상악동 뼈이식 임플란트 과정 직접 보여드립니다

▶ Subscribe    / @seoulkwondental   When people hear the term "maxillary sinus lift," many feel that it is a very big and scary surgery. However, when performing upper molar implants, I consider this surgery to be a very common, basic procedure that we encounter more frequently than you might think. If you have lost teeth in the upper molar area for a long time, the bone thins due to the empty space known as the maxillary sinus, and in that state, it can become difficult to implant a sufficiently stable implant. Therefore, in this video, I will easily explain exactly what a maxillary sinus lift is and how the crest approach and the lateral approach differ using a model. Even when I first heard the term "maxillary sinus lift" back in dental school, I had the question, "What on earth is being lifted in the maxillary sinus?" To be precise, what is being lifted is not the maxillary sinus itself, but the very thin Schneiderian membrane located inside it—in other words, the *maxillary sinus membrane*. I always compare this membrane to an egg membrane when explaining it. It is incredibly thin and delicate, much like the thin membrane on the inside of a boiled eggshell; in fact, beginners often practice lifting the egg membrane slightly to develop a feel for it. In this video, I explain just how sensitive the maxillary sinus membrane is and why safely elevating it is the key. [Why Maxillary Sinus Lift is Necessary] If the area where the upper molars were lost is left untreated for a long time, the bone gradually thins, and the upper maxillary sinus space descends. When this happens, the implant cannot be sufficiently embedded in the bone, which can be disadvantageous in terms of fixation and long-term stability. In such cases, I believe that the implant should not be placed in a way that *floats in mid-air*. Therefore, I consider the core of maxillary sinus lift surgery to be lifting the maxillary sinus membrane as needed and filling the space beneath with bone graft material to *recreate bone where the implant can be stably inserted*. [Difference Between Crestal Approach and Lateral Approach] Maxillary sinus elevation surgery is broadly divided into the Crestal approach and the *Lateral approach*. The principle is the same for both. Ultimately, it is a surgery to lift the maxillary sinus membrane. However, the approach method differs. The crestal approach involves entering narrowly from above, passing through the maxillary sinus floor, and then lifting the membrane, while the lateral approach involves creating a window from the side to directly view and lift the membrane. Many people think the crestal approach is simpler, but I believe it is actually more difficult and requires greater tactile sensation because it is a blind technique where the surgeon cannot see with the eyes. [What I Consider Important in the Crestal Approach] In the crestal approach, the sense of the fingertips is ultimately the most important factor. Even if residual bone is analyzed in advance using CT, during the actual surgery, one must feel with their fingertips the sensation of the drill penetrating the maxillary sinus floor and the sensation of lifting the membrane without tearing it. At this stage, I tend to approach the procedure by using a Densah Bur to perform bone compaction. Afterward, I insert a bone chip and gradually elevate the maxillary sinus membrane using the BAOSFE method. In this video, I demonstrate this process using a model to explain why this surgery is not merely about inserting a drill, but is a *surgery of sense and experience*. [The Lateral Approach May Look Larger, But It Can Actually Be a More Clear Surgery] The lateral approach involves opening the gum and creating a window on the side to directly visualize and elevate the maxillary sinus membrane. Therefore, while it may appear larger and more daunting on the surface, I consider it a clearer surgery in that it allows for visual control. In particular, when placing two or more implants or when a sufficient amount of elevation is desired, the lateral approach can actually be faster and more accurate than the crest approach. In this video, I demonstrate the step-by-step flow of dissecting the membrane, inserting bone, placing the implants, covering the cavity, and suturing. [The Goal Is to Prevent the Maxillary Sinus Membrane from Tearing, But the Key Is the Ability to Manage the Situation] Since the maxillary sinus membrane is extremely thin, the possibility of it tearing must always be kept in mind. I naturally believe that the goal should be *to prevent tearing*. However, in actual clinical practice, tears can occur, so how you respond in that situation is far more important. As I mentioned in the video, if the membrane tears during the crest approach and bone needs to be inserted inside, I believe *you must immediately switch to a lateral approach to repair it*. Ultimately, in maxillary si...