• by kild
  • April 13, 2022
  • 138
  • 130

” Nel mascellare superiore , nella zona dei molari e premolari, molto spesso non si ha una sufficiente altezza ossea per poter inserire gli impianti.
Nei casi in cui la quantità ossea verticale sia inferiore a 7\8 mm si rende necessario quel trattamento chirurgico definito – Sinus Lift- o – Grande rialzo di Seno Mascellare-.
Infatti nella zona dei molari e premolari superiori è presente una cavità paranasale definita Seno Mascellare, che è una cavità accessoria delle cavità nasali. Questa cavità in molti casi arriva a lambire l’osso alveolare e quindi riduce la quantità ossea disponibile per mettere gli impianti.
Tale intervento permette di aumentare l’osso in senso verticale per andare a posizionare degli impianti, che a loro volta serviranno per ancorare dei denti fissi. Ricordiamo che in passato quando non esisteva questa tecnica, e non era possibile inserire gli impianti, nella maggior parte dei casi si doveva inserire una protesi mobile.

Oggi non è più così e fortunatamente con un intervento di routine è possibile inserire dell’osso di origine animale dentro la cavità mascellare per poter successivamente posizionare degli impianti.
La procedura prevede di effettuare l’anestesia locale , poi dopo aver sollevato un lembo mucoperiosteo, si procede ad aprire la parete ossea vestibolare del mascellare superiore.
Arrivati sulla membrana di Schneider ( mucosa che ricopre a parte interna della cavità mascellare), si procede a scollarla per creare uno spazio in cui mettere l’osso.
Dopo aver inserito l’osso si sutura con dei punti riassorbibili e poi dopo si devono aspettare 6 mesi per mettere gli impianti.
In alcuni casi gli impianti vengono messi subito, durante l’intervento di Sinus lift, ma solo se l’osso residuo è sufficiente.
Generalmente per scongiurare infezioni post operatorie è necessaria una terapia antibiotica; in caso di dolore prescriviamo anche degli antidolorifici. Importante dopo l’intervento non mangiare cose calde, non bere alcolici, non fumare. Va mantenuta un’ottima igiene orale, e nel giorno dell’intervento e il successivo va tenuto il ghiaccio sulla guancia dalla parte operata.
Per chi fa immersioni subacquee è necessario astenersi per un periodo variabile da uno a tre mesi, a seconda della guarigione dei tessuti.

Dal giorno in cui si fa l’intervento di Sinus Lift al giorno in cui si potranno mettere le protesi definitive ancorate agli impianti passano da 9 a 12 mesi. Questo perchè non è possibile o meglio io sconsiglio di fare il carico immediato su osso innestato, a causa di una maggior probabilità di fallimento implantare. Conviene attendere qualche mese in più affinché gli impianti siano perfettamente osteointegrati prima di procedere al carico.

130 Comments

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