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Journal of Peking University(Health Sciences) ›› 2019, Vol. 51 ›› Issue (5): 925-930. doi: 10.19723/j.issn.1671-167X.2019.05.022

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Sinus floor elevation and simultaneous dental implantation: A long term retrospective study of sinus bone gain

Qian WANG1,Dan LI2,Zhi-hui TANG2,△()   

  1. 1. Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
    2. Department of Second Clinical Division, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
  • Received:2017-10-09 Online:2019-10-18 Published:2019-10-23
  • Contact: Zhi-hui TANG E-mail:tang_zhihui@live.cn
  • Supported by:
    Supported by the Capital Foundation for Clinical Characteristics and Application Research(Z161100000516229)

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Abstract:

Objective: To evaluate the sinus bone gains after sinus floor elevation procedures with or without grafts when implants were placed simultaneously. Methods: The research included 26 edentulous patients in the maxillary posterior region, who were divided into 2 different groups according to the sinus lift procedures employed: group of osteotome sinus floor elevation with bone grafts (group A) and group of osteotome sinus floor elevation without bone grafts (group B). The implants were placed simultaneously, and were followed for a period of 30-50 months after sinus floor elevation as routine and then were observed for sinus bone change. Results: There were 27 implants (13 implants for group A and 14 implants for group B)and the following time was 40.23(36.20, 48.07) months. The residual bone height (RBH) was (6.64±1.21) mm for group A and ( 6.96±1.36) mm for group B; the difference between the two groups was not statistically significant (P = 0.459).The sinus bone gain (SBG) when followed was (2.20±1.71) mm for group A, and 1.77(0.94, 2.05) mm for group B; the difference between the two groups was not statistically significant (P = 0.583). The quality of apical bone around implant apex was divided into 3 categories which were excellent, fine and fair.The quality of apical bone around implant apex was excellent and fine for 9 implants in group A and 8 implants in group B, and the difference between the two groups was not statistically significant((Fisher exact test,P = 0.695).The implant apex when followed was (0.09±1.32) mm below the new sinus floor for group A and(0.03±0.91) mm for group B, and the difference between the two groups was not statistically significant(P = 0.898). The SBG for the total was 1.85(1.10, 2.20) mm. The SBG was statistically significantly only related to the protrusion height of the implant apex (r=0.383, P = 0.049). Conclusion: Sinus floor elevation procedures with or without grafts can all gain good results. The SBG is related to the protrusion height of the implant apex significantly.

Key words: Sinus floor elevation, Dental implants, Sinus bone gain

CLC Number: 

  • R782.1

Figure 1

Diagram for adjusting A, coronal CBCT slice; B, sagittal CBCT slice; C, horizontal CBCT slice."

Figure 2

Measurements of RBH and angle of sinus floor A, RBH of buccal and palatal side on coronal slice; B, coronal CBCT slice; C, sagittal CBCT slice."

Figure 3

Measurements of sinus width and sinus bone gain A, sinus width; B, sinus bone gain."

Figure 4

Categories of apical bone around implant apex A, excellent; B, fair; C, fine."

Table 1

Information of 27 implants"

Items Implant site Implant length/mm
Premolar Molar 6 8 10
Group A 3 10 7 6
Group B 4 10 1 7 6
Total 7 20 8 13 6

Table 2

Characteristics before sinus floor elevation"

Items Thickness of sinus membrane/mm RBH/mm Angle of sinus floor/(°) SW/mm
Group A 1.34±1.22 6.64±1.21 38.23±11.24 14.65±4.18
Group B 2.40(0.77,6.40) 6.96±1.36 30.68±11.54 15.96±2.16
P 0.038 0.518 0.098 0.311

Table 3

Characteristics after sinus floor elevation"

Items Follow-up time/months PH/mm SBG/mm ABH/mm
Group A 40.23(36.20,48.12) 2.00(1.60,2.65) 2.20±1.71 -0.09±1.32
Group B 40.43±6.92 1.75±1.16 1.77(0.94,2.05) -0.03±0.91
P 0.616 0.155 0.583 0.898

Figure 5

Apical bone around implant apex for group A A, right first molar when followed; B, right first molar when followed; C, right second premolar when followed."

Figure 6

Apical bone around implant apex for group B A, right first molar when followed; B, left first molar when followed; C, right second premolar before implant placement; D, left first molar when followed."

Table 4

Correlation analysis of SBG with potential factors"

Factors P r
PH 0.049 0.383
RBH 0.157 -0.280
Angle of sinus floor 0.225 0.242
Thickness of sinus membrane 0.375 0.178
SW 0.326 0.196
Implant diameter 0.314 0.201
Age 0.164 0.276
Implant length 0.393 0.171
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