| Purpose:The aim of the study was to evaluate the clinical effectiveness in maxillary sinus floor augmentation using graft material comprising hydroxyapatite and biphasic calcium phosphate.Methods:A total of 12 patients(three male and nine female,average age of 48.25±13.78)from the department of Oral Implants,Stomatological Hospital of Shandong University during September 2015 and December 2017,undergoing transcrestal sinus floor elevation with the BonaGraft(60%hydroxyapatite and 40%?-tricalcium phosphate),were enrolled in the present study.14 implants were placed in the posterior maxillary area.The residual bone height in 12 patients was(5.30±1.44)mm.CBCT was performed before the surgery,immediate postoperation and six months after the operation to measure bone changes around the implants in the maxillar sinus.The survival rate of implants,intraoperative and postoperative complications and clinical efficacy were observed after six months of prosthetic rehabilitation.The measurement data included the vertical bone height(BH)from the maxillary sinus to the implant apex and the buccal-lingual/mesio-distal width(L1,L2,L3)around the implant at three different sites.The measurement data was statistically analyzed and tested using SPSS 22.0 software.There was a statistical difference when P value was less than 0.05.Results:(1)Survival rate of implants:14 implants were placed in 12 patients.All the implants met the survival criteria after six months of restoration.The survival rate of implants was 100%.(2)Intraoperative and postoperative complications:No intraoperative and postoperative complications occurred such as maxillary sinus membrane perforation,hemorrhage and maxillary sinusitis except mild facial swelling in 3 to 5 days after surgery,which decreased within seven days.All the implants were well functional after restorations.Mechanical and biological complications including loosing,fracture of screws or peri-implantitis in the implant-supported prostheses were not manifested.(3)Bone formation around implants:After the maxillary sinus floor augmentation,the height BH from the root of the implant to raised maxillay sinus mucosa was(2.30±0.74)mm.The buccal-lingual width of L1?L2?L3 around the implant were(10.12±1.53)mm?(9.1±1.74)mm?(8.31±1.54)mm.The mesio-distal width of L1?L2?L3 around the implant were(10.57±2.84)mm?(9.26±2.59)mm?(9.16±2.69)mm.After six months of operation,CBCT showed that there was sufficient bone around the implant.The BH was(1.96±0.69)mm,the buccal-lingual width of Ll?L2?L3 were(9.97±1.62)mm?(9.02±1.88)mm?(8.28±1.53)mm,and the mesio-distal width of L1?L2?L3 were(10.54±2.84)mm?(9.27±2.58)mm?(9.15±2.70)mm.Six months after implant placement,the bone resorption of BH was(0.34 ±0.21)mm,the bone resorption of the buccal-lingualL1?L2?L3 were(0.15±0.26)mm?(0.13±0.23)mm?(0.05 ± 0.05)mm and the bone resorption of the mesio-distal L1?L2?L3 were(0.04±0.05)mm?(0.10±0.22)mm?(0.05±0.05)mm.The paired t-test was used to compare the measurement data of the same patient at the time of implantation and 6 months after operation.It was found that the height of BH was significantly different,and the width of L1?L2 and L3 was not statistically significant.(4)Effect of prosthetic rehabilitation:All of the implant-supported prostheses could function well after 6 months follow-up.Through evaluating mastication,comfortableness and aesthetic,patients were satisfied with the restorations.Conclusion:During the period of short-term observation,postoperative osseointegration was in good condition when people use graft material comprising 60%hydroxyapatite and 40%?-tricalcium phosphate in maxillary sinus floor augmentation.Patients were satisfied with the clinical effectiveness after functional loading of prostheses.The clinical research suggested that BonaGraft(60%HA and 40%?-TCP)can be used as graft material successfully in maxillary sinus floor augmentation.Long-term clinical effects need to be tracked for further follow-up and more cases. |
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