The use of hydroxyapatite bone cement for sinus floor augmentation with simultaneous implant placement in the atrophic maxilla. A report of 10 cases

Background: Dental implant placement associated with sinus floor augmentation in a severely atrophic maxilla can be performed in a 1- or 2-stage surgical procedure, depending on the height of the residual alveolar bone. A minimum of 4 to 5 mm is recommended for a 1-stage procedure. Methods: This clinical study describes the use of hydroxyapatite (HA) bone cement to stabilize HA-coated cylindrical implants placed simultaneously during sinus augmentation in 10 patients where insufficient bone volume did not allow primary implant stability. A total of 26 HA-coated dental implants were inserted in 10 grafted sinuses of 10 patients. Results: None of the cases presented any difficulty in achieving initial stabilization and parallelism. No clinical complications of the sinuses were evident. Prior to exposure, radiographic evaluation revealed the implants embedded in a densely homogeneous radiopaque mass. At second-stage surgery, there was no clinical evidence of crestal bone loss around the implants. All implants were clinically osseointegrated. All patients received fixed implant-supported prostheses. Mean follow-up was 18 months (range 12 to 24 months). Conclusions: According to this preliminary study, the hydroxyapatite bone cement appears to hold great promise as a grafting alloplastic material for sinus floor augmentations, Its main advantage is its ability to provide initial stability required for osseointegration and proper implant Location and parallelism. Further clinical and histological studies are required before it can be recommended for routine use in sinus lift procedures.