Maxillary Sinus Floor Augmentation Surgery with Autogenous Bone Grafts as Ceiling:A Pilot Study and Test of Principle

Background: Studies have pointed out that the mere elevation of the maxillary sinus membrane might suffice to allow for bone formation indicating the additional use of augmentation materials to be redundant.Purpose: The purpose of this study was to assess whether elevation of the sinus mucosal lining combined with applying an autologous bone graft as a ceiling and placement of a short implant would allow for bone formation around the implant thus surpassing the need for applying augmentation materials around the installed implants.Materials and Methods: Fourteen consecutive patients were subjected to maxillary sinus floor elevation surgery and simultaneous placement of an implant. Using the lateral bone-wall window technique, the membrane was exposed and elevated. Next, a bone graft taken from the zygomatic rim was placed as a ceiling above the inserted implant to ensure that the sinus membrane would not collapsed around a significant part of the implant. Finally, the bone window was returned in place. After connecting the healing abutment, the wound was closed.Results: All implants were stable and no implants were lost. There were no complications after harvesting the bone graft. Radiographic evaluation showed a bone gain of 3.2 +/- 0.9 mm after 3 months and 3.6 +/- 0.9 mm after 1 year. Less than 6% of the implant was not covered by bone after 1 year.Conclusion: Maxillary sinus membrane elevation and simultaneous placement of short endosseous implants with a bone graft as a ceiling on top of the implant result in predictable bone formation around the implant and good osseointegration on radiographs.