The Influence of the Bucco‐Palatal Distance on Sinus Augmentation Outcomes

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Abstract
Background:Maxillary sinus augmentation is one of the most reliable implantsite development options to increase vertical bone height. However,graft consolidation requires adequate angiogenesis and migration ofcells involved in osteogenesis and bone remodeling. It isspeculated that these biologic events are greatly determined by thedimensions of the maxillary sinus cavity. Hence, the purpose ofthis study is to assess the influence of the distance from thelateral to the medial wall of the maxillary sinus on the outcomesof sinus augmentation procedures.Methods:A total of 25 patients in need of sinus augmentation were recruitedfor the study. After initial examination, customized radiographicand surgical guides were fabricated and a cone‐beam computerizedtomography scan was obtained per patient. The bucco‐palataldistance (BPD) was measured at 8, 10, and 12 mm from the alveolarcrest. Sinus grafting was performed by a lateral window approachusing a particulated allograft material. Patients were followed‐upfor 6 months. At the time of implant placement, bone core biopsieswere harvested using the radiographic‐surgical guide. Sections ofthe bone cores at 8, 10, and 12 mm from the alveolar crest werehistomorphometrically analyzed. The proportion of vital bone (%VB)was correlated with the BPD using a statistical model.Results:Twenty‐one patients underwent sinus augmentation for a total of 24sinuses; however, the data analyzed contained only one sinus perpatient. One sinus developed an infection after grafting, resultingin a 96% success rate for the sinus grafting procedure. Twentysinuses were used in the final statistical analysis.Histomorphometric analysis revealed that mean %VB was 22.71 ±19.08, mean percent of remaining allograft was 23.39 ±20.85, and average percent of non‐mineralized connective tissue was53.90 ±13.23. Analysis of the correlation between %VB and BPD by linearregression, using the actual values of BPD showed a strong negativeassociation (R2 =0.141;PConclusion:The findings suggest that the %VB formation after maxillary sinusaugmentation is inversely proportional to the sinus BPD.

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