Comparison of calcium sulfate and tricalcium phosphate in bone grafting after sinus lifting for dental implantation: A randomized controlled trial.

BACKGROUND: Maxillary sinus grafting is considered the most common surgical technique to secure a sufficient bone height for placing dental implants. It is carried out either by making a bony window in the lateral wall of the maxillary sinus (the external procedure) or through the alveolar entrance technique by using alveolar osteotomes (the internal procedure), depending on the quality and quantity of the remaining bone. OBJECTIVES: The aim of the present study was to compare radiologically the amount of bone gain (an increase in bone dimensions) and bone reduction (the loss of the graft volume) obtained by using tricalcium phosphate (TCP) and calcium sulfate (CS) grafts mixed with advanced platelet-rich fibrin (A-PRF). MATERIAL AND METHODS: Nine patients (18 maxillary sinuses) participated in this study, all of whom had bilateral edentulism involving the premolar/molar areas and a bone height of 0.5-5 mm between the sinus floor and the alveolar ridge. Two biomaterials were used in the sinus augmentation procedures. Each patient underwent a bilateral maxillary sinus lift with the use of different bone graft materials - with CS mixed with A-PRF used on one side, and TCP mixed with A-PRF on the other side. The grafting site was selected randomly. Afterward, bone gain and bone reduction were evaluated at the grafting site by using cone-beam computed tomography (CBCT). RESULTS: The mean bone gain on the side treated with TCP mixed with A-PRF was 7.532 ±1.150 mm, and on the side treated with CS mixed with A-PRF side it was 7.961 ±2.781 mm. The comparison of bone gain and bone reduction between the 2 groups showed no statistically significant differences at a 6-month follow-up. CONCLUSIONS: Using CS or TCP mixed with A-PRF was beneficial and safe in the two-stage maxillary sinus lifting procedure. A sufficient amount of bone was obtained for dental implantation.

External sinus lifting using calcium sulphate as a bone grafting in an adult male patient: Case report.

Introduction: and importance: Nowadays, dental implant is considered as a revolutionary method in teeth replacement. Occasionally, missing bone is seen in the area of missing teeth. Oral surgeons need to rebuild this are before implantology, which could be supported by using bone grafts. The practitioners face a problem in the maxilla because of its anatomy and the presence of maxillary sinus. In some cases, and after losing the bone, maxillary sinus needs to be lift before the implant is placed. Calcium sulphate (CS) is one of the promising methods as one of the biocompatible bone grafts. Case presentation: A 30-year-old male patient was reported to the oral and maxillofacial surgery in Faculty of Dentistry, Damascus University. The main complaint was to replace missing teeth (teeth no: 26,27). The patient had no contraindication for surgery.Clinical Findings and Investigations: intra-oral examination revealed a good oral hygiene with no other diseases either in bone or in the oral mucosa. Cone-beam computed tomography systems (CBCT) scan was done to determine the thickness of the remaining bone and the treatment plan was discussed with the patient. Interventions and outcome: the treatment plan was to do external sinus lifting for the posterior left maxilla, using calcium sulphate as a graft and placing the implants after six months. Each procedure during surgical work was documented and monitored using CBCT. The follow-up and results were made by clinical measures as well CBCT to evaluate radiological bone-gain and bone reduction (two-year follow-up). Relevance and impact: the use of calcium sulphate has tremendous benefit as biocompatible bone grafts in sinus lifting in order to gain bone before dental implantation. It may increase the bone gain which will improve the surgical site of the implant.