CATEGORY 92 AUSTRALASIAN DENTIST CLINICAL Introduction e OsseoFrame is a technologically advanced dental implant system that was conceived and developed in Melbourne in 2015. It was based on the historical idea of subperiosteal implants but with major improvements in design, materials and manufacturing technologies that have brought it into the 21st century. Numerous articles have previously showcased the versatility and many advantages of the OsseoFrame, in Implant Dentistry and the Australasian Dentist magazines. is article shows yet another example of the bene ts of the OsseoFrame used in a case where a low maxillary sinus oor could be managed without the need for a sinus lift bone graft. Case report A 66-year-old female came to see the author about her missing teeth (i.e. 24,25,26) in the left maxillary quadrant ( gs. 1, 2). While there appeared to be enough bone in the 24 site, a previous history of periodontal disease left very little bone in the 26 site which would require a sinus lift bone graft prior to implant placement. Various treatment options were discussed, but the patient was drawn to the idea of immediate teeth with the OsseoFrame. Based on the patient’s cone-beam CT scans, a 2-post OsseFrame was designed, and 3D printed in titanium ( g. 3). e option of conical abutments was decided by the author, making inserting the bridge easier. Under general anaesthesia, a broad-based mucoperiosteal ap was raised to expose the zygomatic buttress, anterolateral wall of the left maxilla, and part of the palate. e fully customised design made the OsseoFrame easy to place directly onto the bone and was secured with numerous self-tapping bone screws ( g. 4). e gingivae were repaired with the conical abutments exposed in the oral cavity where the 3-unit bridge was attached and secured with M2 internal screws ( g. 5). A minor occlusal adjustment of the bridge was performed before the patient woke up. e patient was discharged after an hour, and at her 4-month review ( g. 6) the gingivae surrounding the 2 transmucosal posts looked healthy ( g. 7). Discussion e OsseoFrame in this case eliminated the need for a sinus lift bone graft in the 26 site which would have been an essential step if conventional implants were used. e clear advantage is the maxillary sinus cavity is not breached and remains intact and free of foreign material. Furthermore, the ease of placement of the custom device helps reduce the operating time to a minimum as there is no guesswork involved in the proper placement and positioning of the implant. Finally, the patient wakes up with her bridgework already in place which makes it the ideal implant solution for those who are concerned about the protracted time frames when it comes to conventional dental implants. e immediate insertion of the dental prosthesis at the time of surgery is what sets the OsseoFrame apart from other implant systems currently available. Note: e OsseoFrame is a TGA-approved Dental Implantation System (ARTG-286266) that is designed and manufactured by MAXONIQ, an ISO 13485 certi ed MedTech company based in Melbourne. www. maxoniq.com Declaration: Dr George Dimitroulis is a practicing Oral & Maxillofacial Surgeon and Founder of MAXONIQ Pty Ltd, (www. maxoniq.com) a Melbourne-based Medtech Company which developed and manufactures the Subperiosteal implant device, otherwise known as the OsseoFrameTM, described in this article. u All Correspondence: Dr George Dimitroulis, Suite 1, Ground Floor, 124 Grey Street, East Melbourne Vic 3002 Tel: +61 03 9654 3799 F• ax: +61 03 9650 3845 Mob: +61 0409 505 146 • Email: geodim25@gmail.com OSSEOFRAME™: A simple dental implant solution for low sinus floors By Dr George Dimitroulis Oral & Maxillofacial Surgeon – Epworth-Freemasons Hospital – Vic Figure 1: OPG X-ray showing the missing teeth in the left maxillary quadrant with inadequate bone in the 26 site for conventional implants. Figure 3: The 2-post Maxillary OsseoFrame undergoing a fitment check on a biomodel with a 3-unit bridge attached to the transmucosal posts before it is sent to the hospital for implantation. Figure 5: The 3-unit bridge is attached to the transmucosal posts and secured with M2 internal screws. An occlusal adjustment of the acrylic teeth is performed before the patient wakes up from the anaesthesia. Figure 7: Intra-oral photo showing healthy gingivae surrounding the 2 transmucosal conical posts 4 months after implantation of the OsseoFrame. Note the precise parallel positioning of the posts which simplifies the design and insertion pathway of the dental prosthesis. Figure 2: Intra-oral photo showing the atrophic edentulous alveolar ridge of the left posterior maxillary quadrant. Figure 4: The Maxillary OsseoFrame is secured to the maxillary bone with numerous self-tapping bone screws. Note the close adaptation of the titanium plate to the underlying bone. Figure 6: A post-operative OPG X-ray shows the OsseoFrame in the left posterior maxilla secured with multiple bone screws. The 3-unit acrylic bridge is invisible on X-rays.
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