Bone Formation Under the Elevated Sinus Membrane Using Venous Coagulum

Insufficient bone height is a common obstacle to placing dental implants in the posterior maxilla. Sinus grafts have been shown to be a highly predictable way to increase bone height in the posterior maxilla. This case series illustrates a technique using venous coagulum and simultaneous implant placement under the elevated sinus. Bone formation is demonstrated clinically, radiographically, and histologically. To the best of our knowledge, this is the first report of histomorphometric results and microcomputed tomography (micro-CT) using this technique.

A total of five sinus elevations with simultaneous placement of two dental implants were performed with venous blood coagulum as the sole filling biomaterial. At the time of uncovering, after 8 to 9 months of healing, biopsies were harvested from the lateral wall of the maxilla. This study illustrates bone formation under five elevated sinuses, with simultaneous placement of dental implants, using venous coagulum as the sole filling material. Results showed significant gains in bone height adjacent to the implant. Micro-CT showed well-structured trabecular bone. Histomorphometry of biopsies showed 38% to 74% vital bone.

This case series illustrates that bone-grafting materials in the subsinus cavity are not required for successful placement of implants. Use of one's own blood as filling material removes any objections to grafting, including religious, ethical, or fear of disease transmission. Venous coagulum is a simple, inexpensive biomaterial, and its systematic use during a sinus lift may be a relevant option, ultimately leading to increased access to implant treatment options for patients.