Maxillary sinus floor augmentation using bioactive glass granules and autogenous bone with simultaneous implant placement - Clinical and histologicalfindings

This clinical study was undertaken to: 1) evaluate the use of bioactive gla ss Biogran (TM) combined with autogenous bone as grafting material for maxi llary sinus augmentation with simultaneous implant placement using radiogra phy and histology; and 2) document the short-term post-loading success of i mplants inserted in sinus cavities augmented with this material. Unilateral or bilateral sinus augmentation was performed in 12 patients with 3-5 mm o f alveolar crestal bone height in the posterior maxilla prior to grafting. The sinuses were grafted with bioactive glass mixed in a 4:1 ratio with aut ogenous bone. Simultaneously, 2-3 threaded titanium implants were inserted into the augmented sinuses. Second stage surgery was carried out 9 to 12 mo nths post implantation. At abutment connection, 10 core biopsy specimens we re taken from different grafted sites and evaluated histologically. All 27 implants were clinically stable at second stage surgery. A mean increase in mineralized tissue height of 7.1 +/-1.6 mm was evident when comparing the pre-surgical CT scans with those performed 9-12 months following the sinus augmentation procedure. Evaluation of the cores yielded a mean of 30.6 +/-5 .7% of bone tissue in the grafted sites. One implant failed during the pros thetic phase while the remaining 26 implants were stable 12 months post loa ding. This study suggests that Biogran (TM) /autogenous bone graft combinat ion used in one-stage sinus augmentation yields sufficient quality and volu me of mineralized tissue for predictable simultaneous implant placement in patients with 3-5 mm of bone height prior to grafting.