IM0410

user report _ oroantral communications I Radiography After closure of the oroantral communication, the bone graft substitute in the coronal two thirds of the extraction socket but not the oxygenized cellulose in the bottom of the extraction socket could be detected radiographically (Fig. 10). After three to four months, theoutlinesofthegraftparticlesappearedblurred,the formation of a tissue radiologically identical to bone couldbeobservedintheperipheryofthegraftmaterial (Fig. 11). The vertical dimensions of the marginal bone structures were not altered (Figs. 10 & 12). Even after 18 months, variations in the radiopacy could be ob- served in the center of the former extraction socket (Figs.12&13).However,animplantcouldbeinsertedat the former extraction site with sufficient primary sta- bility(Fig.13). Histologicalanalysis In the hard tissue sample taken after 18 months, capillary structures in the central part and a rather compact lamellar bone of various mineralization grades were detected (Fig. 14). The histological analy- sisofthesofttissuesampleshowedaconnectivetissue that is covered with an unkeratinized, stratified squa- mousepitheliumRemnantsofgraftmaterialwerenot observed in either sample, which was expected given that the material was described to resorb completely within three to 14 months (Nair et al. 2006; Rothamel etal.2007). _Discussion It has been shown that the incidence rate of oroantral communications after extraction of upper teethrangesbetween0.3and4.7%(Thomaetal.2006). Ifthemaxillarysinusisnotalreadyinfected,immediate closure of the perforation is indicated in order to pre- vent contamination of the sinus cavity and a subse- quent infection. The flap-based techniques according toRehrmann-WassermundorAxhausenareratherin- vasive and entail surgical tissue relocation procedures due to structural tissue changes. The results are often Fig. 11_Blurring of the outlines of the graft material after 3 moths. Fig. 12_Central remodelling after 18 months. Fig. 13_Sinus floor elevation and insertion of an Aesthura® Classic implant in region 26 after 19 months with 25 Ncm. Tab. 2_Patient overview. I 35implants4_2010 Fig. 11 Fig. 12 Fig. 13 Patient 1 Patient 2 Patient 3 Patient 4 Patient 5 Patient 6 Patient 7 Patient 8 Patient 9 Age (y) 52 37 21 43 53 62 49 54 86 Sex f f f m m m f m f Region 15 26 26 16 26 27 24 18 27 Amount of easy-graft 1 x 0.4 ml 2 x 0.4 ml 1 x 0.15 ml 2 x 0.15 ml 1 x 0.4 ml 2 x 0.4 ml 1 x 0.4 ml 1 x 0.15 ml 1 x 0.4 ml 1 x 0.4 ml Antibiotics – Isocillin 1.2 Mega Isocillin 1.2 Mega Sobelin 300 mg Isocillin 1.2 Mega – – Isocillin 1.2 Mega Isocillin 1.2 Mega Antibiotic intake – 3x1 daily, 4 days 3x1 daily, 4 days 3x1 daily, 4 days 3x1 daily, 8 days – – 3x1 daily, 4 days 3x1 daily, 4 days