Augmentation of the maxillary sinus floor with autogenous bone for the placement of endosseous implants: a preliminary report.

Placement of endosseous implants in the atrophic maxilla is often restricted because of lack of supporting bone. In this article, experience with augmentation of the maxillary sinus floor with autogenous bone grafts to enable insertion of endosseous implants is described. The technique is aimed at providing a cortical layer on top of the graft to ensure a reliable seal of the maxillary sinus and to achieve optimal stability of the bone graft in case of simultaneously placement of dental implants. The procedure was used in 25 patients, using iliac crest grafts (22 patients, 86 implants), symphyseal bone grafts (two patients, six implants), or a maxillary tuberosity bone graft (one patient, one implant). Ninety-three Brånemark implants (Nobelpharma, Götenburg, Sweden) were inserted in 47 grafted maxillary sinuses. The mean follow-up was 16 months (range, 6 to 36 months). No inflammation of the bone grafts nor of the maxillary sinus occurred. The sinus membrane was perforated accidentally in eight cases during the surgical procedure. Five implants (5.4%), all inserted in iliac crest grafts, were lost during the healing period. The patients received implant supported overdentures (16 patients) or bone-anchored bridges (nine patients). From this preliminary study it is concluded that augmentation of the maxillary sinus floor with bone grafts for the insertion of endosseous implants is a promising solution for patients with atrophic maxillae and functional problems with their partial or full dentures.