Two-stage maxillary sinus reconstruction with endosseous implants: a prospective study

Area of Science:

• Oral and Maxillofacial Surgery
• Dental Implantology
• Bone Grafting Techniques

Background:

• Maxillary sinus reconstruction is crucial for dental implant placement in atrophic jaws.
• Iliac corticocancellous bone blocks offer a viable grafting material for sinus floor augmentation.
• Two-stage reconstruction allows for graft consolidation before implant placement.

Purpose of the Study:

• To assess the outcomes of a two-stage maxillary sinus reconstruction protocol.
• To evaluate titanium implant survival and prosthetic rehabilitation following iliac bone grafting to the sinus floor.
• To determine the success rates of implants placed in grafted sinus bone versus adjacent grafted alveolar bone.

Main Methods:

• Prospective evaluation of 50 consecutive patients undergoing two-stage maxillary sinus reconstruction.
• Placement of 314 Brånemark titanium implants into iliac corticocancellous bone blocks grafted to the sinus floor and adjacent alveolar bone.
• Follow-up ranging from 9 to 48 months post-implant placement, with implant integration and prosthetic success recorded.

Main Results:

• Implant integration rates were 84% in grafted sinuses and 75% in the anterior alveolar graft.
• Overall implant survival rate was 80.9%, with a 100% survival rate for fixed prostheses.
• Twelve percent of patients required secondary implant placement due to strategic implant loss; 76% received fixed prostheses.

Conclusions:

• Two-stage maxillary sinus reconstruction with iliac bone blocks and titanium implants yields favorable implant survival and prosthetic success rates.
• This technique effectively restores the maxillary bone for dental implant rehabilitation.
• The results compare favorably with existing literature on sinus augmentation and implantology.