Global Journal of Medical Research, J: Dentistry and Otolaryngology, Volume 23 Issue 1

Lateral Approach Sinus (LAS) and Crestal Approach Sinus (CAS): The Unravelled Paraphernalia for Maxillary Sinus Membrane Advancement LAS v/s CAS Dr. Rinisha Sinha α , Dr. Pranave P σ , Dr. Aishwarya Sabharwal ρ , Dr. Nidhi Saripalli Ѡ , Dr. Shiksha Dhawan ¥ & Dr. Nishita Bhosale § Abstract- The permanent replacement of missing teeth in the maxillary posterior tooth region becomes a tedious task when it is confounded with bone atrophies. To overcome this problem and achieve successful rehabilitation, maxillary sinus membrane elevation procedures have been advocated as the most reliable means. The lateral window technique and the crestal approach are two of the most common approaches. These technologically developed procedures have reported high success rates in cases of deficient residual bone. Over time, there have been many advancements in these techniques that led to the development of user-friendly kits like the Lateral approach Sinus (LAS) kit and the Crestal approach Sinus (CAS) kit. In this case series, we have reported two cases, treated with either of these approaches and have compared the same. We aim at highlighting their ease of application in the clinical field and the promising results obtained with their use. Our clinical experience disclosed that maxillary sinus membrane advancement using both the kits has proven to be a reliable technique for implant placement in sites where the insufficient bone is available. Keywords: crestal approach sinus lift, hard tissue augmentation, lateral window approach sinus lift, platelet-rich fibrin membrane, transalveolar approach sinus lift. I. I ntroduction linicians often face difficulty in placing implants in the posterior maxilla due to the commonly observed resorption after tooth loss, atrophy, or sinus pneumatization in the region, resulting in insufficient bone height.[1] A variety of solutions have been defined to overcome this quandary namely short Corresponding Author α : MDS, Department of Periodontology, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Pune. e-mail: doc.rinisha@gmail.com Author σ : MDS, Department of Oral and Maxillofacial Surgery, Bharati Vidyapeeth Deemed to be University Dental College and Hsopital, Pune. e-mail: pranaveprasad@gmail.com Author ρ Ѡ ¥ : MDS III Postgraduate trainee, Department of Periodontology, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Pune. e-mails: aishwarya_sabharwal@yahoo.com , nidhi.saripalli16@gmail.com , shiksha.95@gmail.com Author § : Lecturer, Department of Periodontology, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Pune. e-mail: drnishita.02nb@gmail.com implants, tilted implants, or maxillary sinus augmentation procedures. [2, 3] Sinus floor elevation procedures are one of the popular, well-accepted, widely performed, and highly predictable procedure. Boyne and James[4] performed a two-stage implant placement procedure using the lateral approach for sinus lift in 1980. Tatum (1986) [5] entered the sinus via the edentulous alveolar bone and conducted vertical tapping through the alveolar ridge to elevate the sinus floor. Later in 1994, Summers [6]gave modification of this technique in the form of explicit osteotomes of diverseradii that could elevate the sinus floor, while simultaneously increasing the thickness of the bone. In this case series, we have presented two cases that were performed using the CAS kit and LAS kit. The crestal approach sinus (CAS) kit (Osstem Implant Co., Busan, Korea)is an innovation that utilizes the crestal approach for elevating the sinus. It uses a unique drilling system in conjugation with hydraulic pressure. On the other hand, the lateral approach sinus (LAS) kit (Osstem Implant Co., Busan, Korea) allows a less invasive and less risky lateral window approach sinus augmentation using specific core and dome drills that helps in the formation of the bony window, while simultaneously elevating the Schneiderian membrane. II. C ase P resentation All surgical operations were carried out under the influence of local anesthesia. First, a sub-crestal incision was made, that extended more than the edentulous site, in the mesio-distal direction. Then, using molt #9 periosteal elevators, a full-thickness mucoperiosteal flap was raised (HuFriedy, Chicago, USA). One-stage implant placement was performed for both the cases (with the LAS kit and the CAS kit). Both the procedures involved the application of xenograft (Cerabone, Biotiss, Germany) for bone augmentation and B&B implants (San Benedetto, BO, Italy) for the replacement of the teeth. C 35 Year Global Journal of Medical Research Volume XXIII Issue I Version I ( D ) 2023 J © 2023 Global Journals