The use of hydroxyapatite bone cement for sinus floor augmentation with simultaneous implant placement in the atrophic maxilla. A report of 10 cases

Background: Dental implant placement associated with sinus floor augmentati on in a severely atrophic maxilla can be performed in a 1- or 2-stage surgi cal procedure, depending on the height of the residual alveolar bone. A min imum of 4 to 5 mm is recommended for a 1-stage procedure. Methods: This clinical study describes the use of hydroxyapatite (HA) bone cement to stabilize HA-coated cylindrical implants placed simultaneously du ring sinus augmentation in 10 patients where insufficient bone volume did n ot allow primary implant stability. A total of 26 HA-coated dental implants were inserted in 10 grafted sinuses of 10 patients. Results: None of the cases presented any difficulty in achieving initial st abilization and parallelism. No clinical complications of the sinuses were evident. Prior to exposure, radiographic evaluation revealed the implants e mbedded in a densely homogeneous radiopaque mass. At second-stage surgery, there was no clinical evidence of crestal bone loss around the implants. Al l implants were clinically osseointegrated. All patients received fixed imp lant-supported prostheses. Mean follow-up was 18 months (range 12 to 24 mon ths). Conclusions: According to this preliminary study, the hydroxyapatite bone c ement appears to hold great promise as a grafting alloplastic material for sinus floor augmentations, Its main advantage is its ability to provide ini tial stability required for osseointegration and proper implant Location an d parallelism. Further clinical and histological studies are required befor e it can be recommended for routine use in sinus lift procedures.