Special Articles : Clinical Anatomy for Dental Implant Treatment
Clinical Anatomy and Treatment Strategies for Maxillary Molars for Implantologists
2024 Volume 37 Issue 2 Pages 113-120
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2024 Volume 37 Issue 2 Pages 113-120
To achieve successful implant surgery, it is imperative to prevent injury to adjacent tissues, such as blood vessels, nerves, mucosa, and muscles, by meticulously assessing the structures within the jawbone. This study examined anatomical specimens of the maxillary sinus and maxillary tuberosity and underscored the significance of risk management in implant therapy in the maxillary molar area.
Tooth loss leads to alveolar bone resorption, significant alveolar bone loss, and descent of the maxillary sinus floor. By utilizing anatomical images from cadaver specimens, we showed a case wherein implant base perforation occurred into the maxillary sinus. It is crucial to consider the course and distribution of the posterior maxillary alveolar artery, which is a branch of the maxillary artery, and the posterior maxillary alveolar nerve branch, which is a branch of the maxillary nerve, from the posterior maxillary tubercle to the maxillary sinus during implant therapy.
From an anatomical perspective, the following three implant therapy approaches for the maxillary molar region are delineated, encompassing scenarios with limited vertical bone volume and presence of the maxillary sinus.
1. Inclined implant placement within existing bone : When conventional implant placement is challenging, utilizing existing bone to position implants at an intentional angle proves effective. Nonetheless, cautious maneuvering is imperative to prevent harm to adjacent blood vessels and nerves.
2. Bone augmentation : In instances of reduced alveolar bone height, bone augmentation is used. Autogenous bone or bone graft materials are employed, necessitating meticulous monitoring of postoperative soft tissue closure.
3. Sinus floor elevation : For cases with limited vertical bone volume, sinus floor elevation is a viable surgical option. Both the lateral and alveolar crest approaches are utilized, demanding careful attention to prevent injury to the intra-maxillary sinus mucosa.
