title: Trans-sinus dental implants, bone morphogenetic protein 2, and immediate function for all-on-4 treatment of severe maxillary atrophy.
abstract: OBJECTIVE
  The aim of this study was to evaluate the clinical outcomes of trans-sinus dental implant placement by use of bone morphogenetic protein 2 (BMP-2) grafting and immediate functional loading by the all-on-4 scheme.
  
  
  METHODS
  After bone reduction to create the all-on-4 shelf or because of severe maxillary atrophy and prominent sinus anatomy, 10 patients were selected to undergo trans-sinus implant placement and simultaneous BMP-2 sinus floor grafting for immediate provisional loading. Insertion torque was measured upon implant placement. Patients were followed up for at least 1 year after final restoration when either a computed tomography scan or panoramic radiograph was obtained and analyzed for the presence of trans-sinus peri-implant bone. Hounsfield units were recorded mid sinus graft.
  
  
  RESULTS
  Of 19 trans-sinus implants, 18 remained integrated at the 1-year follow-up, for a 5.2% failure rate. All sinus grafts formed bone, with a mean of 460 Hounsfield units. Final fixed prostheses were completed for all 10 patients.
  
  
  CONCLUSIONS
  Trans-sinus dental implant placement with BMP-2 grafting to gain anterior-posterior spread for immediate function by use of all-on-4 treatment appears to be a viable alternative to the use of zygomatic implants in the presence of severe maxillary atrophy.
authors.affiliation: ClearChoice Dental Implant Center, Greenwood Village, CO, USA. ole.jensen@clearchoice.com
authors.forename: Ole T
authors.initials: OT
authors.lastname: Jensen
authors.forename: Jared
authors.initials: J
authors.lastname: Cottam
authors.forename: Jason
authors.initials: J
authors.lastname: Ringeman
authors.forename: Mark
authors.initials: M
authors.lastname: Adams
mesh_terms: D001284:Atrophy; D015519:Bone Density / Q000502:physiology; D055396:Bone Morphogenetic Protein 2 / Q000627:therapeutic use*; D018786:Bone Substitutes / Q000627:therapeutic use; D016025:Bone Transplantation; D003758:Dental Implantation, Endosseous / Q000379:methods*; D015921:Dental Implants; D005500:Follow-Up Studies; D006801:Humans; D057893:Immediate Dental Implant Loading; D008437:Maxilla / Q000473:pathology / Q000601:surgery*; D008443:Maxillary Sinus / Q000601:surgery*; D009296:Nasal Cavity / Q000601:surgery; D016348:Osseointegration / Q000502:physiology; D010012:Osteogenesis / Q000502:physiology; D011862:Radiography, Panoramic; D059546:Sinus Floor Augmentation / Q000379:methods; D014057:Tomography, X-Ray Computed; D019415:Torque; D016896:Treatment Outcome
chemical_list: C525718:BMP2 protein, human; D055396:Bone Morphogenetic Protein 2; D018786:Bone Substitutes; D015921:Dental Implants