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European Journal of Oral Implantology

Editor in Chief: Dr. Marco Esposito

Official publication of the British Society of Oral Implantology (BSOI), Italian Society of Oral Surgery and Implantology (SICOI), Danish Society for Oral Implantology (DSOI), German Association of Oral Implantology (DGI), Spanish Society of Implantology (SEI), British Academy of Implant & Restorative Dentistry (BAIRD) and Advanced Dental Implant Research & Education Center (AIC)

ISSN (print) 1756-2406 • ISSN (online) 1756-2414


Winter 2010
Volume 3 , Issue 4

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Sinus lift with guided bone regeneration or anorganic bovine bone: 1-year post-loading results of a pilot randomised clinical trial

Esposito, Marco / Piattelli, Maurizio / Pistilli, Roberto / Pellegrino, Gerardo / Felice, Pietro

Purpose: To compare the efficacy of two different techniques for maintaining the space beneath a maxillary lining lifted using a lateral window approach: rigid synthetic resorbable barriers versus granular anorganic bovine bone. Materials and methods: Ten partially edentulous patients having bilaterally 1 to 5 mm of residual bone height and at least 5 mm bone width below the maxillary sinuses, were randomised in a split-mouth study design, to receive a rigid Inion GTR Biodegradable Membrane System barrier without any graft on one side and 100% loosely packed granular Bio-Oss on the contralateral side following a lateral window, two-stage, sinus lift procedure. After 6 months, two or three implants were inserted at each side and submerged for 4 months. Implants were loaded with provisional acrylic prostheses and replaced, after 4 months, by definitive metal-ceramic prostheses cemented with provisional cement. Outcome measures were implant and prosthetic failures, any complication and peri-implant marginal bone level changes assessed by a blinded outcome assessor. All patients were followed up to 1 year after loading. Results: One patient dropped out after implant placement. One distal implant failed at the Inion side just before delivery of the definitive prosthesis, which was cut and maintained as a single crown. Four complications occurred in three patients at Inion sites (two sinus lining perforations, one fracture of the ceramic cusp of the definitive prosthesis, one iatrogenic peri-implantitis) versus two complications at Bio-Oss sites (one sinus lining perforation and one iatrogenic peri-implantitis). There were no differences for failures or complications between groups; however, in one of the patients where a perforation occurred at the Inion site, at implant placement, the sinus was filled two-thirds with soft tissue and the site was retreated with Bio-Oss. There were no statistically significant differences in bone loss between groups. One year after loading, Inion sides lost an average of 1.5 mm of periimplant bone and Bio-Oss sides about 1.7 mm. Conclusions: A bone graft may not be needed to augment atrophic maxillary sinuses since it is sufficient to keep space with a rigid barrier; however, it may be simpler to fill sinuses with a bone substitute than positioning a rigid barrier to maintain space.

Keywords: anorganic bovine bone, resorbable barrier, sinus lift

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