Sinus Floor Elevation Using a Composite Graft: Clinical Outcome of Immediate Implant Placement

Purpose: The aim of this study is to assess the long-term outcome of a single-stage approach for implant placement and maxillary sinus floor elevation (MSFE) that used a combined scaffold of laminated calvarial bone, platelet-rich plasma (PRP), and beta-tricalcium phosphate. Materials and Methods: Thirty consecutive patients who required MSFE to allow rehabilitation with implant-supported prosthesis entered this survival study. All patients received their dental implants at the time of sinus elevation, and prosthetic loads were applied 4 to 6 months after implant insertion. Clinical outcomes used for evaluation included residual bone height at the subsinus area (height of subsinus bone [HSB], assessment of surgical morbidity, and implant success and survival rates. Results: Simultaneous insertion of 86 implants, either 10 mm long (n = 76) or 12 mm long (n = 10), took place in a total of 22 bilateral and 8 unilateral sinus elevations. Loading was initiated a mean of 3.8 ± 1.5 months after the first surgery. A mean HSB of 4.9 ± 1.7 mm was present before surgery, with 50% of the sample displaying HSBs of less than 4.4 mm. The mean implant survival time was 33.1 months (95% confidence interval, 31.7 to 34.5 months), with high rates of success (94.2%) and survival (96.5%). When patients were classified by their HSB (HSB >= 5 mm vs HSB 5 mm), no differences were seen with regard to age, sex, healing time, or follow-up in terms of implant survival rates (P > .05). Conclusions: Sinus floor elevation using mainly laminated calvarial bone, PRP, beta-tricalcium phosphate, and simultaneous stable implant placement is a predictable technique with low surgical morbidity that allows shorter healing times in patients with reduced bone height. Keywords: calvaria, endoscopic surgery, implant success rate, implant survival rate, platelet-rich plasma, sinus floor elevation, subsinus bone height