Subperiosteal circumventing dehiscent sinuses

This totally edentulous case (1), which radiographs indicated had little or no bone remaining under the sinuses, proved an unpleasant surprise upon exposing the ridge (2). Both sinuses were exposed (3), and pus drained freely from them. Masses of polyps were extracted while cleaning the sinuses. Very heavy impression material (5) was used to prevent its creeping into the sinuses, and the site was closed (6). The sinuses were completely closed three weeks later, upon re-exposing the ridge to insert the implant (7). Note that the implant carefully avoids the sinus areas. Inserted (8,9), its main bulk and support are directed against the hard palate. The tissues healed beautifully (10), and the restoration (11) built up on its palatal side to protect the discontinuous bone under the sinus. Because force directed against the denture is received by the implant posts, the implant-supported denture provides far more protection of the fragile arch than does a conventional denture.

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