Techniques and materials in implant rehabilitation surgery using sinus lift and GBR

OBJECTIVES The main purpose of the article is to highlight the importance of re-solving complex rehabilitation cases, evaluating clinical and ra-diographic outcomes, with attention to perforation reduction, us-ing advanced surgical tech-niques, such as piezoelectric surgery and bone regeneration guided, GBR (Guided Bone Re-generation). These procedures allow you to face the challenges related to the positioning of endosseous implants in cases of increased volume of the maxillary sinus and bone loss, successfully and reliably. MATERIALS AND METHODS The case of a patient who under-went maxillary sinus augmentation via the vestibular approach, combined with GBR and piezo surgery, is described. The drugs used in the pre-operative phase were: Clenil 0.8 mg/2 ml and Libenar 22 g/l by aerosol, amoxi-cillin 1 g every 12 hours for 6 days, 7 days before the operation. The operation involved the use of Re-Bone bovine bone substitute and Shelter membrane in bovine pericardium, 4/0 silk suture. Af-ter surgery, the patient followed a post-operative care regimen with anti-inflammatory therapy, paracetamol as needed and Bentelan 1 mg for the following 4 days. The insertion of dental implants in the treated areas can stimulate bone maturation and remodeling. The choice between placing grafts and implants si-multaneously or a two-stage ap-proach is also discussed. RESULTS AND CONCLUSIONS The radiographic and clinical re-sults of the operation indicate the success of filling the atrophic ar-ea of the maxillary sinus with the graft material, bovine bone gran-ules. The treated area, after 6 months, showed a significant increase in bone thickness and height. The conclusion summarizes the effectiveness of the GBR tech-nique for implant purposes. This clinical procedure has proven to be highly reliable in the case of rehabilitation of patients with se-vere posterior maxillary bone deficits. Overall, the text highlights the im-portance of advanced surgical techniques and guided bone re-generation to successfully ad-dress the clinical challenges relat-ed to the placement of dental im-plants in situations of maxillary si-nus volume increase and bone loss. The use of piezo surgery makes the procedure more pre-cise and less invasive, also guar-anteeing a better post-operative experience compared to tradition-al rotary instruments. The information contained in the text can be useful for dental pro-fessionals dealing with such complex cases.CLINICAL SIGNIFICANCE The clinical implications mainly concern:-implant treatments in cases of increased volume of the maxil-lary sinus and bone loss. The text highlights the growing de-mand for implant treatments and the challenges related to bone resorption and atrophy in the maxillary sinus area. This provides a deeper understand-ing of the challenges that can arise in such situations and the advanced techniques that can be used to address them;-piezoelectric instruments and GBR technique for maxillary si-nus lift can be used successful-ly to address complex surgical rehabilitation cases.