Journal of Periodontal and Implant Science

Korean Academy of Periodontology (대한치주과학회)
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Incomplete bone formation after sinus augmentation: A case report on radiological findings by computerized tomography at follow-up

  • Lee, Kyung-Shil (Department of Periodontology, Kyung Hee University School of Dentistry) ;
  • Kwon, Young-Hyuk (Department of Periodontology, Kyung Hee University School of Dentistry) ;
  • Herr, Yeek (Department of Periodontology, Kyung Hee University School of Dentistry) ;
  • Shin, Seung-Il (Department of Periodontology, Kyung Hee University School of Dentistry) ;
  • Lee, Ji-Yeon (Department of Periodontology, Kyung Hee University School of Dentistry) ;
  • Chung, Jong-Hyuk (Department of Periodontology, Kyung Hee University School of Dentistry)
  • Received : 2010.07.23
  • Accepted : 2010.10.12
  • Published : 2011.01.11
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Abstract

Purpose: The aim of this case report is to present a case of incomplete bone formation after sinus augmentation. Methods: A patient having alveolar bone resorption of the maxillary posterior edentulous region and advanced pneumatization of the maxillary sinus was treated with sinus elevation using deproteinized bovine bone in the Department of Periodontology, Kyung Hee University School of Dentistry and re-evaluated with computed tomography (CT) follow-up. Results: Even though there were no significant findings or abnormal radiolucency on the panoramic radiograph, incomplete bone formation in the central portion of the augmented sinus was found fortuitously in the CT scan. The CT scan revealed peri-implant radiolucency in the apical portion of the implant placed in the augmented maxillary sinus. Nevertheless, the dental implants placed in the grafted sinus still functioned well at over 15 months follow-up. Conclusions: The result of this case suggests that patients who received maxillary sinus augmentation may experience incomplete bone formation. It is possible that 1) osteoconductive graft material with poor osteogenic potential, 2) overpacking of graft material that restricts the blood supply, and 3) bone microbial contamination may cause the appearance of incomplete bone formation after sinus augmentation. Further studies are needed to elucidate the mechanism of this unexpected result and care must be taken to prevent it.

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References

  1. Boyne PJ, James RA. Grafting of the maxillary sinus floor with autogenous marrow and bone. J Oral Surg 1980;38: 613-6.
  2. Peleg M, Chaushu G, Mazor Z, Ardekian L, Bakoon M. Radiological findings of the post-sinus lift maxillary sinus: a computerized tomography follow-up. J Periodontol 1999; 70:1564-73. https://doi.org/10.1902/jop.1999.70.12.1564
  3. Murakami K, Itoh T, Watanabe S, Naito T, Yokota M. Periodontal and computer tomography scanning evaluation of endosseous implants in conjunction with sinus lift procedure. A 6-case series. J Periodontol 1999;70:1254-9. https://doi.org/10.1902/jop.1999.70.10.1254
  4. Pjetursson BE, Tan WC, Zwahlen M, Lang NP. A systematic review of the success of sinus floor elevation and survival of implants inserted in combination with sinus floor elevation. J Clin Periodontol 2008;35:216-40. https://doi.org/10.1111/j.1600-051X.2008.01272.x
  5. Wallace SS, Froum SJ. Effect of maxillary sinus augmentation on the survival of endosseous dental implants. A systematic review. Ann Periodontol 2003;8:328-43. https://doi.org/10.1902/annals.2003.8.1.328
  6. Mardinger O, Nissan J, Chaushu G. Sinus floor augmentation with simultaneous implant placement in the severely atrophic maxilla: technical problems and complications. J Periodontol 2007;78:1872-7. https://doi.org/10.1902/jop.2007.070175
  7. Barone A, Santini S, Sbordone L, Crespi R, Covani U. A clinical study of the outcomes and complications associated with maxillary sinus augmentation. Int J Oral Maxillofac Implants 2006;21:81-5.
  8. Schwartz-Arad D, Herzberg R, Dolev E. The prevalence of surgical complications of the sinus graft procedure and their impact on implant survival. J Periodontol 2004;75: 511-6. https://doi.org/10.1902/jop.2004.75.4.511
  9. Zijderveld SA, van den Bergh JP, Schulten EA, ten Bruggenkate CM. Anatomical and surgical findings and complications in 100 consecutive maxillary sinus floor elevation procedures. J Oral Maxillofac Surg 2008;66:1426-38. https://doi.org/10.1016/j.joms.2008.01.027
  10. Hallman M, Sennerby L, Zetterqvist L, Lundgren S. A 3-year prospective follow-up study of implant-supported fixed prostheses in patients subjected to maxillary sinus floor augmentation with a 80:20 mixture of deproteinized bovine bone and autogenous bone clinical, radiographic and resonance frequency analysis. Int J Oral Maxillofac Surg 2005;34:273-80. https://doi.org/10.1016/j.ijom.2004.09.009
  11. Hallman M, Cederlund A, Lindskog S, Lundgren S, Sennerby L. A clinical histologic study of bovine hydroxyapatite in combination with autogenous bone and fibrin glue for maxillary sinus floor augmentation: results after 6 to 8 months of healing. Clin Oral Implants Res 2001;12:135-43. https://doi.org/10.1034/j.1600-0501.2001.012002135.x
  12. Skoglund A, Hising P, Young C. A clinical and histologic examination in humans of the osseous response to implanted natural bone mineral. Int J Oral Maxillofac Implants 1997;12:194-9.
  13. Yildirim M, Spiekermann H, Biesterfeld S, Edelhoff D. Maxillary sinus augmentation using xenogenic bone substitute material Bio-Oss in combination with venous blood: a histologic and histomorphometric study in humans. Clin Oral Implants Res 2000;11:217-29. https://doi.org/10.1034/j.1600-0501.2000.011003217.x
  14. Fuerst G, Tangl S, Gruber R, Gahleitner A, Sanroman F, Watzek G. Bone formation following sinus grafting with autogenous bone-derived cells and bovine bone mineral in minipigs: preliminary findings. Clin Oral Implants Res 2004;15:733-40. https://doi.org/10.1111/j.1600-0501.2004.01077.x
  15. Roldan JC, Jepsen S, Schmidt C, Knuppel H, Rueger DC, Acil Y, et al. Sinus floor augmentation with simultaneous placement of dental implants in the presence of plateletrich plasma or recombinant human bone morphogenetic protein-7. Clin Oral Implants Res 2004;15:716-23. https://doi.org/10.1111/j.1600-0501.2004.01070.x
  16. Busenlechner D, Huber CD, Vasak C, Dobsak A, Gruber R, Watzek G. Sinus augmentation analysis revised: the gradient of graft consolidation. Clin Oral Implants Res 2009; 20:1078-83. https://doi.org/10.1111/j.1600-0501.2009.01733.x
  17. Quinones CR, Hurzeler MB, Schupbach P, Kirsch A, Blum P, Caffesse RG, et al. Maxillary sinus augmentation using different grafting materials and osseointegrated dental implants in monkeys. Part II. Evaluation of porous hydroxyapatite as a grafting material. Clin Oral Implants Res 1997; 8:487-96. https://doi.org/10.1034/j.1600-0501.1997.080607.x
  18. Haas R, Donath K, Fodinger M, Watzek G. Bovine hydroxyapatite for maxillary sinus grafting: comparative histomorphometric findings in sheep. Clin Oral Implants Res 1998; 9:107-16. https://doi.org/10.1034/j.1600-0501.1998.090206.x
  19. Margolin MD, Cogan AG, Taylor M, Buck D, McAllister TN, Toth C, et al. Maxillary sinus augmentation in the nonhuman primate: a comparative radiographic and histologic study between recombinant human osteogenic protein- 1 and natural bone mineral. J Periodontol 1998;69: 911-9. https://doi.org/10.1902/jop.1998.69.8.911
  20. Hurzeler MB, Quinones CR, Kirsch A, Gloker C, Schupbach P, Strub JR, et al. Maxillary sinus augmentation using different grafting materials and dental implants in monkeys. Part I. Evaluation of anorganic bovine-derived bone matrix. Clin Oral Implants Res 1997;8:476-86. https://doi.org/10.1034/j.1600-0501.1997.080606.x
  21. Hurzeler MB, Quinones CR, Kirsch A, Schupbach P, Krausse A, Strub JR, et al. Maxillary sinus augmentation using different grafting materials and dental implants in monkeys. Part III. Evaluation of autogenous bone combined with porous hydroxyapatite. Clin Oral Implants Res 1997;8:401- 11. https://doi.org/10.1034/j.1600-0501.1997.080507.x
  22. Bruder SP, Kurth AA, Shea M, Hayes WC, Jaiswal N, Kadiyala S. Bone regeneration by implantation of purified, culture-expanded human mesenchymal stem cells. J Orthop Res 1998;16:155-62. https://doi.org/10.1002/jor.1100160202
  23. Schliephake H, Knebel JW, Aufderheide M, Tauscher M. Use of cultivated osteoprogenitor cells to increase bone formation in segmental mandibular defects: an experimental pilot study in sheep. Int J Oral Maxillofac Surg 2001;30:531-7. https://doi.org/10.1054/ijom.2001.0164
  24. Kon E, Muraglia A, Corsi A, Bianco P, Marcacci M, Martin I, et al. Autologous bone marrow stromal cells loaded onto porous hydroxyapatite ceramic accelerate bone repair in critical-size defects of sheep long bones. J Biomed Mater Res 2000;49:328-37. https://doi.org/10.1002/(SICI)1097-4636(20000305)49:3<328::AID-JBM5>3.0.CO;2-Q
  25. De Kok IJ, Peter SJ, Archambault M, van den Bos C, Kadiyala S, Aukhil I, et al. Investigation of allogeneic mesenchymal stem cell-based alveolar bone formation: preliminary findings. Clin Oral Implants Res 2003;14:481-9. https://doi.org/10.1034/j.1600-0501.2003.110770.x
  26. Rosenberg MM. Free osseous tissue autografts as a predictable procedure. J Periodontol 1971;42:195-209. https://doi.org/10.1902/jop.1971.42.4.195
  27. Garrett S, Loos B, Chamberlain D, Egelberg J. Treatment of intraosseous periodontal defects with a combined adjunctive therapy of citric acid conditioning, bone grafting, and placement of collagenous membranes. J Clin Periodontol 1988;15:383-9. https://doi.org/10.1111/j.1600-051X.1988.tb01016.x
  28. Vastardis S, Yukna RA, Mayer ET, Atkinson BL. Periodontal regeneration with peptide-enhanced anorganic bone matrix in particulate and putty form in dogs. J Periodontol 2005;76:1690-6. https://doi.org/10.1902/jop.2005.76.10.1690
  29. Verdugo F, Castillo A, Moragues MD, Ponton J. Bone microbial contamination influences autogenous grafting in sinus augmentation. J Periodontol 2009;80:1355-64. https://doi.org/10.1902/jop.2009.090113
  30. Choukroun J, Simonpieri A, Del Corso M, Mazor Z, Sammartino G, Dohan Ehrenfest DM. Controlling systematic perioperative anaerobic contamination during sinus-lift procedures by using metronidazole: an innovative approach. Implant Dent 2008;17:257-70. https://doi.org/10.1097/ID.0b013e318181349a
  31. Hanisch O, Lozada JL, Holmes RE, Calhoun CJ, Kan JY, Spiekermann H. Maxillary sinus augmentation prior to placement of endosseous implants: a histomorphometric analysis. Int J Oral Maxillofac Implants 1999;14:329-36.
  32. Nkenke E, Stelzle F. Clinical outcomes of sinus floor augmentation for implant placement using autogenous bone or bone substitutes: a systematic review. Clin Oral Implants Res 2009;20 Suppl 4:124-33.
  33. Raghoebar GM, Timmenga NM, Reintsema H, Stegenga B, Vissink A. Maxillary bone grafting for insertion of endosseous implants: results after 12-124 months. Clin Oral Implants Res 2001;12:279-86. https://doi.org/10.1034/j.1600-0501.2001.012003279.x

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