Combined management of dental sinusitis and less invasive techniques for sinus floor elevation

This seminar will show the main causes of odontogenic sinusitis that need combined treatment by multiple specialists and in particular otolaryngologists, dentists, oral surgeons, and maxillofacial surgeons. The multidisciplinary approach is indispensable to achieve a lasting and radical result.

Some sinusitis is linked with a definite cause-effect relationship to dental, endodontic, periodontal, and implant complications. Even today, most odontogenic sinusitis is caused by dental rather than implant complications. In some cases, it is possible to treat these complications fractionally by means of dental remediation and, at a later stage, otolaryngology or oral surgery. Sometimes it is necessary to perform combined surgeries for both the management of acute and chronic odontogenic sinusitis.

In this seminar, the flow chart useful for defining the time sequence of these approaches will be shown. There are also some sinus lift techniques that are both lateral and crestal and can reduce the risks of complications.

At distal maxillary sites, the loss of natural teeth leads to bone atrophy, compromising the ability to place dental implants of adequate length. Therefore, it is necessary to restore proper bone volume with a sinus augmentation procedure.

The lateral approach is based on the detachment of Schneider’s membrane through a vestibular osteotomy to create a space to be filled with bone mixed with biomaterial. For the procedure to be successful, it is important to ensure graft stability and prevent perforation of the Schneider’s membrane.

A lateral elevation technique, Sinus Pack, which allows the graft material to be stabilized and prevents granule migration even if the membrane is perforated, and a fluid-dynamic crestal elevation technique, Sinus Flow, which uses a specific dispenser and a micronized, collagenous biomaterial will be shown.