Maxillary sinus floor augmentation using bioactive glass granules and autogenous bone with simultaneous implant placement. Clinical and histological findings.
This clinical study was undertaken to: 1) evaluate the use of bioactive glass Biogran combined with autogenous bone as grafting material for maxillary sinus augmentation with simultaneous implant placement using radiography and histology; and 2) document the short-term post-loading success of implants inserted in sinus cavities augmented with this material. Unilateral or bilateral sinus augmentation was performed in 12 patients with 3-5 mm of alveolar crestal bone height in the posterior maxilla prior to grafting. The sinuses were grafted with bioactive glass mixed in a 4:1 ratio with autogenous bone. Simultaneously, 2-3 threaded titanium implants were inserted into the augmented sinuses. Second stage surgery was carried out 9 to 12 months post implantation. At abutment connection, 10 core biopsy specimens were taken from different grafted sites and evaluated histologically. All 27 implants were clinically stable at second stage surgery. A mean increase in mineralized tissue height of 7.1 +/- 1.6 mm was evident when comparing the pre-surgical CT scans with those performed 9-12 months following the sinus augmentation procedure. Evaluation of the cores yielded a mean of 30.6 +/- 5.7% of bone tissue in the grafted sites. One implant failed during the prosthetic phase while the remaining 26 implants were stable 12 months post loading. This study suggests that Biogran/autogenous bone graft combination used in one-stage sinus augmentation yields sufficient quality and volume of mineralized tissue for predictable simultaneous implant placement in patients with 3-5 mm of bone height prior to grafting.
Cordioli
G
G
Department of Periodontology, Institute of Clinical Dentistry, University of Padova, Padova; Private Practice, Padova, Italy.
Mazzocco
C
C
Schepers
E
E
Brugnolo
E
E
Majzoub
Z
Z
D000328:Adult; D000540:Alveolar Ridge Augmentation / Q000379:methods*; D001672:Biocompatible Materials / Q000627:therapeutic use; D001706:Biopsy; D018786:Bone Substitutes / Q000627:therapeutic use*; D016025:Bone Transplantation; D000044:Dental Abutments; D003758:Dental Implantation, Endosseous; D015921:Dental Implants; D017267:Dental Prosthesis Design; D019094:Dental Prosthesis, Implant-Supported; D019232:Dental Restoration Failure; D005260:Female; D005500:Follow-Up Studies; D005898:Glass; D006801:Humans; D008297:Male; D008437:Maxilla / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008443:Maxillary Sinus / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D013314:Stress, Mechanical; D014025:Titanium; D014057:Tomography, X-Ray Computed; D014182:Transplantation, Autologous; D016896:Treatment Outcome
D001672:Biocompatible Materials; C073544:Biogran; D018786:Bone Substitutes; D015921:Dental Implants; D014025:Titanium