to increase the bone’s vertical and horizontal dimensions in the posterior maxilla to facilitate successful dental implant placement.

Conclusion

The BKS sinus lift technique introduced and elucidated in this study has demonstrated its simplicity and feasibility in facilitating the streamlined autogenous transplantation for maxillary sinus augmentation. It bears resemblance to the conventional procedure of drilling and screwing dental bone implants. Through the utilization of square threads and the simultaneous action of drilling and screwing, enhanced stability is achieved for the BKS implant, even when 1/3 of its volume is inserted within the confines of the maxillary sinus cavity. Notably, the experimental tests did not manifest the disconcerting sensation of instability, often encountered when implants lose their bone anchorage during the implantation process. Despite the limitations acknowledged in this study, the proposed technique has proven to be effective in indirectly elevating the maxillary sinus without exposing the sinus membrane to the external environment. Future investigations will focus on assessing the biological response elicited by this technique.

 

2. Methods and Materials used:

Five bioactive kinetic screws (BKS), fabricated by Usiform Ltd. from 304 stainless steel, were machined to precise dimensions of 10 mm in length and 4 mm in diameter, with a 15 mm shaft for connection to the powerful Techdrill Surgical Motor-1 implant motor, boasting an impressive 150-watt capacity and a pre-set torque of 45 N/cm for seamless drilling and screw insertion. The insertion and removal of these screws were meticulously monitored using the advanced Lutron TQ 8801 digital torquemeter, while the quantity of bone graft material harvested by the revolutionary BKS implant was meticulously assessed using the high-precision Brifit precision professional digital mini scale, calibrated from 0.001 to 20.00 g.

MIT and MRT

Throughout the insertion of the BKS into the atrophic maxilla, a persistent and unvarying insertion torque was observed, steadily escalating as the entirety of the internal volume became filled with bone. The surgical motor, operating within its limitations of 600 rpm, automatically executed a gradual augmentation in rotation.

Conclusion

The BKS sinus lift technique introduced and elucidated in this study has demonstrated its simplicity and feasibility in facilitating the streamlined autogenous transplantation for maxillary sinus augmentation. It bears resemblance to the conventional procedure of drilling and screwing dental implants. Through the utilization of square threads and the simultaneous action of drilling and screwing, enhanced stability is achieved for the BKS implant, even when 1/3 of its volume is inserted within the confines of the maxillary sinus cavity. Notably, the experimental tests did not manifest the disconcerting sensation of instability, often encountered when implants lose their bone anchorage during the implantation process. Despite the limitations acknowledged in this study, the proposed technique has proven to be effective in indirectly elevating the maxillary sinus without exposing the sinus membrane to the external environment. Future investigations will focus on assessing the biological response elicited by this technique.

Wight Measurement

The precise weight of the compressed and condensed bone within the internal compartment of the BKS was directly measured using a highly accurate Brifit scale, thereby establishing the exact quantity of bone transplanted during the proposed procedure for indirect maxillary sinus augmentation.

Maxillary sinus augmentation

An integral component of oral rehabilitation with dental implants, has become a pivotal procedure for enhancing volume and bone quality in atrophic maxillae. While autogenous grafts are considered the gold standard for bone grafting, their execution is not without drawbacks.