Abstract
Implants inserted in the posterior maxilla frequently need additional surgery for successful bone augmentation. One of the most common procedures for this is transalveolar sinus floor elevation. There are different protocols for this procedure, and there is controversy over the simultaneous application of grafting material upon elevating. In this prospective randomized clinical study in humans, a total of 49 transalveolar sinus floor elevations were performed in 49 different patients, divided into a control group (without graft, 25 patients) and a test group (with graft, 24 patients). The analyzed variables were obtained through digital orthopantomography on day 0 (day of surgery) and 18 months after surgery. These measurements showed a tendency towards greater vertical bone gain in the test group, but this was not statistically significant. Therefore, considering that sinus elevation and implant placement without the application of grafts is a successful treatment with fewer complications, a critical assessment of the need for these biomaterials is necessary.
Highlights
Since the 1970s, classical longitudinal studies have shown that the first teeth to be lost due to periodontal disease are the maxillary molars, whose prolonged absence causes a reduced bone volume due to pneumatization of the maxillary sinus and alveolar bone resorption from the lack of mechanical stimulation [1,2,3,4,5,6,7]
The success of implant therapy is directly related to primary stability, and in turn, to the bone volume present at the implant site
In 1994, Summers proposed the use of tapered osteotomes with increasing diameters to conserve more bone when drilling was not carried out
Summary
Since the 1970s, classical longitudinal studies have shown that the first teeth to be lost due to periodontal disease are the maxillary molars, whose prolonged absence causes a reduced bone volume due to pneumatization of the maxillary sinus and alveolar bone resorption from the lack of mechanical stimulation [1,2,3,4,5,6,7]. The success of implant therapy is directly related to primary stability, and in turn, to the bone volume present at the implant site. The first author to propose a transalveolar approach to correct the pneumatization of the sinus cavity and place implants was Tatum in 1986 through a “socket former”, which is the same size as the implant to be placed [13,14]. Autografts, allografts, xenografts, or synthetic materials were added [15,16,17,18]
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