Sinus bone grafting procedures using ultrasonic bone surgery: 5-year experience.
Ultrasonic bone surgery was recently introduced as an osteotomic technique; however, documentation is scarce. This article reports on the application of ultrasonic bone surgery for 53 bone-augmentation procedures in the posterior maxilla in 34 patients over 5 years. The initial residual bone height under the sinus varied between 1 and 9 mm (mean: 3.7 mm). Distribution according to residual bone height classes was 7.7% for Class B, 39.3% for Class C, and 53.0% for Class D. The procedures included bony window opening of the sinus, cortical and cancellous bone harvesting, and activation of the sinus wall. During the sinus approach, 2 of 53 membranes (3.8%) were perforated and covered with a membrane made of platelet-poor plasma. Bone grafting was carried out with autologous bone at 22 implant sites (18.8%), with a mixture of autologous bone and anorganic bovine bone mineral (Bio-Oss) at 29 sites (24.8%), and with Bio-Oss alone at 66 sites (56.4%). The perforated membranes healed uneventfully. At second-stage surgery, four implants failed. The survival rate of the 117 placed implants was 96.6%. No implant failed after loading. Performing the sinus grafting procedure with ultrasonic bone surgery limited the occurrence of membrane perforation; by changing the tips, all surgical steps were performed safely and comfortably.
Blus
Cornelio
C
Department of Periodontology, University of Brescia, Italy. corblus@hotmail.com
Szmukler-Moncler
Serge
S
Salama
Maurice
M
Salama
Henry
H
Garber
David
D
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000540:Alveolar Ridge Augmentation / Q000379:methods*; D001857:Bone Matrix / Q000637:transplantation; D018786:Bone Substitutes / Q000627:therapeutic use; D016025:Bone Transplantation / Q000379:methods; D015921:Dental Implants; D019232:Dental Restoration Failure; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008437:Maxilla / Q000601:surgery*; D008443:Maxillary Sinus / Q000601:surgery*; D008567:Membranes, Artificial; D008875:Middle Aged; D008903:Minerals / Q000627:therapeutic use; D016348:Osseointegration / Q000502:physiology; D010949:Plasma; D053657:Platelet-Rich Plasma; D020545:Respiratory Mucosa / Q000293:injuries; D012189:Retrospective Studies; D012449:Safety; D016019:Survival Analysis; D020858:Tissue and Organ Harvesting / Q000379:methods; D014464:Ultrasonic Therapy / Q000295:instrumentation / Q000379:methods*
C077540:Bio-Oss; D018786:Bone Substitutes; D015921:Dental Implants; D008567:Membranes, Artificial; D008903:Minerals