ABSTRACT
PURPOSE: The aim of this study is to assess the long-term outcome of a single-stage approach for implant placement and maxillary sinus floor elevation (MSFE) that used a combined scaffold of laminated calvarial bone, platelet-rich plasma (PRP), and beta-tricalcium phosphate. MATERIALS AND METHODS: Thirty consecutive patients who required MSFE to allow rehabilitation with implant-supported prosthesis entered this survival study. All patients received their dental implants at the time of sinus elevation, and prosthetic loads were applied 4 to 6 months after implant insertion. Clinical outcomes used for evaluation included residual bone height at the subsinus area (height of subsinus bone [HSB], assessment of surgical morbidity, and implant success and survival rates. RESULTS: Simultaneous insertion of 86 implants, either 10 mm long (n = 76) or 12 mm long (n = 10), took place in a total of 22 bilateral and 8 unilateral sinus elevations. Loading was initiated a mean of 3.8 ± 1.5 months after the first surgery. A mean HSB of 4.9 ± 1.7 mm was present before surgery, with 50% of the sample displaying HSBs of less than 4.4 mm. The mean implant survival time was 33.1 months (95% confidence interval, 31.7 to 34.5 months), with high rates of success (94.2%) and survival (96.5%). When patients were classified by their HSB (HSB ≥ 5 mm vs HSB < 5 mm), no differences were seen with regard to age, sex, healing time, or follow-up in terms of implant survival rates (P > .05). CONCLUSIONS: Sinus floor elevation using mainly laminated calvarial bone, PRP, beta-tricalcium phosphate, and simultaneous stable implant placement is a predictable technique with low surgical morbidity that allows shorter healing times in patients with reduced bone height.
Subject(s)
Biocompatible Materials/therapeutic use , Calcium Phosphates/therapeutic use , Immediate Dental Implant Loading/methods , Oral Surgical Procedures, Preprosthetic/methods , Platelet-Rich Plasma , Sinus Floor Augmentation/methods , Adult , Aged , Female , Graft Survival , Humans , Male , Maxillary Sinus/surgery , Middle Aged , Skull , Time Factors , Transplant Donor SiteSubject(s)
Foreign Bodies/surgery , Maxilla , Perciformes , Sphenoid Bone , Acinetobacter Infections/surgery , Acinetobacter baumannii/isolation & purification , Animals , Ethmoid Bone/injuries , Ethmoid Bone/surgery , Foreign Bodies/microbiology , Humans , Magnetic Resonance Angiography , Male , Maxilla/injuries , Maxilla/surgery , Maxillary Artery/surgery , Maxillary Sinus/injuries , Maxillary Sinus/surgery , Middle Aged , Serratia Infections/surgery , Serratia liquefaciens/isolation & purification , Sphenoid Bone/injuries , Sphenoid Bone/surgery , Tomography, X-Ray ComputedABSTRACT
This paper reports on an alternative treatment method for mandibular reconstruction in a very rare symptomatic adult form of fibrous dysplasia. The treatment included excision of all the dysplastic tissue excluding the inner cortex and the lower border of the mandible, where cryosurgery was applied. Platelet-rich plasma was added to the autogenous bone and used to fill dead spaces and interfaces. Three months after reconstruction, implants were inserted in the hard dense bone that showed no resorption. Seven years after surgery, the patient was completely asymptomatic and had an excellent cosmetic outcome. A very simple method, based on a new paradigm approach, provided excellent functional and cosmetic results avoiding complex reconstruction procedures and delayed hospitalization in a patient with fibrous dysplasia.
