Comparison Between Maxillary Sinus Lifting in Combination With Implant Placement With Versus Without Bone Grafts (Clinical and Radiographic Study)

Abstract

Introduction: Placement of implants in the posterior maxillary region is usually complicated by maxillary sinuses pneumatization, post-extraction bone resorption, and unfavorable quality of alveolar bone. Hence, the height of the residual bone is reduced which makes placing the standard implant difficult. Maxillary sinus lifting is one possible solution.Objective: The aim of this study was to evaluate the clinical and radiographical maxillary sinus lifting technique without graft material versus sinus lifting technique with graft material.Materials and Methods: this study was made as a clinical randomized controlled trial, the study sample included 14 patients. The sample was selected to match the inclusion and exclusion criteria. The selected patients were divided into two equal groups, both groups had gone through lifting of maxillary sinus simultaneously with implant placement, group1: maxillary sinus lifting was made for seven patients in combination with implant placement without bone graft. In group2: maxillary sinus lifting was made for seven patients in combination with implant placement with bone graft (Osteon TM II bone graft material). Clinical and radiographic evaluation was done through 6 months post-operatively. Results:Regarding postoperative clinical evaluation, group 1 had mild pain and edema postoperatively than that of group 2. The postoperative radiographical evaluation bone was evidenced and recorded around all implants at six months postoperatively in both groups, however, no statistical significant difference was recorded between both groups in the amount of bone density formed after 6 months postoperatively.

Maxillary sinus augmentation by direct implant valve approach versus balloon technique.

“…Changes in vertical bone height: Vertical bone height means, standard deviations, t-values, and p-values within each group illustrated in the table (1) and fig (4). Paired t-test showed a highly statistically significant difference in comparing preoperative versus post-operative vertical bone height in both two groups.…”

“…Wound closure was performed utilizing a non-absorbable suture gauge (4/0). The post-operative vertical bone height was measured in the axial view of CBCT, table (1). Group two: (Balloon group): After exposing the alveolar bone, a pilot drill was used, followed by a 2 mm twist drill with a stopper set for the desired osteotomy length, leaving a 1 -2 mm inferior to the maxillary sinus floor (according to the CBCT image).…”

“…These may cause not only a quantitative reduction but also a qualitative deterioration of bone leading to a skeletal bone segment inadequate for implant placement. In these situations, the residual vertical bone height is diminished making standard dental implant placement difficult (1)(2)(3)(4)(5)(6) . Several techniques and procedures have been proposed to address this challenge and to obtain adequate bone dimensions for dental implant insertion.…”

“…Several techniques and procedures have been proposed to address this challenge and to obtain adequate bone dimensions for dental implant insertion. Boyne and James (1) introduced the maxillary sinus augmentation by lateral approach, a modification of the known sinus procedure according to Caldwell-Luc, to allow proper implant insertion into an atrophic maxillary ridge. Subsequently, sinus augmentation with lateral access has been widely studied as a safe and predictable treatment (7,8) .…”

Clinical and radiological comparison of a dynamic implant valve vs a hydraulic maxillary sinus lift augmentation technique with simultaneous implant insertion

“…Depending on the remaining residual ridge, the lateral or crestal technique is employed to elevate the maxillary sinus membrane (MSM). [5][6][7][8] Tatum 8 first proposed a crestal technique for sinus membrane lift elevation in 1986. Summers, 9 proposed the osteotomy technique, which uses a crestal approach in a straightforward, conservative, and minimally invasive approach than the lateral surgical technique.…”