Retrospective study on the merits of bone grafts and the influence of implant protrusion length after osteotome sinus elevation surgery

doi:10.7518/hxkq.2021.05.012

Abstract

Abstract: Objective

This study aims to evaluate the endo-sinus bone remodeling of dental implants placed via osteotome sinus floor elevation (OSFE) after 6 months and using different implant protrusion lengths and bone grafts through cone beam computed tomography (CBCT).

Methods

Ninety-six patients with 124 implants were included and assigned into four groups. Group 1: implant protrusion length<4 mm with bone graft; group 2: implant protrusion length>4 mm with bone graft; group 3: implant protrusion length<4 mm without bone graft; group 4: implant protrusion length>4 mm without bone graft. Apical bone gain (ABG), cortical bone gain (CBG), bone density gain (BDG), and marginal bone loss (MBL) were observed and analyzed at baseline and 6 months after implant surgery.

Results

The CBG in grafted groups 1 and 2 was higher than that in non-grafted groups. The ABG and BDG were higher in non-grafted groups 3 and 4 than in grafted groups, and the levels in group 3 were higher than those in group 4. The CBG in grafted group 2 was higher than that in group 1. No significant difference was observed in MBL analysis.

Conclusion

The BDG of IPL<4 mm implants was higher than IPL>4 mm implant when bone grafts were not applied. No relevance was observed between IPL and CBG. Bone grafts can accelerate endo-sinus bone remodeling by increasing CBG and dissipating the influence of IPL on BDG.

Key words: dental implant, bone grafts, implant protrusion length, osteotome sinus floor elevation

CLC Number:

R 783

Yang Dawei, Xiao Jingyi, Zhang Peng, Lu Boyao, Liang Xing.. Retrospective study on the merits of bone grafts and the influence of implant protrusion length after osteotome sinus elevation surgery[J]. West China Journal of Stomatology, 2021, 39(5): 570-575.

Figures/Tables 7

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References 23

1	Sbordone C, Toti P, Guidetti F, et al. Volume changes of autogenous bone after sinus lifting and grafting procedures: a 6-year computerized tomographic follow-up[J]. J Craniomaxillofac Surg, 2013, 41(3): 235-241.
2	Borges FL, Dias RO, Piattelli A, et al. Simultaneous sinus membrane elevation and dental implant placement without bone graft: a 6-month follow-up study[J]. J Pe-riodontol, 2011, 82(3): 403-412.
3	Boyne PJ, Lilly LC, Marx RE, et al. De novo bone induction by recombinant human bone morphogenetic protein-2 (rhBMP-2) in maxillary sinus floor augmentation[J]. J Oral Maxillofac Surg, 2005, 63(12): 1693-1707.
4	Choukroun J, Diss A, Simonpieri A, et al. Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part V: histologic evaluations of PRF effects on bone allo-graft maturation in sinus lift[J]. Oral Surg Oral Med O-ral Pathol Oral Radiol Endod, 2006, 101(3): 299-303.
5	Ella B, Sédarat C, Noble Rda C, et al. Vascular connections of the lateral wall of the sinus: surgical effect in sinus augmentation[J]. Int J Oral Maxillofac Implants, 2008, 23(6): 1047-1052.
6	Lundgren S, Andersson S, Gualini F, et al. Bone reformation with sinus membrane elevation: a new surgical technique for maxillary sinus floor augmentation[J]. Clin Implant Dent Relat Res, 2004, 6(3): 165-173.
7	Moraschini V, Uzeda MG, Sartoretto SC, et al. Maxilla-ry sinus floor elevation with simultaneous implant placement without grafting materials: a systematic review and meta-analysis[J]. Int J Oral Maxillofac Surg, 2017, 46(5): 636-647.
8	Nedir R, Nurdin N, Khoury P, et al. Osteotome sinus floor elevation with and without grafting material in the severely atrophic maxilla. A 1-year prospective randomized controlled study[J]. Clin Oral Implants Res, 2013, 24(11): 1257-1264.
9	Ahn JJ, Cho SA, Byrne G, et al. New bone formation following sinus membrane elevation without bone graf-ting: histologic findings in humans[J]. Int J Oral Maxillofac Implants, 2011, 26(1): 83-90.
10	Toffler M. Osteotome-mediated sinus floor elevation: a clinical report[J]. Int J Oral Maxillofac Implants, 2004, 19(2): 266-273.
11	Si MS, Shou YW, Shi YT, et al. Long-term outcomes of osteotome sinus floor elevation without bone grafts: a clinical retrospective study of 4-9 years[J]. Clin Oral Implants Res, 2016, 27(11): 1392-1400.
12	Yang J, Xia T, Fang J, et al. Radiological changes asso-ciated with new bone formation following osteotome sinus floor elevation (OSFE): a retrospective study of 40 patients with 18-month follow-up[J]. Med Sci Monit, 2018, 24: 4641-4648.
13	Falah M, Sohn DS, Srouji S. Graftless sinus augmentation with simultaneous dental implant placement: clinical results and biological perspectives[J]. Int J Oral Maxillofac Surg, 2016, 45(9): 1147-1153.
14	Cossellu G, Farronato G, Farronato D, et al. Space-maintaining management in maxillary sinus lifting: a novel technique using a resorbable polymeric thermo-reversi-ble gel[J]. Int J Oral Maxillofac Surg, 2017, 46(5): 648-654.
15	Atef M, Hakam MM, ElFaramawey MI, et al. Nongrafted sinus floor elevation with a space-maintaining titanium mesh: case-series study on four patients[J]. Clin Implant Dent Relat Res, 2014, 16(6): 893-903.
16	Si MS, Zhuang LF, Gu YX, et al. Osteotome sinus floor elevation with or without grafting: a 3-year randomized controlled clinical trial[J]. J Clin Periodontol, 2013, 40(4): 396-403.
17	Zhang XM, Shi JY, Gu YX, et al. Clinical investigation and patient satisfaction of short implants versus longer implants with osteotome sinus floor elevation in atrophic posterior maxillae: a pilot randomized trial[J]. Clin Implant Dent Relat Res, 2017, 19(1): 161-166.
18	Lundgren S, Johansson AS, Cricchio G, et al. Clinical outcome and factors determining new bone formation in lateral sinus membrane elevation with simultaneous implant placement without grafting material: a cross-sectional, 3-17 year follow-up study[J]. Clin Implant Dent Relat Res, 2019, 21(5): 827-834.
19	Cai Q, Zhou Y, Li B, et al. Osteotome sinus floor elevation under special procedure with grafting material in the severely atrophic maxilla: radiographic study of 48 mon-ths follow-up[J]. J Biomater Tissue Eng, 2018, 8(3): 410-415.
20	Nedir R, Nurdin N, Abi Najm S, et al. Short implants placed with or without grafting into atrophic sinuses: the 5-year results of a prospective randomized controlled study[J]. Clin Oral Implants Res, 2017, 28(7): 877-886.
21	González-García R, Monje F. The reliability of cone-beam computed tomography to assess bone density at dental implant recipient sites: a histomorphometric analysis by micro-CT[J]. Clin Oral Implants Res, 2013, 24(8): 871-879.
22	Kühl S, Götz H, Brochhausen C, et al. The influence of substitute materials on bone density after maxillary sinus augmentation: a microcomputed tomography study[J]. Int J Oral Maxillofac Implants, 2012, 27(6): 1541-1546.
23	Si MS, Mo JJ, Zhuang LF, et al. Osteotome sinus floor elevation with and without grafting: an animal study in Labrador dogs[J]. Clin Oral Implants Res, 2015, 26(2): 197-203.

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