Dental News - Sinus lift surgery in severely resorbed maxillae: One-year follow-up

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Sinus lift surgery in severely resorbed maxillae: One-year follow-up

Digital panoramic radiograph 12 months after prosthetic loading. (Image: Dr. Luigi Canullo)
Dr. Luigi Canullo

Dr. Luigi Canullo

Thu. 28. June 2018

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The aim of this prospective study was to clinically analyze the behavior of implants inserted into severely resorbed maxillae after sinus grafting.

Materials and methods: Twenty-six wide-diameter implants with a rough surface over their entire length were inserted during 13 consecutive sinus lifts. Radiographic analysis was preoperatively requested for each patient. After Schneiderian membrane elevation, a magnesium-enriched hydroxyapatite (Mg-e HA) and collagen-based scaffold with a porous 3-D structure was used to prevent perforation during implant placement. Sinus grafting was performed using a biomimetic Mg-e HA. No membrane was used to cover the buccal window. The preoperative residual bone height ranged between 1 and 4 mm (mean value: 2.5 mm; SD: 1.0 mm).

After 6 months of healing, uncovering was carried out and the definitive restoration was seated after 2 weeks. In order to monitor the stability changes, resonance frequency analysis was performed and ISQ (Implant Stability Quotient) values were collected at the first surgery (baseline, T0), at the abutment connection (T1) and at the 1-year follow-up (T2).

In order to measure bone changes, the patients underwent panoramic radiographs after 2-year follow-up. Image analysis software calculated the grafted bone height changes at the level of the implant site, comparing preoperative and follow-up panoramic radiographs.

Results: No postoperative complications were observed. The mean ISQ value was 42.5 (SD: 2.7) at T0, 75.3 (SD: 8.2) at T1 and 81.5 (SD: 2.6) at T2. Statistically significant differences (P ≤ 0.005) regarding mean ISQ values were found between T1 and T0, as well as between T1 and T2. After 12 months of functional loading, only 1 implant was lost (cumulative survival rate: 96.15%). During the same observation period, the mean radiographic vertical height of the grafted sinus floor was 11.05 mm (SD: 2.10 mm), with a mean gain of 8.50 mm.

Conclusion: Within the limitations of this study, despite preoperative critical residual bone height, maxillary sinus lift restoration using a biomimetic Mg-e HA and an Mg-e HA/collagen-based scaffold with a porous 3-D structure seems to be a reliable procedure.

Editorial note: The full article was published in the 1/2018 issue of the Journal of Oral Science and Rehabilitation.

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