Transalveolar maxillary sinus floor elevation using osteotomes with or without grafting material. Part II: Radiographic tissue remodeling.
OBJECTIVE
To evaluate the pattern of tissue remodeling after maxillary sinus floor elevation using the transalveolar osteotome technique with or without utilizing grafting materials.


METHODS
During the period of 2000-2005, 252 Straumann dental implants were inserted using the transalveolar sinus floor elevation technique in a group of 181 patients. For 88 or 35% of those implants, deproteinized bovine bone mineral with a particle size of 0.25-1 mm was used as the grafting material, but for the remaining 164 implants, no grafting material was utilized. Periapical radiographs were obtained with a paralleling technique and digitized. Two investigators, who were blinded to whether grafting material was used or not, subsequently evaluated the pattern of tissue remodeling.


RESULTS
The mean residual bone height was 7.5 mm (SD 2.2 mm), ranging from 2 to 12.7 mm. The mean residual bone height for implants placed with grafting material (6.4 mm) was significantly less compared with the implants installed without grafting material (8.1 mm). The implants penetrated on average 3.1 mm (SD 1.7 mm) into the sinus cavity. The measured mean radiographic bone gain using the transalveolar technique without grafting material was significantly less, 1.7 mm (SD 2 mm) compared with a mean bone gain of 4.1 mm (SD 2.4 mm), when grafting material was used. Furthermore, the probability of gaining 2 mm or more of new bone was 39.1% when no grafting material was used. The probability increased to 77.9% when the implants were installed with grafting material.


CONCLUSIONS
When the transalveolar sinus floor elevation was performed without utilizing grafting material, only a moderate gain of new bone could be detected mesial and distal to the implants. On the other hand, when grafting material was used, a substantial gain of new bone was usually seen on the radiographs.
Pjetursson
Bjarni E
BE
Department of Reconstructive Dentistry, Faculty of Odontology, University of Iceland, Reykjavik, Iceland. bep@hi.is
Ignjatovic
Diana
D
Matuliene
Giedre
G
Brägger
Urs
U
Schmidlin
Kurt
K
Lang
Niklaus P
NP
D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging; D000540:Alveolar Ridge Augmentation / Q000379:methods*; D001672:Biocompatible Materials; D001857:Bone Matrix / Q000637:transplantation; D001861:Bone Regeneration / Q000502:physiology; D016723:Bone Remodeling / Q000502:physiology; D018786:Bone Substitutes / Q000627:therapeutic use*; D003094:Collagen; D015921:Dental Implants; D019094:Dental Prosthesis, Implant-Supported; D019232:Dental Restoration Failure; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008437:Maxilla / Q000000981:diagnostic imaging / Q000601:surgery*; D008443:Maxillary Sinus / Q000000981:diagnostic imaging / Q000601:surgery*; D008567:Membranes, Artificial; D008903:Minerals / Q000627:therapeutic use; D010027:Osteotomy / Q000295:instrumentation / Q000379:methods*; D011446:Prospective Studies; D016300:Radiography, Bitewing; D019252:Radiography, Dental, Digital; D016037:Single-Blind Method; D014945:Wound Healing / Q000502:physiology
C106416:Bio-Gide; C077540:Bio-Oss; D001672:Biocompatible Materials; D018786:Bone Substitutes; D015921:Dental Implants; D008567:Membranes, Artificial; D008903:Minerals; D003094:Collagen