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Stage Characterization and Marginal Bone Loss Evaluation Up to 96 Months of Crestal Sinus Augmentation With Sequential Drills: A Retrospective Study

Bernardello, Fabio DDS*; Felice, Pietro DDS; Spinato, Sergio DDS; Rebaudi, Alberto DDS§; Righi, Davide DDS; Malagoli, Claudio DDS; Torres-Lagares, Daniel DDS#; Ruiz, Rafael Flores DDS**; Zaffe, Davide MBiolSc††

doi: 10.1097/ID.0000000000000342
Basic and Clinical Research

Introduction: The 2-stage crestal approach to augment the maxillary sinus is a little-used technique. The aim of this retrospective study was to assess events characterizing stages of this technique after implant placement in the posterior maxilla with residual bone height less than 4 mm and evaluate the marginal bone loss (MBL) changes over time.

Material and Methods: Thirty-three patients underwent unilateral sinus augmentations using the trancrestal technique with mineralized allograft. Six-months (6 m) after first surgery, if skeletal subsidence prevented insertion of a 10-mm-length implant, additional grafting was performed during implant (n = 33) insertion. Radiographs were taken before grafting (baseline), immediately after and at 6 months; immediately after and 6 months after implant placement; and at follow-up (24–96 m).

Results: One implant was lost (ISR = 96.97%). Of the remaining 32 patients, 14 (A group) underwent standard implant placement, whereas 18 (B group) underwent additional grafting immediately before implant placement. Given that B-group patients initially obtained lower crestal bone height after first surgery, additional grafting procedures provided greater crestal height in the B group. A significant relationship between ending (eMBL) and 6mMBL was found in both groups, with greater values in the B group. However, in both groups, eMBL was always greater if 6mMBL was greater than 0.44 mm.

Discussion: Results suggest a high and low skeletal-reactivity patient categorization. In both patient categories, MBL greatly depends upon 6-month values. Investigations are necessary to relate sinus size with results obtained by this 2-stage crestal approach.

Conclusions: The 2-stage crestal sinus lift procedure not only provides predictable results, but also allows low skeletal-reactivity patient recovery.

*Private Practice, Via Francesco Bonvicini, Terranegra di Legnago Verona, Italy.

Assistant Professor, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.

Private Practice, Via F. Cavallotti, Sassuolo, Modena, Italy.

§Private Practice, Piazza della Vittoria, Genova, Italy.

Private Practice, Via Traversetolo, Parma, Italy.

Private Practice, Via Garagnani, Castelfranco Emilia, Modena, Italy.

#Director, Master in Oral Surgery, Oral Surgery Department, University of Seville C/Avicena, Seville, Spain.

**Professor, Master in Oral Surgery, Oral Surgery Department, University of Seville C/Avicena, Seville, Spain.

††Professor of Human Anatomy, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.

Reprint requests and correspondence to: Davide Zaffe, MBiolSc, Metaboliche e Neuroscienze, Sez. di Morfologia Umana, Via del pozzo 71, Policlinico, 41124 Modena, Italy, Phone: +39 0594224804, Fax: +39 0594224861, E-mail:

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