Long-term changes in graft height after maxillary sinus augmentation, onlay bone grafting, and combination of both techniques: a long-term retrospective cohort study.
OBJECTIVE
This investigation focused on long-term changes in graft height, implant survival rate, and peri-implant tissue conditions of dental implants placed in alveolar ridges after augmentation procedures with a follow-up of 10 years.


METHODS
We conducted a retrospective cohort study with prospective long-term follow-up of 25 patients with edentulous severe atrophic maxillary situations who received a vertical augmentation procedure with autologous bone prior to implant placement. The participants were divided into three groups according to whether they underwent sinus elevation, onlay grafting, or a combination of both techniques. After a four-month healing period, 127 implants were inserted in the corresponding regions. Following a six-month healing period, the participants underwent prosthodontic rehabilitation, incorporating a fixed or removable implant denture. The cohort was clinically and radiographically followed up 1, 5, and 10 years after augmentation. The following parameters were measured: radiographic vertical bone changes, implant loss, peri-implant pocket depth (PD), width of keratinized mucosa (KM), sulcus fluid flow rate (SFFR), and the radiographic distance between the implant shoulder and the first visible bone-to-implant contact (DIB).


RESULTS
Seven implants were lost during the observation period, resulting in a cumulative 10-year survival rate of 94.48%. Significant bone loss occurred during the first 12 months, after which the resorption slowed down and bone height eventually stabilized. After 10 years, the total vertical bone loss was 27.51% after onlay grafting, 28.14% after sinus elevation, and 30.24% in the combination group, with no statistically significant between-group differences. Peri-implant follow-up examinations revealed a positive correlation between SFFR and PD, respectively, DIB, and a negative correlation between SFFR and KM.


CONCLUSIONS
The treatment method does not seem to impact vertical bone loss following augmentation using autologous grafts. This approach results in long-term stability of dental implants. A sufficient width of keratinized peri-implant mucosa is important to prevent peri-implant bone loss and inflammation.
Department of Oral and Maxillofacial Surgery, University of Erlangen- Nuremberg, Erlangen, Germany; Faculty of Dentistry, University of Toronto, Toronto, ON, Canada.
Christian
C
Schmitt
Tarek
T
Karasholi
Rainer
R
Lutz
Jörg
J
Wiltfang
Friedrich-Wilhelm
FW
Neukam
Karl Andreas
KA
Schlegel
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001862:Bone Resorption; D016025:Bone Transplantation / Q000379:methods*; D003758:Dental Implantation, Endosseous / Q000295:instrumentation / Q000379:methods*; D019232:Dental Restoration Failure; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011862:Radiography, Panoramic; D012189:Retrospective Studies; D059546:Sinus Floor Augmentation / Q000379:methods*; D014182:Transplantation, Autologous; D016896:Treatment Outcome