Cesar Luchetti and Alicia Kitrilakis
Department of Implant Dentistry. National University of La Plata. Argentina
Nasal cavity lift associated with implant placement is not a common procedure. However, is useful in some cases with ridge atrophy and a low nasal floor. In this case we describe the technique to do the nasal lift. The surgery was performed by Dr. Luchetti and crowns were made by Dr. Kitrilakis.
The nasal cavity lift is some times easier than maxillary sinus lift. The pituitary mucosa is often more resistant than Schneider membrane and there is not need to make an access window.
The technique is simple. Once the incisions were made, the flap must be raised to reach the nasal cavity. Then, the mucosa is detached using the same curettes we use to use for sinus lift procedures and a bone graft is placed below the pituitary. Implant placement can be done simultaneously or in a two stage approach. The main difference with sinus lift is that is not recommendable to make a lift bigger than 3-4 millimeters.
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| Preoperative situation. |
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Flap raised. An old failing implant is present and must be extracted. |
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Curette doing the pituitary lift before the final placement of the implants. |
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Implants in position. Due to limitations in the ridge anatomy, there were placed in the areas where we achieved the best initial fixation. The blue arrows point the nasal cavity. |
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Graft in nasal cavity placed. In this case we use a bovine hidroxyapatite. |
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Graft placed in the ridge irregularities. |
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Polilactic Acid polimerizable membrane is placed to protect the graft. |
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| Suture. |
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Seven days postoperative. |
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| Abutments in place. |
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Metal substructure try in. |
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Final ceramic crowns. |
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