Transcrestal Sinus Floor Elevation with Coral-Derived Hydroxyapatite: pilot study.

Objective: The purpose of this pilot study is to set a mini-invasive surgical protocol for the rehabilitation of edentulous posterior maxilla, consisting of the positioning of short or standard implants in combination with sinus lifting, with the adjunct of coral-derived hydroxyapatite (Duravit Crestal Sinus Lift & Novocore Plus by B&B Dental Implant Company S.r.l.,Bologna, Italy). Method: 12 patients with residual bone height <4mm were included in this pilot study. After the elevation of a full-thickness flap, the cortical bone has been perfored with a pilot drill. The guide path has expanded with a compactor-expander 2mm wide, then 3mm wide and then, depending from the bone thickness, 4mm wide compactor was used. All these compactor were used 1mm inside the sinus. Coral-derived hydroxyapatite was placed by injector into the surgical cavity and the pushed into the sinus to elevate the membrane. Finally the implant was placed. All implant site were underprepared to achieve implant primary stability. After implant placement, the flap was repositioned and sutured with 4.0 non-adsorbable sutures. All patients received a standard post-surgical and maintenance protocol. Periapical radiographs were taken immediately after implant placement, at the prosthetic phase, and at each follow-up visit. Patients were left healing for 4 months before prosthetic phase. 12 implants have been inserted. All implants supports a screw-retained single-crown prosthesis. Result: All 12 implant placed achieved osseintegretion. Overall implant success and survival rates were 100% and average marginal bone loss was 0.60±0.2mm at 1 year follow-up visit. All prosthetic rehabilitations were successful and in function. Conclusion: Within the limits of this pilot study the proposed treatment protocol for mini invasive sinus floor elevation seems to be a viable option for rehabilitation of edentulous posterior atrophic maxilla.