Evaluation of bone formation following the osteotome sinus floor elevation technique without grafting using cone beam computed tomography: a preliminary study

Patrayu Taebunpakul,Chanchai Wongchuensoontorn,Panapohn Suk-Arj

doi:10.1186/s40729-019-0181-7

Patrayu Taebunpakul, Chanchai Wongchuensoontorn + Show 1 more

Open Access

https://doi.org/10.1186/s40729-019-0181-7

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Abstract

BackgroundOsteotome sinus floor elevation (OSFE) is used to increase the bone volume at the site of the maxillary sinus through the transalveolar approach. However, there is uncertainty regarding the necessity of the use of grafting material in order to maintain the space for new bone formation.ObjectiveThis study aimed to evaluate new bone formation 6 months after osteotome sinus floor elevation without grafting and to evaluate the correlations between residual bone height (RBH), implant protrusion length (IPL), and endo-sinus bone gain (ESBG).Material and methodsThirty-one implants (27 patients) from area 14–17 and 24–27 were included in the study. All implants had a history of OSFE without grafting, with cone beam computed tomography (CBCT) taken prior to the surgery. The clinical examination and radiographic examination using CBCT were performed again 6 months after implantation. The RBH, new bone level, ESBG, and IPL were measured. Paired sample t test and Pearson correlation were used to analyze the data.ResultsThe average RBH before surgery was 7.14 ± 1.07 mm and 6 months after surgery was 8.95 ± 1.17 mm. There was a significant increase in new bone formation in the 6 months following surgery (p < 0.05). The average ESBG and IPL were 1.8 ± 0.79 mm and 2.02 ± 0.73 mm, respectively. There was a significant positive correlation between the IPL and ESBG (p < 0.05) while there was a negative correlation between RBH and ESBG. This study also demonstrates a decrease in the percentage of bone formation in relation to IPL as the IPL increases. The survival rate of the implant was 100%.ConclusionSignificant new bone formation can be detected around the implant site 6 months after implantation using OSFE technique without grafting. There is a negative correlation between the RBH and ESBG. While IPL is correlated to ESBG and appears to be the influencing factors of bone formation changes in the maxillary sinus. The preliminary radiographic results suggest that OSFE technique without grafting in combination with optimal IPL can provide sufficient bone height for implant support with a 100% implant survival rate.

Highlights

Conventional implant placement is often difficult when the residual bone height is inadequate
Significant new bone formation can be detected around the implant site 6 months after implantation using osteotome sinus floor elevation (OSFE) technique without grafting
While implant protrusion length (IPL) is correlated to endo-sinus bone gain (ESBG) and appears to be the influencing factors of bone formation changes in the maxillary sinus

Summary

Introduction

Conventional implant placement is often difficult when the residual bone height is inadequate. Support for the implant may be lacking, and there is a risk of perforating the maxillary sinus membrane. In many of these cases, sinus floor elevation is required to increase the bone height to permit successful implant placement [1]. Recent innovations, such as tilting implants and short implants, can be used alongside sinus floor elevation to further improve patient outcomes [2, 3]. Osteotome sinus floor elevation (OSFE) is used to increase the bone volume at the site of the maxillary sinus through the transalveolar approach. There is uncertainty regarding the necessity of the use of grafting material in order to maintain the space for new bone formation

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