J Periodontal Implant Sci.  2010 Feb;40(1):25-32. 10.5051/jpis.2010.40.1.25.

A radiographical study on the changes in height of grafting materials after sinus lift: a comparison between two types of xenogenic materials

• Hieu PD
• Chung JH
• Yim SB
• Hong KS

• KMID: 2094712
• DOI: http://doi.org/10.5051/jpis.2010.40.1.25

Abstract

PURPOSE
The performance of implant surgery in the posterior maxilla often poses a challenge due to insufficient available bone. Sinus floor elevation was developed to increase the needed vertical height to overcome this problem. However, grafting materials used for the sinus lift technique eventually show resorption. The present study radiographically compared and evaluated the changes in height of the grafting materials after carrying out maxillary sinus elevation with a window opening procedure. This study also evaluated the difference between two xenogenic bone materials when being used for the sinus lifting procedure.
METHODS
Twenty-one patients were recruited for this study and underwent a sinus lift procedure. All sites were treated with either bovine bone (Bio-Oss(R)) with platelet-rich plasma (PRP) or bovine bone (OCS-B(R))/PRP. A total of 69 implants were placed equally 6-8 months after the sinus lift. All sites were clinically and radiographically evaluated right after the implant surgery, 7-12 months, 13-24 months, and 25-48 months after their prosthetic loading.
RESULTS
Changes of implant length/bone length with time showed a statistically significant decreasing tendency (P < 0.05). There was no significant change in the Bio-Oss(R) group (P > 0.05). In contrast, the OCS-B(R) group showed a significant decrease with time (P < 0.05). However, no significant difference was observed between the two groups (P > 0.05).
CONCLUSIONS
The results showed that there was significant reduction in comparison with data right after placement, after 7 to 12 months, 13 to 24 months, and over 25 months; however, reduction rates between each period have shown to be without significance. No significant difference in height change was observed between the Bio-Oss(R) and the OCS-B(R) groups.

Keyword

Bone substitutes; Maxillary sinus

MeSH Terms

Bone Substitutes
Floors and Floorcoverings
Humans
Lifting
Maxilla
Maxillary Sinus
Platelet-Rich Plasma
Transplants
Bone Substitutes

Figure

• 

  Figure 1 Diagram for the measurement of bone level and height. IL: implant length, BL: bone level.

• 

  Figure 2 Statical analysis of BL/IL as time passed. BL: bone level, IL: implant length.

• 

  Figure 3 Statically analysis of each group as time passed.

• 

  Figure 4 Statical analysis between groups as time passed.

Reference

1. Adell R, Eriksson B, Lekholm U, Branemark PI, Jemt T. Long-term follow-up study of osseointegrated implants in the treatment of totally edentulous jaws. Int J Oral Maxillofac Implants. 1990; 5:347–359.

2. Albrektsson T, Dahl E, Enbom L, Engevall S, Engquist B, Eriksson AR, et al. Osseointegrated oral implants: a Swedish multicenter study of 8139 consecutively inserted Nobelpharma implants. J Periodontol. 1988; 59:287–296.

3. Chanavaz M. Maxillary sinus: anatomy, physiology, surgery, and bone grafting related to implantology: eleven years of surgical experience (1979-1990). J Oral Implantol. 1990; 16:199–209.

4. Rosen MD, Sarnat BG. Change of volume of the maxillary sinus of the dog after extraction of adjacent teeth. Oral Surg Oral Med Oral Pathol. 1955; 8:420–429.

5. Tatum H Jr. Maxillary and sinus implant reconstructions. Dent Clin North Am. 1986; 30:207–229.

6. Misch CE. Bone character: second vital implant criterion. Dent Today. 1988; 7:39–40.

7. Lekholom U, Zarb GA. Patient selection and preparation. In : Branemark PI, Zarb GA, Albrektsson T, editors. Tissue-integrated prostheses: osseointegration in clinical dentistry. Chicago: Quintessence;1985. p. 199–220.

8. Boyne PJ, James RA. Grafting of the maxillary sinus floor with autogenous marrow and bone. J Oral Surg. 1980; 38:613–616.

9. Jensen J, Simonsen EK, Sindet-Pedersen S. Reconstruction of the severely resorbed maxilla with bone grafting and osseointegrated implants: a preliminary report. J Oral Maxillofac Surg. 1990; 48:27–32.

10. Adell R, Lekholm U, Grondahl K, Branemark PI, Lindstrom J, Jacobsson M. Reconstruction of severely resorbed edentulous maxillae using osseointegrated fixtures in immediate autogenous bone grafts. Int J Oral Maxillofac Implants. 1990; 5:233–246.

11. Isaksson S. Evaluation of three bone grafting techniques for severly resorbed maxillae in conjunction with immediate endosseous implants. Int J Oral Maxillofac Implants. 1994; 9:679–688.

12. Kahnberg KE, Nystrom E, Bartholdsson L. Combined use of bone grafts and Branemark fixtures in the treatment of severely resorbed maxillae. Int J Oral Maxillofac Implants. 1989; 4:297–304.

13. Summers RB. A new concept in maxillary implant surgery: the osteotome technique. Compendium. 1994; 15:152–158.

14. Summers RB. The osteotome technique. Part 3: Less invasive methods of elevating the sinus floor. Compendium. 1994; 15:698–704.

15. Buchmann R, Khoury F, Faust C, Lange DE. Peri-implant conditions in periodontally compromised patients following maxillary sinus augmentation. A long-term post-therapy trial. Clin Oral Implants Res. 1999; 10:103–110.

16. Nabers CL, O'Leary TJ. Autogenous bone transplants in the treatment of osseous defects. J Periodontol. 1965; 36:5–14.

17. Dragoo MR, Sullivan HC. A clinical and histological evaluation of autogenous iliac bone grafts in humans. I: Wound healing 2 to 8 months. J Periodontol. 1973; 44:599–613.

18. Nishibori M, Betts NJ, Salama H, Listgarten MA. Short-term healing of autogenous and allogeneic bone grafts after sinus augmentation: a report of 2 cases. J Periodontol. 1994; 65:958–966.

19. McAllister BS, Margolin MD, Cogan AG, Buck D, Hollinger JO, Lynch SE. Eighteen-month radiographic and histologic evaluation of sinus grafting with anorganic bovine bone in the chimpanzee. Int J Oral Maxillofac Implants. 1999; 14:361–368.

20. Wanschitz F, Figl M, Wagner A, Rolf E. Measurement of volume changes after sinus floor augmentation with a phycogenic hydroxyapatite. Int J Oral Maxillofac Implants. 2006; 21:433–438.

21. Hatano N, Shimizu Y, Ooya K. A clinical long-term radiographic evaluation of graft height changes after maxillary sinus floor augmentation with a 2:1 autogenous bone/xenograft mixture and simultaneous placement of dental implants. Clin Oral Implants Res. 2004; 15:339–345.

22. Cho SH, Kim OS. Radiographic change of grafted sinus floor after maxillary sinus floor elevation and placement of dental implant. J Korean Acad Periodontol. 2006; 36:345–359.

23. Keller EE, Eckert SE, Tolman DE. Maxillary antral and nasal one-stage inlay composite bone graft: preliminary report on 30 recipient sites. J Oral Maxillofac Surg. 1994; 52:438–447.

24. Blomqvist JE, Alberius P, Isaksson S. Retrospective analysis of one-stage maxillary sinus augmentation with endosseous implants. Int J Oral Maxillofac Implants. 1996; 11:512–521.

25. Hallman M, Hedin M, Sennerby L, Lundgren S. A prospective 1-year clinical and radiographic study of implants placed after maxillary sinus floor augmentation with bovine hydroxyapatite and autogenous bone. J Oral Maxillofac Surg. 2002; 60:277–284.

26. Jaffin RA, Berman CL. The excessive loss of Branemark fixtures in type IV bone: a 5-year analysis. J Periodontol. 1991; 62:2–4.

27. Friberg B, Jemt T, Lekholm U. Early failures in 4,641 consecutively placed Branemark dental implants: a study from stage 1 surgery to the connection of completed prostheses. Int J Oral Maxillofac Implants. 1991; 6:142–146.

28. Jemt T, Lekholm U. Implant treatment in edentulous maxillae: a 5-year follow-up report on patients with different degrees of jaw resorption. Int J Oral Maxillofac Implants. 1995; 10:303–311.

29. Bahat O. Treatment planning and placement of implants in the posterior maxillae: report of 732 consecutive Nobelpharma implants. Int J Oral Maxillofac Implants. 1993; 8:151–161.

30. Adell R, Lekholm U, Rockler B, Branemark PI. A 15-year study of osseointegrated implants in the treatment of the edentulous jaw. Int J Oral Surg. 1981; 10:387–416.

31. Hurzeler MB, Kirsch A, Ackermann KL, Quinones CR. Reconstruction of the severely resorbed maxilla with dental implants in the augmented maxillary sinus: a 5-year clinical investigation. Int J Oral Maxillofac Implants. 1996; 11:466–475.

32. Coombs CJ, Mutimer KL, Holmes AD, Levant BA, Courtemanche DJ, Clement JG. Osseointegration in sinus-forming bone. Plast Reconstr Surg. 1995; 95:866–875.

33. Johansson B, Grepe A, Wannfors K, Aberg P. CT-scan in assessing volumes of bone grafts to the heavily resorbed maxilla. J Craniomaxillofac Surg. 1998; 26:Suppl 1. 85.

34. Jensen OT, Shulman LB, Block MS, Iacono VJ. Report of the Sinus Consensus Conference of 1996. Int J Oral Maxillofac Implants. 1998; 13:Suppl. 11–45.

35. Block MS, Kent JN, Kallukaran FU, Thunthy K, Weinberg R. Bone maintenance 5 to 10 years after sinus grafting. J Oral Maxillofac Surg. 1998; 56:706–714.

36. Nystrom E, Kahnberg KE, Albrektsson T. Treatment of the severely resorbed maxillae with bone graft and titanium implants: histologic review of autopsy specimens. Int J Oral Maxillofac Implants. 1993; 8:167–172.

37. Listrom RD, Symington JM. Osseointegrated dental implants in conjunction with bone grafts. Int J Oral Maxillofac Surg. 1988; 17:116–118.