Since the development of the sinus graft procedure in the mid-1970s, clinicians have been evaluating alternatives to autologous bone. Over the years numerous bone substitutes, including allografts, alloplasts, and xenografts, have been used or combined with autologous bone for sinus grafting. The 1996 Sinus Graft Consensus evaluated retrospective data on various graft materials and concluded that they all seemed to perform well. However, the data analysis did not factor the amount of residual bone below the sinus. Bone substitutes were recommended for the posterior maxilla with less resorption or sinus pneumatization. Prospective clinical trials have been recommended to evaluate bone substitutes in cases with minimal residual bone height. This presentation will explore the many benefits, as well as the drawbacks, of the various sinus bone grafting materials and techniques. Factors such as healing time requirements, outcomes of immediate loading of implants, patient acceptance, economic incentives, and postoperative morbidity associated with different donor sites will be discussed.
Craig M. Misch, DDS, MDS, is a clinical associate professor in the Department of Implant Dentistry at New York University and a clinical assistant professor in the Department of Surgical Services at the University of Pittsburgh. He also maintains a private practice in Sarasota, Florida. He holds specialty certificates in prosthodontics and oral implantology and completed specialty training in oral and maxillofacial surgery. He has written and lectured extensively on the topics of reconstructive surgery, bone grafting, implant surgery, and prosthodontics and has been a featured speaker at the annual meetings of the Academy of Osseointegration and the American Association of Oral and Maxillofacial Surgeons. Dr Misch is a diplomate of the American Board of Oral and Maxillofacial Surgery and a member of the editorial boards of two journals.