Implant Insertion after Using of Oxidized Regenerated Cellulose as a Graft Material in a Transalveolar Maxillary Sinus Floor Elevation

Abstract

Objectives: To evaluate the use of oxidized regenerated cellulose as a graft material in trans alveolar maxillary sinus floor elevation and implant insertion. Patient and methods: A clinical study was conducted on sixteen patients, suffering from partially edentulous areas at the maxillary posterior region. Sixteen patients with 18 implants were divided randomly into two equal groups 8 patients with 9 implants in each group. Study group, patients were subjected to trans alveolar sinus lift and Oxidized cellulose (SurgicelSNoW)® Absorbable Hemostat, Ethicon Inc., USA) graft were applied and immediate implant placement. Control group, patients were subjected to trans alveolar sinus lift and implants applied without any graft. All patients were followed up clinically and radiographically by Cone Beam Computed Tomography (CBCT) at the intervals of 6 and 9 months to evaluate bone density and bone height around dental implants and stability of the dental implants. Results: There was no statistically significant difference between the two groups regarding the mean of change in IQS values between the immediate and 6 months postoperatively, while there was highly statistically significant increase in the ISQ in both groups, the radiographic parameters of this study include measuring bone height and density of neoformed bone, where there was a highly significant increase in the height in a study group (performed by ORC graft) more than the control group (performed without any graft). Both techniques resulted in successful clinically stable implants after a follow-up period of up to 9 months. Conclusion: According to the results of this study we could conclude that: Osteotome mediated maxillary sinus lifting with simultaneous implant placement using oxidized regenerated cellulose graft is a promising technique compared to other grafting materials as technically safe, cheap, fast and its application does not require a sophisticated procedure through trans alveolar sinus membrane elevation and simultaneous implant insertion. Oxidized regenerated cellulose could be considered as an alternative reasonable grafting material with comparable outcomes to osteon II with less postoperative complications, if the residual bone below sinus floor ≥ 8 mm, it ́s not required to use graft materials for sinus floor augmentation and if the residual bone height is ≤ 6 mm ORC could be used as filling material for crestal sinus floor augmentation.