SINUS LIFT METHOD IN PRESENCE OF FOREIGN BODY IN AREA OF BOTTOM OF MAXILLARY SINUS Russian patent published in 2023 - IPC A61B17/24 A61C8/00 

FIELD: medicine; surgical dentistry.

SUBSTANCE: incision is made from the mucous membrane to the bone along the alveolar ridge in the area of missing teeth and an intrasulcular incision is made along the necks of the teeth, limiting the area of reconstruction on the vestibular side. The mucoperiosteal flap is peeled off in the vestibular direction. An osteotomy of the anterolateral wall of the maxillary sinus of a rectangular shape with a width of at least 15 and not more than 30 mm and a height of 8–10 mm is performed using an ultrasonic tip. The formed bone block is separated from the mucous membrane of the maxillary sinus. Peeling, mobilization and elevation of the mucous membrane of the maxillary sinus are performed. A foreign body is removed in the form of a filling material or in the form of a fragment of the patient’s tooth root when they are located between the bone and the mucous membrane. If a foreign body is located in the sinus cavity, the mucous membrane of the maxillary sinus is excised in the area of the adjacent foreign body and removed. Microsurgical sutures are applied to the edges of the mucous membrane of the maxillary sinus. The maxillary sinus is sanitized through a perforation hole in the elevated mucous membrane. Then the perforation defect is reduced by placing a suture on the lower part of the mucous membrane with fixation on the upper bone wall through a hole formed by a bur and microsurgical sutures are applied to the edges of the mucous membrane of the maxillary sinus. The perforation of the sinus mucosa is closed with a collagen membrane placed under the sinus mucosa with autologous fibrin obtained by centrifugation of the patient’s venous blood. The space between the elevated mucous membrane of the maxillary sinus and the bone floor of the maxillary sinus is filled with autogenous bone chips, previously obtained at the first stage of the operation in the area of the tubercle of the upper jaw and/or the branch of the lower jaw. The bone block is turned 15–90°, the burr hole is closed with it and it is fixed with a titanium microscrew. Dental implantation is performed after 170–190 days. If the width of the bone tissue is less than 6 mm, after filling the subantral volume, intercortical splitting is additionally performed.

EFFECT: method makes it possible to perform a sinus lift in the presence of a foreign body in the area of the bottom of the maxillary sinus, to ensure a lasting clinical effect of dental implantation with anatomical restoration of the reconstructed area, to ensure sufficient width of the alveolar ridge, to form the required shape and volume of the created bone fragment and the reconstructed alveolar ridge of the patient, to ensure the possibility of installation of dental implants during the reconstruction of the patient's alveolar bone, and improve the patient's quality of life.

2 cl, 3 ex