Dr. Arun Garg - April 24, 2009

American Dental Implant Association
The Miami Implant Update
Dr. Arun Garg – April 24, 2009

Maxillary Sinus Bone Grafting – An innovative, Predictable, and Efficient Method for Crestal Approach
· 3 Techniques
o Lateral Window (1-5mm Crestal Bone)
o Sinu-Drill (5-13mm Crestal Bone)
o Osteotomes (13mm + Crestal bone)
· Need a panorex at minimum
o What you SHOULD do is a CT Scan
· Don’t go higher than 15 above the crestal bone
o Otherwise you’ll go into the maxillary artery – LOTS of bleeding
· Bone maturation is 4-10 months
· Particulate graft material gets a LOT more vascularity than block grafting
· The only time you would ever consider a block is for structural stability
· Bone grafting NEEDS primary closure for it to heal, unlike extractions and unlike perio surgery
· Tears occur 10-50% of the time
o Use a membrane
· Sinu-Drill – SLS system by IIT (Sinu-Drill)
o Expensive, but less invasive
o Drill goes in without tearing membrane
· Osteotomes (13mm +)
o To get 1-3mm more bone
· Eventually bone replaces the graft: takes 4-12 months
· PRP alone is not enough to grow bone predictable… should use graft material as well