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ePaper created 2015-11-17, 15:11:47 | version 1.38.0
30 Volume 1 | Issue 1/2015 Journal of Oral Science & Rehabilitation oral swelling remained (Fig. 4f) and something hard could be felt underneath the mucosa. As one β-TCP granule had become exposed, the migrated β-TCP granules and barrier mem- brane were removed six months after surgery (Figs. 4g & h). One year after surgery, the swelling of the sinus membrane remained and the volume of the augmented area had de- creased considerably compared with that on the day of surgery (Fig. 4i). Lateral window coverage and migration The relationship between the degree of migra- tion and lateral window coverage after one week of healing is shown in Table 1. In Group 1, β-TCP granules had migrated through the lat- eral window toward the buccal side in 11 sites (61.1%), and Type C had occurred in three sites (16.7%).InGroup2,TypeAwasseenin110sites (96.5%),andTypeCwasobservedinthreesites (2.6%) in spite ofthe full coverage ofthe lateral window. Case 2 (70-year-old female, Group 2, Type 2, Type C, nonsmoker) Inthis case, sincethe anteriorwallofthe maxil- larysinuswasverythin,thelateralwindowwas covered with two collagen membranes and the wound was closed without a releasing incision (Figs. 5a–d). One week after surgery, Type 2 swelling of the sinus membrane was observed (Fig. 5e) and the β-TCP granules had migrated toward the buccal side from all directions (Fig. 5f, blue arrows). Case 3 (43-year-old female, Group 2, Type 3, TypeA, nonsmoker) The sinus floor augmentation was performed and the lateral window was completely cov- ered with a titanium mesh plate and fixed with three titanium microscrews (Figs. 6a–d). One week aftersurgery,Type 3 swelling ofthe sinus membranewas observed andthetrap doorhad lifted up due to the pressure of the swelling (Fig. 6e, yellow arrows). However, no β-TCP granules had migrated through the lateralwin- dow (Fig. 6e), and the swelling disappeared spontaneously three months after surgery (Fig. 6f). One year after surgery, the titanium mesh plate and screws were removed and the implants were placed successfully (Fig. 6g). C om plic a tion s a fter s i nu s f lo o r au gme ntati o n Figs. 4d–i Figs. 4d–i (d) A sagittal CBCT slice image taken one week after surgery. Type 3 swelling of the maxillary sinus membrane had occurred. Some β-TCP granules had disappeared from the augmented area (red arrows). (e) A horizontal CBCT slice image taken one week after surgery. The β-TCP granules had migrated toward the buccal side through the lateral window and moved beyond the canine (yellow arrows). (f) An intra-oral photograph taken ten days after surgery. The swelling at the sulcus remained and a hard object was palpable underneath the gingiva. (g) Six months after surgery, a β-TCP granule became exposed through the gingiva. (h) The migrated β-TCP granules, the barrier membrane and the microscrews were removed. (i) A sagittal CBCT slice image taken one year after sinus floor augmentation. d e f g h i