Abstract
PurposeThe success rate of dental implants after graftless sinus augmentation versus conventional sinus augmentation surgery in atrophic maxillae in edentulous patients was investigated.MethodsThis randomized study was performed in ten edentulous patients with marked maxillary atrophy. On the graftless side, the sinus membrane was lifted by a resorbable membrane. The control side was augmented with a mixture of autografts and xenografts. Implant placement followed 6 months postoperatively. Outcomes were implant survival, success of prosthetic rehabilitation and stability of vertical bone gain.ResultsTen patients were included. Postoperative radiology showed sufficient bone gain on both maxillary sides. Follow-up varied from 57 to 88 months. The conventional side showed significant (p = 0.041) more bone gain than the experimental side (respectively, 9.69 mm and 6.20 mm). A total of 59 implants were placed: 30 after conventional, 29 after graftless augmentation. One implant was lost on the conventional side and four on the experimental side. The implant survival was significantly higher on the conventional side (96.7% vs. 86.2%, p < 0.001, RR = 4.14). Prosthetic restoration was functionally successful in all cases.ConclusionBone gain and implant survival were significantly lower in the non-grafted side versus the grafted side. Prosthetic rehabilitation was possible in all ten patients. The non-grafted technique may have some potential for clinical use, although it showed poorer results.Trial registration The Netherlands Trialregister. NTR NL3541 (NTR3696). Registered 20 January 2013, https://www.trialregister.nl/trial/3541.
Highlights
Extreme atrophy of the edentulous maxilla is a common problem that requires augmentation surgery for achieving a sufficient alveolar bone volume allowing for dental implant placement [1,2,3]
Six months after maxillary sinus augmentation, only one Radiology Six months after augmentation all patients showed sufficient new bone formation, which allowed for dental implant placement
At the end of this study, we wondered whether graftless sinus floor augmentation, as we investigated it, could be a real alternative to the many existing techniques described in the literature to create a stable bone supply in the atrophic posterior maxilla pre-implantologically
Summary
Extreme atrophy of the edentulous maxilla is a common problem that requires augmentation surgery for achieving a sufficient alveolar bone volume allowing for dental implant placement [1,2,3]. Simultaneous augmentation and implantation in the posterior maxilla is another possibility and has been discussed widely in literature [20,21,22]. It is acceptable only if the remaining vertical bone height and width are sufficient for primary implant stability
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