Evaluation of sinus bone resorption and marginal bone loss after sinus bone grafting and implant placement

Objective. The objective of this study was to evaluate the sinus bone graft resorption and marginal bone loss around the implants when allograft and xenograft are used. Study design. Sinus bone grafting and implant placement (Osstem, Korea) were performed on 28 patients from September 2003 to January 2006. In group I, a total of 49 implants were placed in 23 maxillary sinus areas of 16 patients together with bone graft using xenograft (Bio-Oss) and a minimal amount of autogenous bone. In group II, 24 implants were placed in 13 maxillary sinus areas of 12 patients together with bone graft using a minimal amount of autogenous bone and equal amounts of allograft (Regenaform) and Bio-Oss in group II. Results. Early osseointegration failures of 3 implants in 3 patients (group I: 1 patient, 1 implant; group II: 2 patients, 2 implants) were observed, and revisions were performed for these 3 implant sites, followed by complete prosthodontic treatments. The average height of the remaining alveolar bone before the surgery, immediately after the surgery, and 1 year after the surgery was 4.9 mm, 19.0 mm, and 17.2 mm, respectively, in group I. In group II, the average height of the remaining alveolar bone was 4.0 mm, 19.2 mm, and 17.8 mm before the surgery, immediately after the surgery, and 1 year after the surgery, respectively. The average marginal bone loss 1 year after prosthodontic loading and after 20.8 months' follow-up was 0.6 mm and 0.7 mm, respectively, in group I. A 93.9% success rate was observed for group I, with 3 implants showing bone resorption of > 1.5 mm within 1 year of loading. For group II, the average marginal bone loss 1 year after prosthodontic loading and after 19.7 months' follow-up was 0.7 mm and 1.0 mm, respectively. An 83.3% success rate was observed for group II, with 4 implants showing bone resorption of > 1.5 mm within 1 year of loading. Conclusions. Based on the observations in this study, it was concluded that mixed grafting with demineralized bone matrix for maxillary sinus bone grafting has no significant short-term merit regarding bone healing and stability of implants compared with anorganic bovine bone alone. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 107: e21-e28)