Peri-implant conditions in periodontally compromised patients following maxillary sinus augmentation - A long-term post-therapy trial

Augmentation of the maxillary sinus in the atrophied edentulous posterior maxilla is an integral part of implant prosthodontics. This study examined the clinical outcome in 50 periodontally compromised successfully treated subjects with severe maxillary atrophy following oral implantation with Branemark, IMZ or Frialit-2 endosseous implants between 1991 and 1994. Simultaneous sinus augmentation was achieved using autogenous bone grafts harvested from the anterior mandible. Oral implants in 37 periodontally healthy patients directly placed in the stable local maxillary bone served as controls. The oral rehabilitation included implant supported restorations or removable superstructures over a period between 3 and 5 years. The peri-implant status of implant abutments inserted in the periodontal compromised augmented maxilla resulted in values comparable to the local maxillary bone except for the GCF rates with enhanced levels of 63.9+/-49.9 (controls 37.9+/-40.7). The average periimplant Periotest values in the augmented maxillary sinus (test group) were -3.1 PT and +0.2 PT in the controls. The Periotest scores in the sinus area ranked between -7.0 and +5.0 with mean PT values of -1.5 for IMZ, -3.2 for Branemark and -4.0 for Frialit-2 abutments. The functional integration of oral implants following sinus augmentation with autologous bone grafts and conventionally placed endosseous implants in the local bone was similar. The additional implant stabilization within the mandibular cortical bone grafts resulted in very low Periotest scores. In periodontally compromised subjects treated for chronic adult periodontitis with minimal maxillary bone height less than 5 mm the endosseous implantation with simultaneous sinus augmentation is recommended as an appropriate technique for long-term oral implant rehabilitation.