Simultaneous Sinus Lifting and Alveolar Distraction of a Severely Atrophic Posterior Maxilla for Oral Rehabilitation with Dental Implants

Figure 2

Representative case of bilateral sinus lifting and simultaneous total alveolar distraction for an edentulous severely atrophic maxilla (Case 2, Table 1). (a, b) Preoperative intraoral views; (c) preoperative CT views; (d) intraoperative view. After the end of the bilateral sinus floor elevation and completion of the total alveolar osteotomy: (e)sufficient sinus lifting with an equal-volume mixture of particulate autogenous cancellous bone/β-TCP was observed and the bilateral alveolar distractors were set; (f) postoperative panoramic X-ray; (g) after the end of vertical distraction; (h) good vertical distraction was obtained, but the maxillary alveolar arch was very narrow and V-shaped; (i) bilateral alveolar segmental widening with distraction was followed with use of an orthodontic palatal expansion device (the Hyrax device); (j) implant placement at ideal positioning was obtained for dental implant-anchored fixed prosthetic rehabilitation; (k, l) the definite prosthesis was set after 2 years with a provisional restoration during the postloading period for total oral rehabilitation; (m) panoramic X-ray taken 3 years later.