Sinus floor augmentation with simultaneous implant placement in the severely atrophic maxilla: Technical problems and complications

Background: A one-stage surgical technique has been adopted that allows simultaneous implant placement in as little as 1 to 2 mm of residual bone. The aim of this retrospective study was to describe results and complications in sinus augmentation of severely atrophic edentulous maxillae in patients with 1 to 3 mm residual bone height and compare them to a group of patients treated following the standard protocol with residual bone height > 4 mm. Methods: The study consisted of a study group (N = 25) and a control group (N = 30). All patients were consecutive admissions treated for one-stage sinus augmentation by one surgeon during the years 2001 to 2005. Patients' medical files were reviewed mainly regarding operative technical problems and complications. Results: Included in the study were 60 sinuses and 164 simultaneous implants placed in grafted maxillary sinuses. Eight implants failed, seven of which were in the study group; three were in heavy smokers with residual bone of 1 to 3 mm. The success rate was 92% for the study group and 98.7% for the control group. A borderline statistically significant difference was found in the success rates between the groups using the Fisher exact test (P=0.069). Conclusion: Sinus augmentation with simultaneous implant placement can be used to treat the atrophic maxilla in patients with 1 to 3 mm of vertical residual bone height when careful case planning and surgical techniques are used.