title: The influence of the bucco-palatal distance on sinus augmentation outcomes.
abstract: BACKGROUND
  Maxillary sinus augmentation is one of the most reliable implant site development options to increase vertical bone height. However, graft consolidation requires adequate angiogenesis and migration of cells involved in osteogenesis and bone remodeling. It is speculated that these biologic events are greatly determined by the dimensions of the maxillary sinus cavity. Hence, the purpose of this study is to assess the influence of the distance from the lateral to the medial wall of the maxillary sinus on the outcomes of sinus augmentation procedures.
  
  
  METHODS
  A total of 25 patients in need of sinus augmentation were recruited for the study. After initial examination, customized radiographic and surgical guides were fabricated and a cone-beam computerized tomography scan was obtained per patient. The bucco-palatal distance (BPD) was measured at 8, 10, and 12 mm from the alveolar crest. Sinus grafting was performed by a lateral window approach using a particulated allograft material. Patients were followed-up for 6 months. At the time of implant placement, bone core biopsies were harvested using the radiographic-surgical guide. Sections of the bone cores at 8, 10, and 12 mm from the alveolar crest were histomorphometrically analyzed. The proportion of vital bone (%VB) was correlated with the BPD using a statistical model.
  
  
  RESULTS
  Twenty-one patients underwent sinus augmentation for a total of 24 sinuses; however, the data analyzed contained only one sinus per patient. One sinus developed an infection after grafting, resulting in a 96% success rate for the sinus grafting procedure. Twenty sinuses were used in the final statistical analysis. Histomorphometric analysis revealed that mean %VB was 22.71 +/- 19.08, mean percent of remaining allograft was 23.39 +/- 20.85, and average percent of non-mineralized connective tissue was 53.90 +/- 13.23. Analysis of the correlation between %VB and BPD by linear regression, using the actual values of BPD showed a strong negative association (R(2) = 0.141; P <0.001).
  
  
  CONCLUSIONS
  The findings suggest that the %VB formation after maxillary sinus augmentation is inversely proportional to the sinus BPD.
authors.affiliation: Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI 48109-1078, USA. avila@umich.edu
authors.forename: Gustavo
authors.initials: G
authors.lastname: Avila
authors.forename: Hom-Lay
authors.initials: HL
authors.lastname: Wang
authors.forename: Pablo
authors.initials: P
authors.lastname: Galindo-Moreno
authors.forename: Carl E
authors.initials: CE
authors.lastname: Misch
authors.forename: Robert A
authors.initials: RA
authors.lastname: Bagramian
authors.forename: Ivan
authors.initials: I
authors.lastname: Rudek
authors.forename: Erika
authors.initials: E
authors.lastname: Benavides
authors.forename: Ildefonso
authors.initials: I
authors.lastname: Moreno-Riestra
authors.forename: Thomas
authors.initials: T
authors.lastname: Braun
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Neiva
mesh_terms: D000328:Adult; D000368:Aged; D000539:Alveolar Process / Q000473:pathology; D000540:Alveolar Ridge Augmentation / Q000295:instrumentation / Q000379:methods*; D001706:Biopsy; D016025:Bone Transplantation / Q000473:pathology; D002508:Cephalometry / Q000379:methods; D054893:Cone-Beam Computed Tomography / Q000379:methods; D003238:Connective Tissue / Q000473:pathology; D003758:Dental Implantation, Endosseous; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008297:Male; D008437:Maxilla / Q000473:pathology* / Q000601:surgery; D008443:Maxillary Sinus / Q000473:pathology / Q000601:surgery*; D008567:Membranes, Artificial; D008875:Middle Aged; D009092:Mucous Membrane / Q000473:pathology; D010012:Osteogenesis / Q000502:physiology; D010159:Palate / Q000473:pathology*; D013530:Surgical Wound Infection / Q000209:etiology; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D008567:Membranes, Artificial