Long-term changes in graft height after maxillary sinus augmentation, onlay bone grafting, and combination of both techniques: a long-term retrospective cohort study
, , , , , . Long-term
changes in graft height after maxillary sinus augmentation, onlay bone
grafting, and combination of both techniques: a long-term retrospective
cohort study. Clin. Oral Impl. Res. 00, 2012; 000–000 doi: 10.1111/clr.12045
Abstract
Objectives
This
investigation focused on long-term changes in graft height, implant
survival rate, and peri-implant tissue conditions of dental implants
placed in alveolar ridges after augmentation procedures with a follow-up
of 10 years.
Material and methods
We
conducted a retrospective cohort study with prospective long-term
follow-up of 25 patients with edentulous severe atrophic maxillary
situations who received a vertical augmentation procedure with
autologous bone prior to implant placement. The participants were
divided into three groups according to whether they underwent sinus
elevation, onlay grafting, or a combination of both techniques. After a
four-month healing period, 127 implants were inserted in the
corresponding regions. Following a six-month healing period, the
participants underwent prosthodontic rehabilitation, incorporating a
fixed or removable implant denture. The cohort was clinically and
radiographically followed up 1, 5, and 10 years after augmentation. The
following parameters were measured: radiographic vertical bone changes,
implant loss, peri-implant pocket depth (PD), width of keratinized
mucosa (KM), sulcus fluid flow rate (SFFR), and the radiographic
distance between the implant shoulder and the first visible
bone-to-implant contact (DIB).
Results
Seven
implants were lost during the observation period, resulting in
a cumulative 10-year survival rate of 94.48%. Significant bone loss
occurred during the first 12 months, after which the resorption slowed
down and bone height eventually stabilized. After 10 years, the total
vertical bone loss was 27.51% after onlay grafting, 28.14% after sinus
elevation, and 30.24% in the combination group, with no statistically
significant between-group differences. Peri-implant follow-up
examinations revealed a positive correlation between SFFR and PD,
respectively, DIB, and a negative correlation between SFFR and KM.
Conclusion
The
treatment method does not seem to impact vertical bone loss following
augmentation using autologous grafts. This approach results in long-term
stability of dental implants. A sufficient width of keratinized
peri-implant mucosa is important to prevent peri-implant bone loss and
inflammation.
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