Maxillary sinus elevation with an alloplastic material and implants: 11 years of clinical and radiologic follow-up

Purpose: The aim of this retrospective study was to determine the clinical and radiologic results, over an 11-year period, of resorbable hydroxyapatite used as a bone substitute in maxillary sinus elevation. Materials and Methods: Between 1996 and 2007, we treated 26 patients with maxillary sinus elevation (27 sinuses) using resorbable hydroxyapatite and simultaneous insertion of 47 titanium implants. Patients were recruited, screened, and accepted or rejected sequentially based on specific inclusion/exclusion criteria. Ten months later, 2-stage surgery and prosthetic rehabilitation were performed. Results: During the 11-year follow-up period (mean, 6 years), all the implants appeared clinically and radiologically integrated. The cumulative survival rate was 100%. During the observation period, the resorption of the graft apically to the implant was 1.8 mm on average. Conclusion: The posterior area of the maxilla often represents a challenging clinical situation because of either the lack of alveolar bone or the structural characteristics of the trabeculae in that specific area. The high survival rate of the implants and the stability of the mineralization of the graft confirmed that resorbable hydroxyapatite was a suitable material for sinus grafting.