Related Experiment Videos
[Maxillary sinus examination after sinus floor elevation combined with autologous onlay osteoplasty]
C Wilkert-Walter1, S Jänicke, E Spüntrup
1Klinik für Zahn-, Mund-, Kiefer- und Plastische Gesichtschirurgie, Universitätsklinikum, RWTH Aachen, Pauwelsstrasse 30, 52074 Aachen. C.Wilkert@post.rwth-aachen.de
Background:
Complication rates after sinus floor augmentation of up to 10% are mentioned in literature, often when heterologous bone implants are used. The aim of our retrospective study was to determine the complication rate involving the maxillary sinus of patients treated with autologous spongiosa.
Patients And Methods:
In 46 patients with an absolute maxillary atrophy (61% female, 39% male, mean age 49 years), a sinus floor augmentation, if necessary combined with an onlay bone graft of the iliac crest, was performed. Implants (Brånemark) were placed in a two-stage procedure after 3-6 months. Prior to surgery, a panoramic film was made for diagnosis and treatment planning; in addition, a sinus X-ray was taken when disease of the maxillary sinus was suspected. panoramic radiography was routinely taken after surgery. A clinical and radiological follow-up examination was performed after 6-12 months, and the patients answered a questionnaire. This study also included evaluation of operation reports and case histories. Ultrasound as well as magnetic resonance imaging to prevent radiation exposure were performed additionally.
Results:
In spite of perforation of the maxillary sinus mucosa in about 25%, removal of the bone graft due to inflammation was not necessary. A transient sinusitis developed in 2%. The implant loss rate (3 out of 154) may be called small.
Discussion:
Even though alternative heterologous graft materials exist, maxillary sinus floor elevation with autologous bone graft is still a safe option. Changes of the maxillary sinus are detectable in a small percentage, relatively often due to preexisting unrecognized or subclinical diseases of the maxillary sinus. Magnetic resonance imaging is, in spite of the high financial and technical effort required, a serious alternative to computed tomography. The combination of autologous bone graft with calcium phosphate ceramics, platelet-rich plasma, or synthetic bone growth factors should be tested as an alternative treatment method.