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The International Journal of Oral & Maxillofacial Implants
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Int J Oral Maxillofac Implants 35 (2020), No. 4     30. July 2020
Int J Oral Maxillofac Implants 35 (2020), No. 4  (30.07.2020)

Page 808-815, doi:10.11607/jomi.7878, PubMed:32724935


Graftless Maxillary Sinus Floor Augmentation with Simultaneous Porcine Bone Layer Insertion: A 1- to 5-Year Follow-up Study
Luongo, Roberto / Sgaramella, Nicola / Traini, Tonino / Bugea, Calogero
Purpose: Evidence suggests that maxillary sinus floor augmentation via a lateral approach can be performed without positioning a bone graft inside, when one or more implants can be placed simultaneously. The aim of this study was to test if the placement of a porcine cortical bone layer underneath the sinus membrane can increase bone formation and implant stability.
Materials and Methods: One hundred seventy-two patients with posterior maxilla atrophy needing implant rehabilitation were selected. Two hundred six sinus augmentation procedures were performed via a lateral approach, and 295 implants were placed in the same session of the sinus elevation surgery. In all the surgeries, a porcine cortical bone layer was placed underneath the sinus membrane, without using any graft material. After 6 to 7 months of healing, the implants were uncovered, then restored with porcelain-fused-to-metal crowns and monitored with a followup of 1 to 5 years.
Results: The implant cumulative success rate was 95.2%, while the residual bone crest height changed from 2.67 ± 1.11 mm to 12.54 ± 1.42 mm, with an increase of 9.87 mm on average. Marginal bone resorption was 0.83 mm on average after 1 year of loading, while the mean implant stability measured at the moment of implant placement and 6 to 7 months later increased from an implant stability quotient (ISQ) of 62.61 ± 5.7 to an ISQ of 70.07 ± 8.2.
Conclusion: This study confirms the validity of the graftless sinus elevation surgery when simultaneous implant placement is performed. The use of a porcine cortical bone layer seems to increase, from a radiologic point of view, the amount of bone around the implants, reducing healing time, cost, and biologic complications for the patient.

Keywords: cortical bone layer, implant, posterior maxilla, sinus elevation, sinus graft, sinus membrane