Maxillary sinus lift has a well-known impact on the delicate homeostasis of the maxillary sinus and the concomitant presence of systemic, naso-sinusal or maxillary sinus diseases may favor the development of post-operative complications, such as maxillary rhino-sinusitis, which can compromise a good surgical outcome.

On the basis of these considerations, the management of sinus lift candidates should include the careful identification of any situations contraindicating the procedure and, if naso-sinusal disease is suspected, a clinical assessment by an ear, nose and throat specialist, which should include nasal endoscopy.

Moreover, if necessary, a computed tomography scan of the maxillofacial district can be performed, particularly in the ostio-meatal complex.

This occurs during a preventive-diagnostic step (first step), which should be dedicated to detect presumably irreversible and potentially reversible contraindications to a sinus lift.

Then, the preventive-therapeutic step (second step) is aimed at correcting, mainly with the aid of endoscopic surgery, such potentially reversible ear, nose and throat contraindications as middle-meatal anatomical structural impairments, phlogistic-infective diseases and benign naso-sinusal neoplasms.

The removal of these contraindications achieves naso-sinusal homeostasis recovery, and restores the physiological drainage and ventilation of the maxillary sinus.
The last situation requiring ENT assessment concerns the management of iatrogenic complications, such as maxillary rhino-sinusitis, and is realized in the diagnostic-therapeutic step (third step).

It is aimed at ensuring early diagnosis and prompt treatment of maxillary rhino-sinusitis in order to avoid, if possible, implant loss and, in particular, the related major complications.

The present study focuses on three steps within the context of a multidisciplinary management of sinus lift, in which otorhinolaryngological factors may be the key to a successful outcome.

MANAGEMENT OF CANDIDATE FOR MAXILLARY SINUS LIFT FIRST STEP: preventive-diagnostic step SECOND STEP: preventive-therapeutic step THIRD STEP: Diagnostic-therepeutic step MAIN FORMS OF RHINO-SINUSITIS acute: characterized by single occurrences which persist for less than 4 weeks subacute: occurrences which persist for 4-12 weeks chronic: persists for more than 12 weeks and causes structural, functional mucosal alterations recurring: recurrence of acute inflammations at least 3 times in 6 months or 4 times in 12 months, each one persisting for more than 7-10 days, without structural, functional mucosal alterations and characterized by complete recovery (restitutio ad integrum).

Congresso Nazionale dei Docenti di Discipline Odontostomatologiche e Chirurgia Maxillo Facciale
Firenze – Siena, 14-16 Aprile 2011

Università degli Studi di Bari Dipartimento di Odontostomatologia e Chirurgia
Direttore: Prof.ssa D. DE VITO
Calabrodental S.r.l. Unità Operativa di Chirurgia Maxillo-Facciale Regione Calabria – Crotone Dir. San: Dott. M. W. Marrelli

AUTHORS
F. Inchingolo, F. Schinco*, G. Dipalma, M. De Carolis, M. Tatullo, A. M. Inchingolo, A. Palladino, M. Marrelli, A. D. Inchingolo

REFERENCES