Abstract
Nowadays implant-prosthetic rehabilitations are one of the best solutions for rehabilitating our patients. These allow obtaining rehabilitations with optimal functional and aesthetic performances. Often patients, who undergo implant-prosthetic therapy, have the conditions of edentulias, single or multiple, that have been going on for some time. This, according to the literature, produces resorption of the alveolar bone, a process that is complicated in the posterior area of the upper arch by a pneumatization of the maxillary sinuses. The loss of vertical height, so that the implant fixtures can be inserted, requires a maneuver called maxillary sinus floor elevation. This procedure, now safely performed with piezoelectric instruments, allows increasing bone height through bone grafting. In this study, the tissue obtained from a patient, after 15 years from the intervention, was evaluated by histological and SEM analyses. The bone healing in the patient has led to a perfect integration between the patient’s bone and the fresh frozen allograft used, however still present and detectable after 15 years.
Highlights
Implant-supported rehabilitation of the atrophic posterior maxilla generally finds the maxillary sinus both as a boundary and an opportunity
The present study reported the histomorphometric evaluation of a bone specimen retrieved 15 years after sinus augmentation performed by using a cortico-cancellous block of fresh frozen bone allograft
The histologic observations of the present study demonstrated a perfect integration between newly-formed bone and fresh frozen allograft, whose remnants are still present and detectable (15% of the biopsy volume) fifteen years after the grafting procedure
Summary
Implant-supported rehabilitation of the atrophic posterior maxilla generally finds the maxillary sinus both as a boundary and an opportunity. Since its introduction in the early 1980s [1,2], the surgical approach to access maxillary sinus and its clinical indications have greatly evolved. Lateral sinus augmentation can be safely performed with piezoelectric instrumentation [3,4,5], and reliable alternatives (transcrestal approach, short implants) are available in selected cases [6,7,8]. In sinus floor elevation, autogenous bone is still the better material in terms of osteogenicity, osteoconduction, osteoinduction, and osteointegration, a robust body of evidence showed comparable results using an allograft, alloplastic, xenograft, and blood clot alone in.
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