Stage Characterization and Marginal Bone Loss Evaluation Up to 96 Months of Crestal Sinus Augmentation With Sequential Drills: A Retrospective Study. Issue 6 (December 2015)

• Record Type: Journal Article
• Authors: Bernardello, Fabio; Felice, Pietro; Spinato, Sergio; Rebaudi, Alberto; Righi, Davide; Malagoli, Claudio; Torres-Lagares, Daniel; Ruiz, Rafael Flores; Zaffe, Davide
• Is Part Of: Implant dentistry. Volume 24:Issue 6(2015:Dec.)
• Publication Date: 2015-12
• Subjects: allograft -- crestal sinus floor augmentation -- dental implants -- marginal bone loss -- sequential drills; Dental implants -- Periodicals; 617.69305
• DOI: 10.1097/ID.0000000000000342
• Languages: English
• ISSNs: 1056-6163

Abstract

Abstract : Introduction: The 2-stage crestal approach to augment the maxillary sinus is a little-used technique. The aim of this retrospective study was to assess events characterizing stages of this technique after implant placement in the posterior maxilla with residual bone height less than 4 mm and evaluate the marginal bone loss (MBL) changes over time. Material and Methods: Thirty-three patients underwent unilateral sinus augmentations using the trancrestal technique with mineralized allograft. Six-months (6 m) after first surgery, if skeletal subsidence prevented insertion of a 10-mm-length implant, additional grafting was performed during implant (n = 33) insertion. Radiographs were taken before grafting (baseline), immediately after and at 6 months; immediately after and 6 months after implant placement; and at follow-up (24–96 m). Results: One implant was lost (ISR = 96.97%). Of the remaining 32 patients, 14 (A group) underwent standard implant placement, whereas 18 (B group) underwent additional grafting immediately before implant placement. Given that B-group patients initially obtained lower crestal bone height after first surgery, additional grafting procedures provided greater crestal height in the B group. A significant relationship between ending (eMBL) and 6mMBL was found in both groups, with greater values in the B group. However, in both groups, eMBL was always greater if 6mMBL was greater than 0.44 mm. Discussion: Results suggest a high and low skeletal-reactivity patient categorization. In both patient categories, MBL greatly depends upon 6-month values. Investigations are necessary to relate sinus size with results obtained by this 2-stage crestal approach. Conclusions: The 2-stage crestal sinus lift procedure not only provides predictable results, but also allows low skeletal-reactivity patient recovery.