J Periodontal Implant Sci.  2010 Dec;40(6):283-288. 10.5051/jpis.2010.40.6.283.

Incomplete bone formation after sinus augmentation: A case report on radiological findings by computerized tomography at follow-up

Affiliations
  • 1Department of Periodontology, Kyung Hee University School of Dentistry, Seoul, Korea. chungjh@khu.ac.kr
  • 2Institute of Oral Biology, Kyung Hee University School of Dentistry, Seoul, Korea.

Abstract

PURPOSE
The aim of this case report is to present a case of incomplete bone formation after sinus augmentation.
METHODS
A patient having alveolar bone resorption of the maxillary posterior edentulous region and advanced pneumatization of the maxillary sinus was treated with sinus elevation using deproteinized bovine bone in the Department of Periodontology, Kyung Hee University School of Dentistry and re-evaluated with computed tomography (CT) follow-up.
RESULTS
Even though there were no significant findings or abnormal radiolucency on the panoramic radiograph, incomplete bone formation in the central portion of the augmented sinus was found fortuitously in the CT scan. The CT scan revealed peri-implant radiolucency in the apical portion of the implant placed in the augmented maxillary sinus. Nevertheless, the dental implants placed in the grafted sinus still functioned well at over 15 months follow-up.
CONCLUSIONS
The result of this case suggests that patients who received maxillary sinus augmentation may experience incomplete bone formation. It is possible that 1) osteoconductive graft material with poor osteogenic potential, 2) overpacking of graft material that restricts the blood supply, and 3) bone microbial contamination may cause the appearance of incomplete bone formation after sinus augmentation. Further studies are needed to elucidate the mechanism of this unexpected result and care must be taken to prevent it.

Keyword

Bone formation; Computed tomography; Maxillary sinus

MeSH Terms

Bone Resorption
Dental Implants
Dentistry
Durapatite
Follow-Up Studies
Humans
Maxillary Sinus
Osteogenesis
Transplants
Dental Implants
Durapatite

Figure

  • Figure 1 Panoramic radiograph at first visit.

  • Figure 2 After extraction of #16, marked alveolar bone resorption and pneumatization of the maxillary sinus is visible.

  • Figure 3 Diagnostic stent for the implant placement at #16i and 17i.

  • Figure 4 Maxillary sinus augmentation was performed.

  • Figure 5 Radiopacity of the augmented sinus had increased at 7 months after the operation.

  • Figure 6 First implant surgery on #16i and 17i was performed.

  • Figure 7 Second implant surgery on #16i and 17i was performed 6 months after the first implant surgery.

  • Figure 8 Final prosthetic loading was initiated 13 months after the first implant surgery.

  • Figure 9 Bone cavity in #16i and 17i area was found in the computed tomography scan (32 months after the sinus augmentation).

  • Figure 10 Panoramic radiograph of the most recent visit.


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