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Using Digital Implant Planning in Assessing Outcomes of Maxillary Sinus Augmentation Procedures: A Retrospective
Gayathri M Shenoy1, Konstantinos Vazouras2, Aruna Ramesh3
1Private Practice limited to Periodontology and Implant Dentistry, Providence, Rhode Island.
Purpose:
The aim of this retrospective pilot study was to use digital implant planning to assess radiographic outcomes of maxillary sinus augmentation bone grafting procedures (ideal, excess, or insufficient) in reference to the planned implant.
Materials And Methods:
After ethical approval was received, deidentified data for subjects treated for a maxillary sinus elevation procedure was extracted. Patient-specific variables (age group, gender, race, smoking, diabetes, and cardiovascular disease) and site-specific variables (type of bone graft, type of membrane, membrane perforation, and other complications) were collected, as recorded in the electronic health records. For the records that satisfied the inclusion criteria, preoperative and postoperative cone-beam computed tomography scans for lateral sinus augmentation procedures were retrieved, superimposed, and imported into the implant planning software. An ideal implant was planned digitally in a cross-sectional view by an expert in prosthodontics (KV). The implant measurements in apicocoronal (AC) and buccopalatal (BP) dimensions were kept standard for all cases and were confirmed by two previously calibrated co-investigators (GS, ID). Statistical analysis involved descriptive and bivariate analysis.
Results:
A total of 350 electronic health records were reviewed and 26 were included. Descriptive analysis revealed that in the AC dimension, 40.63% of procedures resulted in insufficient amount of bone graft and 37.50% of procedures resulted in excess bone graft; 21.88% of procedures had ideal amount of bone graft in the AC dimension. For the BP dimension, 81.25% of procedures resulted in ideal and 18.75% in insufficient amounts of bone graft.
Conclusion:
This study revealed that a limited number of maxillary sinus procedures resulted in ideal bone grafting in both the AC and BP dimensions when considering predetermined restorative guidelines for the final implant position. An excess and/or insufficient amount of bone grafting in at least one dimension resulted most of the times. With the use of technology and an interdisciplinary team of experts, future studies should aim to quantify the amount of bone graft needed for an ideal maxillary sinus elevation for upcoming implant placement.
