Evaluation of bone formation following the osteotome sinus floor elevation technique without grafting using cone beam computed tomography: a preliminary study

Abstract

Background Osteotome sinus floor elevation (OSFE) is used to increase the bone volume at the site of the maxillary sinus through the transalveolar approach. However, there is uncertainty regarding the necessity of the use of grafting material in order to maintain the space for new bone formation. Objective This study aimed to evaluate new bone formation 6 months after osteotome sinus floor elevation without grafting and to evaluate the correlations between residual bone height (RBH), implant protrusion length (IPL), and endo-sinus bone gain (ESBG). Material and methods Thirty-one implants (27 patients) from area 14–17 and 24–27 were included in the study. All implants had a history of OSFE without grafting, with cone beam computed tomography (CBCT) taken prior to the surgery. The clinical examination and radiographic examination using CBCT were performed again 6 months after implantation. The RBH, new bone level, ESBG, and IPL were measured. Paired sample t test and Pearson correlation were used to analyze the data. Results The average RBH before surgery was 7.14 ± 1.07 mm and 6 months after surgery was 8.95 ± 1.17 mm. There was a significant increase in new bone formation in the 6 months following surgery ( p < 0.05). The average ESBG and IPL were 1.8 ± 0.79 mm and 2.02 ± 0.73 mm, respectively. There was a significant positive correlation between the IPL and ESBG ( p < 0.05) while there was a negative correlation between RBH and ESBG. This study also demonstrates a decrease in the percentage of bone formation in relation to IPL as the IPL increases. The survival rate of the implant was 100%. Conclusion Significant new bone formation can be detected around the implant site 6 months after implantation using OSFE technique without grafting. There is a negative correlation between the RBH and ESBG. While IPL is correlated to ESBG and appears to be the influencing factors of bone formation changes in the maxillary sinus. The preliminary radiographic results suggest that OSFE technique without grafting in combination with optimal IPL can provide sufficient bone height for implant support with a 100% implant survival rate. Electronic supplementary material The online version of this article (10.1186/s40729-019-0181-7) contains supplementary material, which is available to authorized users.

Histologic, Histomorphometric, and Clinical Analysis of the Effects of Growth Factors in a Fibrin Network Used in Maxillary Sinus Augmentation

“…The inclusion criteria for this study were partially edentulous patients with a unilateral loss of teeth in the maxillary molar or premolar areas with severe atrophy and a residual alveolar ridge height of less than 5 mm. Both MPM and β-TCP showed clinically satisfactory results, but in the literature, there are many studies such as osteotome sinus floor elevation technique [52] and osseodensification [53] when residual bone height is limited in maxillary posterior region. Further investigations were needed for extreme atrophic cases (for example 0-1 mm residual height) whether MPM could be successful.…”

Patient Perception and Radiographic Assessment of Sinus Lifting Procedure using Densah Bur versus Osteotome-mediated sinus lifting: A Randomized Clinical Trial

“…The bone tended to increase in the first three years and then became stable afterwards. In 2019, Suk-Arj et al 11 conducted a study on osteotome sinus floor elevation without grafting material with short term 6 months follow-up period. They revealed that the average of ESBG was 1.80 ± 0.79 mm and 1.96 ± 0.67 mm in the coronal and sagittal view respectively.…”

“…Sample size calculation was based on the radiographic outcome of endo-sinus bone gain. According to Suk-Arj et al, 11 the endo-sinus bone gain in the osteotome group was 1.96 ± 0.67 mm and the estimated minimum clinical important difference was 1.3 based on expert's opinion. By adopting a two-sided 5% significance level and a power of 80%, a predicted sample size of 5 patients per group was necessary.…”

Influence of implant protrusion length on non-grafting osteotome sinus floor elevation with simultaneous implant: a 3- to 9-year retrospective study

“…The average IPL in some studies was around 2 mm and achieved a high percentage of ESBG [ 22 , 23 , 34 ]. Thus, we selected 2 mm as the first interval point in this study in order to see whether the %ESBG would be higher with a IPL over than 2 mm.…”

“…Several studies [14,[20][21][22][23] have found that the IPL was positively correlated with the endo-sinus bone gain (ESBG) following non-grafting OSFE. The protruding implant was considered as the maintenance for endosinus space under the elevated membrane, which contributes to bone formation around implants [22]. Therefore, greater ESBG can be obtained with a longer IPL.…”