Long-Term Success of Sinus Augmentation Using A Synthetic Alloplast: A 20 Patients, 7 Years Clinical Report

Long-Term Success of Sinus Augmentation Using A Synthetic Alloplast: A 20 Patients, 7 Years Clinical Report
March 2005
Butz, Stan J. BDS*; Huys, Luc W.J. LTH, BDS DDS, DScÇƒÜ
Implant Dentistry: Volume 14(1) March 2005 pp 36-42
Lippincott Williams & Wilkins
*Private practice, PO Box 2178, Knysna, South Africa. ÇƒÜPrivate practice, Ten Putte 27, 8200 Brugge 2, Belgium and A.Z. Koningin Fabiola, 8370 Blankenberge, Belgium
Reprint requests and correspondence to:; Luc W. J. Huys, LTH, BDS, DDS, DSc; Ten Putte 27; 8200 Brugge 2, Belgium; Phone: +32 (0)50 357633; Fax: +32 (0)50 356369; E-mail: luc.huys@skynet.be
Abstract
An adverse architecture of the maxillary sinus is no longer a contraindication for implant placement. Grafting the sinus has become an accepted treatment modality. Techniques for lifting the sinuses are well documented and numerous articles have been published. The main difference between the multitude of articles seems to be the graft material used. After having used different grafts, with varying success, this article reflects the authors' impressions on one particular grafting material, a composite synthetic bone substitute. The objective of this clinical study was to evaluate the effectiveness, reliability and predictability of that synthetic graft material (Bioplant¨?HTR¨?). After treating 20 patients (22 sites, 56 implants), and after a follow-up period as long as 7 years, it was clinically and radiographically observed that achieved results are enhanced if this synthetic graft material is used and that its use enhances sinus augmentation outcome and predictability. It provides the patient with the benefits of implant-supported restorations in a simple, quick, cost-effective, predictable, and secure manner.
The lack of available bone height has always been a problem when placing root-form dental implants. In the posterior maxilla, buccolingual and apico-occlusal resorption due to tooth loss is often observed. Maxillary sinus pneumatization demands an appropriate approach. Sinus lifting with the grafting of the floor of the maxillary sinus is one of the techniques that have been proposed for improving the long-term retention of dental implants.1 This procedure was first presented by Tatum2 and later published by Boyne and James3 as a procedure designed to increase the available bone height of the sinus floor. Smiler4 added various procedures and techniques, that when properly performed, can enhance the creation of sufficient quantity and quality of bone for dental implant placement. Among these, grafting with autogenous bone from the iliac crest is considered to be the gold standard5 although the harvesting procedure considerably increases the operating time, as well as the demands made on the patients. Furthermore, autogenous bone has the tendency to slowly resorb during the healing time of 9 months required for graft maturation.6
Consequently, research focused, and still focuses, on grafting materials from other origins to prevent that major drawback. Literature abounds with successful results after using allografts, xenografts, and alloplasts, alone or in combination. Unfortunately, in practice, the time and financial commitments, as well as the uncertain outcomes inherent in most of those approaches often pose significant obstacles to acceptance of the therapy by the patient.7-11 Numerous histological examinations have been performed after using many bone substitutes. The vast majority of these, however, were based on animal experiments. For understandable ethical reasons, there is little possibility of human histological examination follow-up for any bone substitute material at various time intervals over a period of years.12 In a well documented article, Szab?? reports about remarkable results of one particular alloplast as revealed by clinical, radiological and histological examinations over a period of 5 years in the human model.11,12 In an effort to shorten the course of therapy and lessen the financial burden to the patient, this alloplast was used, in combination with autogenous bone, to predictably treat the atrophic posterior maxilla. The following are our experience and long-term benefits of this procedure.
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