Essentials of Maxillary Sinus Augmentation, 1st Edition : Implant Dentistry

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Book Review

Essentials of Maxillary Sinus Augmentation, 1st Edition

Kraut, Richard A. DDS

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Implant Dentistry 27(3):p 266-267, June 2018. | DOI: 10.1097/ID.0000000000000778
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This 6 chapter book offers an excellent primer for anyone starting out doing maxillary sinus augmentation. The illustrations throughout the book are superb. The text, although brief, is clear and succinct. The detail which is provided is truly outstanding throughout the book.

Chapter 1: Sinus Augmentation: General Considerations—provides an overview of both the lateral approach to sinus augmentation and the crestal approach. The Figures show step by step how each procedure is performed and, most impressively, the author includes a final panoramic radiograph showing the successful case of a lateral augmentation 1 year after surgery. The second half of this Chapter talks about the prerequisites for a crestal approach to sinus membrane augmentation and offers a brief overview of this technique.

Chapter 2: Anatomical Landmarks: Preoperative Evaluation—discusses a detailed review of posterior maxillary and sinus anatomy and makes recommendations for either the lateral or the crestal technique depending on the initial available bone in the area that the implants are to be placed. There is an excellent discussion about the vascularity of the maxillary sinus and how the alveolar antral artery is present in 62% of cases approximately 18 mm apical to the nonresorbed posterior maxillary alveolar ridge. The presence of this artery is beautifully illustrated both in computed tomography scanning images and a clinical photograph. Clinicians performing lateral sinus augmentation need to be aware of this artery and need to be prepared to cauterize the artery should it become perforated during the course of the sinus augmentation. The Chapter concludes with a discussion of the thickness of the sinus membrane and accurately points out that the thickness of the membrane can be extremely variable. The thicker the membrane, the easier it would be for the clinician to achieve augmentation without perforation.

Chapter 3: Instruments and Biomaterials—clearly provides the reader with detailed images of the instrumentation needed and shows the instrumentation being used to perform both lateral sinus augmentation, as well as crestal sinus augmentation, utilizing both conventional and ultrasonic techniques. There is also a discussion of biomaterials that can be used for sinus augmentation. I found the discussion of materials to be lacking in that there was no discussion of the use of bone morphogenic protein, which, in the United States of America, was approved by the Food and Drug Administration approximately 10 years ago.

Chapter 4: The Lateral Approach Technique—details the lateral approach to sinus augmentation utilizing ultrasonic instrumentation. The description is complete, accurate, and phenomenally illustrated.

Chapter 5: The Crestal Approach Technique—provides a detailed description of vertical sinus augmentation. The diagrams are easy to follow and the use of the balloon technique is clearly shown to aid in augmentation without perforation. The Chapter concludes with a set of illustrations of augmentation through the crestal approach utilizing low flow irrigation to elevate the sinus membrane rather than the balloon technique which is featured at the start of the Chapter.

Chapter 6: Preoperative Risk Assessment and Postoperative Care—I found the discussion of membrane perforation to be the most helpful and honest. They quote Dr. Pikos from a 1999 article talking about membrane perforations ranging from 10% to 35% and they talk about 11%–56% perforation from Drs. Farre-Pages in 2011. Other studies are quoted as having perforation rates of 25%. The authors provide their opinion on how to proceed when perforations occur depending on the size of the perforation. When the membrane is completely lost during the approach to the sinus, they believe that one should wait 6 months and then re-enter once the membrane has had a chance to be regenerated.

There are references to videos throughout the book; however, the videos were not available for review. The Essentials of Maxillary Sinus Augmentation provides clinicians with an easy to follow outline for sinus augmentation, both from a lateral and crestal approach. The book would have been enhanced with a greater discussion of bone grafting materials that are used in sinus augmentation. Overall, this is an excellent text and one that I recommended for people starting out adding sinus augmentation to their armamentarium.

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