Tackling the root of the issue: Educational 3D Anatomy of the Maxillary Sinus

Touch Surgery’s newly released dental implant surgery interactive resource, Anatomy for Maxillary Sinus Floor Augmentation, authored by Dr. Michael G. Newman, Dr. Irina Dragan, and Dr. Satheesh Elangovan, is the first of its kind. The maxillary sinus floor is an area of complex anatomy difficult to understand using conventional resources such as textbooks, videos, hands-on courses and dissection.

Known and well‐documented complications … can be prevented, or their incidence greatly reduced, through a thorough understanding of maxillary sinus anatomy” – Testori, T., Weinstein, T., Taschieri, S. and Wallace, S. (2019). Risk factors in lateral window sinus elevation surgery. Periodontology 2000, 81(1), pp.91-123.

Our new simulation covers the anatomy of the maxillary sinus in-depth, combining comprehensive 3D views of skeletal and neurovascular anatomy, illustrations, and examples of real clinical data. Clinicians, students and residents can review the key points of maxillary sinus anatomy step by step, and then test and verify their understanding on the app.

“In the surgical arena, there are very few opportunities to practice the surgical procedure before actually having to perform it on a patient.” – Dr. Irina Dragan, Director of Faculty Education and Instructional Development, Tufts University School of Dental Medicine

In patients with long-term tooth loss, alveolar bone resorption and/or pneumatization of the maxillary sinus may occur, resulting in an inadequate amount of bone height and volume for implant support. To counter this problem, maxillary sinus floor augmentation may be performed, where the Schneiderian membrane is raised from the sinus floor and bone graft material placed in the newly created space, through a lateral or crestal approach (Greenstein, et al., 2008; Kumar, et al., 2018).

“There is a steep learning threshold associated with this procedure that is ideally suited for Touch Surgery’s Cognitive Task Simulation methodology.” – Dr. Satheesh Elangovan, University of Iowa, USA

The high prevalence of anatomical variation, the complexity of the neurovasculature, and the dexterity and knowledge required for the delicate manipulation of the Schneiderian membrane are all contributing factors. Resulting complications, such as membrane perforation, intraoperative bleeding or postoperative infection (Meleo, et al., 2012; Testori et al., 2012) can be daunting events for an implant surgeon to manage.

Technology is playing an increasing role in how we educate patients, and how we train for and perform surgery. For example, presurgical evaluation can now be assisted with patient-specific 3D printed anatomy, to allow for challenges to be anticipated before surgery. In terms of accessible training for surgeons, there are very few, if any, interactive tools to improve the cognitive aspects of learning the procedure. Simulation-based didactic teaching tools can allow trainee clinicians to improve their skill sets from their pockets.

“Touch Surgery simulations have demonstrated construct, face and content validity. This application is an effective adjunct to traditional learning methods, as users have demonstrated cognitive competencies prior to performing surgical procedures in the operating room.” – Dr. Michael G. Newman, DDS, FACD.

This resource will be of great value to the surgeons performing this complex procedure. It provides an opportunity to learn, practice, and rehearse many of the important skills and knowledge required to perform the surgery. The Anatomy for Maxillary Sinus Floor Augmentation simulation is now available on the Touch Surgery app. You can download the app on iOS and Android.

You can also check out the overview page to learn more about the contents, learning objectives, anatomical considerations and surgical planning for sinus floor augmentation and more.

The use of Touch Surgery in dental education was presented as part of lectures at the Spanish Society of Periodontology in June 2019, and at the International Association of Dental Research in Vancouver in June 2019.

Additionally, a presentation of the first study validating Touch Surgery in Periodontology will take place at the American Academy of Periodontology meeting in Chicago, in November 2019.

The simulation has been authored by people who have a wealth of experience in teaching and learning and who are in clinics daily. This has allowed for a learning tool that will meet the needs of not only the recent graduates but also people who have practiced for years.

Dr Michael G. Newman, DDS, FACD, is a Professor Emeritus at UCLA, editor of the Newman and Carranza Clinical Periodontology 13th Edition, international textbook, and the Dentistry Advisor to Touch Surgery. Dr. Newman is a periodontist and a Past President of the American Academy of Periodontology. He practiced clinical periodontics for over 30 years and was in the first group of AAP designated Periodontists trained by PI Branemark in Gothenburg, Sweden.

Dr Irina Dragan, DDS, MS, is the Director of Faculty Education and Instructional Development at Tufts University, School of Dental Medicine in Boston. Dr Dragan and team are the recipient of an Academy of Osseointegration award, looking at maxillary sinus elevation and the use digital planning to facilitate the procedure.

Dr Satheesh Elangovan, BDS, DSc, DMSc, is a Professor in the Department of Periodontics, at the University of Iowa College of Dentistry in Iowa City. Dr Elangovan is an Associate and Online Editor of the Newman and Carranza Clinical Periodontology international textbook.

The authors thank Professor Gustavo Avila-Ortiz, University of Iowa, USA for his invaluable review of this simulation.

Edited by Dr. Michael G. Newman, Dr. Irina Dragan and Dr. Satheesh Elangovan.