Distal Displacement of Maxillary Sinus Anterior Wall Versus Conventional Sinus Lift with Lateral Access: A 3-Year Retrospective Computerized Tomography Study.

Giovanni Battista Menchini-Fabris,Roberto Crespi,Paolo Toti,Ugo Covani,Giovanni Crespi

doi:10.3390/ijerph17197199

Giovanni Battista Menchini-Fabris, Roberto Crespi + Show 3 more

Open Access

https://doi.org/10.3390/ijerph17197199

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Abstract

Background: The present study is designed to compare the outcomes of two sinus augmentation procedures: distal displacement of the anterior wall versus standard sinus lifting and grafting with a lateral window approach. Methods: In the displacement group, a localized surgical fracture of the sinus floor achieved through an electromagnetic device results in the distal displacement of the anterior wall. In the filling group, sinus lifting (with lateral access) and grafting with particulate xenogeneic bone substitute was performed. Bone volume beneath the maxillary sinus was investigated with computerized tomography after baseline and postoperative data superimposition. Clinical and radiological outcomes over three years had been evaluated. Results: Forty-three dental implants were selected. The two sinus lift procedures significantly increased the bone volume (p-value ≤ 0.0017) in the displacement group from 1.17 ± 0.34 to 1.53 ± 0.39 cc, with a final bone gain of +0.36 ± 0.17 cc, and in the filling group from 1.24 ± 0.41 to 1.94 ± 0.68 cc, with a bone augmentation of +0.71 ± 0.31 cc. No events of dental implant bulging into the maxillary sinus occurred. Two implants failed early on in the filling group, attesting the 3-year survival rate of 92.6% (CI95%: 82.7–100%). Marginal bone loss at the distal aspect was 1.66 ± 0.72 and 1.25 ± 0.78 mm, respectively, for the displacement and filling groups, with a significant difference (p-value = 0.0497). Conclusion: Results showed a significant and effective bone gain around dental implants at a 3-year survey for both sinus augmented by backward displacement of the anterior wall (+34%) and sinus lifting and grafting with a lateral window approach (+57%).

Highlights

Maxillary sinuses are two-side cavities within the splanchnocranium above the posterior maxillary area of the alveolar bone
A secondary septum is generally caused by loss of the alveolar bone surrounding root apices of an extracted tooth, which contributes to maxillary sinus hyperpneumatization [1]
The primary aim of the present study is to evaluate, at a 3-year follow-up, the effect of different sinus lifting approaches on the volume remodeling of the crestal bone around implant-supported fixed prostheses

Summary

Introduction

Maxillary sinuses are two-side cavities within the splanchnocranium above the posterior maxillary area of the alveolar bone. The dimensions of these pyramidal cavities are extremely variable from person to person and depend on peculiar interior features, that is, the presence of congenital or secondary sinus septa. The present study is designed to compare the outcomes of two sinus augmentation procedures: distal displacement of the anterior wall versus standard sinus lifting and grafting with a lateral window approach. Methods: In the displacement group, a localized surgical fracture of the sinus floor achieved through an electromagnetic device results in the distal displacement of the anterior wall. Sinus lifting (with lateral access) and grafting with particulate xenogeneic bone substitute was performed. The two sinus lift procedures significantly increased the bone volume (p-value ≤ 0.0017)

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