Sinus graft with safescraper: 5-year results

J Oral Maxillofac Surg. 2011 Feb;69(2):482-90. doi: 10.1016/j.joms.2010.10.037.

Abstract

Purpose: In the procedure of sinus floor elevation, autogenous bone, allogenic grafts, and several other bone substitutes are used. However, autogenous bone is still considered the gold standard. Donor sites for autogenous bone are generally the iliac crest, oral cavity, calvarium bone, and tibia. In this work the experience with the use of a Safescraper device for harvesting of autogenous bone is reported and a decision-making algorithm for grafting in sinus floor elevation procedures is proposed.

Materials and methods: Forty sinus augmentation procedures were performed in 34 patients. All sinuses were filled with a mixture of autogenous bone and bovine hydroxyapatite. A Safescraper device was used to harvest autologous bone from the maxillary area. Platelet-rich plasma was used to sustain bone placement. Sixty-five dental implants were placed at 4 months with a flapless procedure. A clinical and radiological 5-year retrospective case series of a cohort is reported.

Results: In all cases new bone formation was confirmed radiologically and implant placement was performed successfully. Analysis of samples obtained by biopsy with histology and microcomputed tomography showed the presence of mature bone. Healing problems were observed in only 1 case.

Conclusions: Sinus augmentation with bone grafts obtained from oral cavity with a bone scraper device has the advantage of providing autogenous bone without the need for an extra surgical approach. This procedure yields satisfactory results in bone formation, implant survival, and patient satisfaction. When combined with a flapless approach for implant placement, a decrease in the morbidity of the entire process is achieved.

MeSH terms

  • Adult
  • Aged
  • Alveolar Ridge Augmentation / instrumentation
  • Alveolar Ridge Augmentation / methods*
  • Biopsy
  • Bone Substitutes / therapeutic use
  • Bone Transplantation / instrumentation*
  • Cohort Studies
  • Dental Implantation, Endosseous
  • Dental Implants
  • Durapatite / therapeutic use
  • Female
  • Follow-Up Studies
  • Humans
  • Imaging, Three-Dimensional
  • Male
  • Maxilla / surgery
  • Maxillary Sinus / surgery*
  • Middle Aged
  • Minerals / therapeutic use
  • Osteogenesis / physiology
  • Patient Satisfaction
  • Platelet-Rich Plasma
  • Retrospective Studies
  • Survival Analysis
  • Tissue and Organ Harvesting / instrumentation*
  • Transplantation, Autologous
  • X-Ray Microtomography
  • Zygoma / surgery

Substances

  • Bio-Oss
  • Bone Substitutes
  • Dental Implants
  • Minerals
  • Durapatite