From a radiologic and histologic point of view at 6 months after surgery, the use of PRF as the sole filling material during a simultaneous sinus lift and implantation stabilized a high volume of natural regenerated bone in the subsinus cavity up to the tip of the implants. Choukroun's PRF is a simple and inexpensive biomaterial, and its systematic use during a sinus lift seems a relevant option, particularly for the protection of the Schneiderian membrane.
Dental implant placement associated with augmentation of the sinus floor in the severely atrophic maxilla can be performed in 1- or 2-surgical stages, depending on the height of the residual alveolar bone. A minimum of 4 to 5 mm of residual alveolar bone height is recommended for a 1-stage surgical procedure. The present study describes a 1-stage procedure in cases where the residual alveolar bone height in the posterior maxilla was 1 to 2 mm. A total of 55 hydroxyapatite-coated dental implants were inserted in 20 grafted sinuses of 20 patients. No case presented any difficulty in achieving initial stabilization and parallelism. No perforation of the sinus membrane or clinical complications of the sinuses were evident. Prior to exposure, radiographic evaluation revealed bone consolidation and a close bone-implant relation. At second-stage surgery, there was no clinical evidence of crestal bone loss around the implants. All implants were clinically osseointegrated. All patients received fixed implant-supported prosthesis. The mean follow-up was 26.4 months (range 15 to 39 months). There was no implant loss after loading. The following surgical modifications are essential: a wide lateral window opening, the use of a bone mill to homogenize the bone graft, meticulous condensation, and clinical measurements to ensure implant parallelism.
To evaluate the effectiveness and predictability of a novel biomechanical, minimally invasive bone instrumentation technique that enhances bone density through compaction grafting, called osseous densification, and allows for transcrestal sinus membrane elevation and augmentation with simultaneous implant placement. Materials and Methods: Patients who were consecutively treated with the bone densification and transcrestal sinus augmentation technique and were followed up in three treatment centers between May 2012 and September 2017 were included in this retrospective study. The summary statistics are presented as means for continuous variables and percentages for categorical variables. Results: In total, 222 patients with 261 implants were included in the final clinical analysis. The included follow-up period ranged from 6 to 64 months with a mean of 35 months. The subsinus residual bone height at baseline was 5.4 mm (SD: 1.9). Following the sinus augmentation, a significant vertical increase of 7 mm (SD: 2.49) was observed. No sinus membrane perforations and no late implant failures were observed from 6 up to 64 months follow-up, yielding a cumulative implant survival rate of 97%. Conclusion: This osseous densification technique for maxillary implant site preparation with transcrestal sinus augmentation and simultaneous implant placement led to favorable clinical outcomes with up to 64 months of follow-up.
Within the limits of this study, the data indicate that nonfunctional immediate loading of single-tooth implants placed in fresh extraction sites in the anterior maxilla can result in successful implant integration and stable peri-implant conditions up to 6 years.
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