J Periodontal Implant Sci.  2019 Feb;49(1):47-57. 10.5051/jpis.2019.49.1.47.

Maxillary sinus augmentation using biphasic calcium phosphate: dimensional stability results after 3–6 years

• Cha JK
• Kim C
• Pae HC
• Lee JS
• Jung UW
• Choi SH

• KMID: 2440177
• DOI: http://doi.org/10.5051/jpis.2019.49.1.47

Abstract

PURPOSE
This study was designed to observe the resorption pattern of biphasic calcium phosphate (BCP) used for maxillary sinus augmentation over a 3- to 6-year healing period, and to investigate factors affecting the resorption of BCP.
METHODS
A total of 47 implants placed in 27 sinuses of 22 patients were investigated. All patients had residual bone height less than 5 mm at baseline. The modified Caldwell-Luc approach was used to elevate the maxillary sinus membrane, and the sinus cavity was filled with BCP (70% hydroxyapatite and 30% β-tricalcium phosphate). Implant placement was done simultaneously or in a staged manner. Serial radiographic analysis was performed up to 6 years postoperatively.
RESULTS
During the follow-up period, no implant loss was reported. The mean reduced height of the augmented sinus (RHO) was 0.27±1.08 mm at 36 months, and 0.89±1.39 mm at 72 months postoperatively. Large amounts of graft material (P=0.021) and a long healing period (P=0.035) significantly influenced the amount of RHO. In particular, there was a significant relationship between a healing period longer than 40 months and RHO.
CONCLUSIONS
BCP can achieve proper dimensional stability with minimal reduction of the graft height in a 3- to 6-year healing period after maxillary sinus augmentation. The healing period and the amount of graft material influenced the resorption of BCP.

Keyword

Bone substitutes; Dental implants; Maxillary sinus floor augmentation

MeSH Terms

Bone Substitutes
Calcium*
Dental Implants
Durapatite
Follow-Up Studies
Humans
Maxillary Sinus*
Membranes
Sinus Floor Augmentation
Transplants
Bone Substitutes
Calcium
Dental Implants
Durapatite

Figure

• 

  Figure 1 Schematic drawing illustrating the linear measurements taken from radiographs. (A) Immediately after the sinus augmentation. (B) Follow-up after the sinus augmentation. Figure 1 is modified from a figure in our previous study [15]. ASH(m): mesial augmented sinus height, ASH(d): distal augmented sinus height, OBH(m): mesial original alveolar bone height, OBH(d): distal original alveolar bone height, RHO(m): mesial reduced height of augmented sinus, RHO(d): distal reduced height of augmented sinus, MBL(m): mesial marginal bone loss, MBL(d): distal marginal bone loss, I: implant fixture length.

• 

  Figure 2 Panoramic radiographs. (A) Before maxillary sinus augmentation surgery. (B) Immediately after maxillary sinus augmentation and implantation surgery (1-stage). (C) Five years after surgery.

• 

  Figure 3 Graph showing changes of augmented sinus height over the follow-up period in all participants.

• 

  Figure 4 Mean changes of augmented sinus height over the follow-up period.

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