Peri-implant conditions in periodontally compromised patients following maxillary sinus augmentation - A long-term post-therapy trial

Augmentation of the maxillary sinus in the atrophied edentulous posterior m axilla is an integral part of implant prosthodontics. This study examined t he clinical outcome in 50 periodontally compromised successfully treated su bjects with severe maxillary atrophy following oral implantation with Brane mark, IMZ or Frialit-2 endosseous implants between 1991 and 1994. Simultane ous sinus augmentation was achieved using autogenous bone grafts harvested from the anterior mandible. Oral implants in 37 periodontally healthy patie nts directly placed in the stable local maxillary bone served as controls. The oral rehabilitation included implant supported restorations or removabl e superstructures over a period between 3 and 5 years. The peri-implant sta tus of implant abutments inserted in the periodontal compromised augmented maxilla resulted in values comparable to the local maxillary bone except fo r the GCF rates with enhanced levels of 63.9+/-49.9 (controls 37.9+/-40.7). The average periimplant Periotest values in the augmented maxillary sinus (test group) were -3.1 PT and +0.2 PT in the controls. The Periotest scores in the sinus area ranked between -7.0 and +5.0 with mean PT values of -1.5 for IMZ, -3.2 for Branemark and -4.0 for Frialit-2 abutments. The function al integration of oral implants following sinus augmentation with autologou s bone grafts and conventionally placed endosseous implants in the local bo ne was similar. The additional implant stabilization within the mandibular cortical bone grafts resulted in very low Periotest scores. In periodontall y compromised subjects treated for chronic adult periodontitis with minimal maxillary bone height less than 5 mm the endosseous implantation with simu ltaneous sinus augmentation is recommended as an appropriate technique for long-term oral implant rehabilitation.