Effect of Maxillary Sinus Anatomy on Bone Gain After Lateral Window Sinus Floor Elevation: A Case-Control Study

Area of Science:

• Dentistry
• Oral Surgery
• Regenerative Medicine

Background:

• Sinus floor elevation (SFE) using the lateral window approach is a common procedure to augment the maxillary posterior region.
• Understanding the influence of anatomical variations on SFE outcomes is crucial for predictable results.

Purpose of the Study:

• To investigate the impact of maxillary sinus anatomy, specifically sinus width (SW) and residual bone height (RBH), on the outcomes of sinus floor elevation (SFE) procedures.
• To evaluate the effects of SW and RBH on grafted volume (GV) and vertical graft resorption (VGR) following SFE.

Main Methods:

• Cone-beam computed tomography (CBCT) and digital panoramic radiographs were used to assess 33 maxillary sinus regions in 26 patients before and after SFE.
• Measurements included maxillary sinus volume, grafted volume (GV), sinus width (SW), residual bone height (RBH), and vertical graft resorption (VGR).
• Statistical analysis was performed to evaluate the relationship between anatomical parameters (RBH, SW) and SFE outcomes (GV, VGR).

Main Results:

• Grafted volume (GV) varied significantly with sinus width (SW), with narrow sinuses yielding less volume (2.60 cm³) compared to average (3.44 cm³) and wide (3.70 cm³).
• Vertical graft resorption (VGR) was notably higher in wider sinuses (3.46 mm) compared to narrow (1.50 mm) and average (1.58 mm) sinuses.
• Posterior maxillary residual bone height (RBH) did not show a statistically significant effect on either GV or VGR.

Conclusions:

• Maxillary sinus width is a critical anatomical factor influencing both the amount of bone graft placed (GV) and its subsequent resorption (VGR) in SFE procedures.
• While RBH did not impact new bone formation with hydroxyapatite-derived inorganic bovine bone, increasing sinus width led to decreased GV and increased VGR.
• Surgical planning for SFE should consider sinus width to optimize graft volume and minimize resorption for improved treatment predictability.