Volume stability of hydroxyapatite and β-tricalcium phosphate biphasic bone graft material in maxillary sinus floor elevation: a radiographic study using 3D cone beam computed tomography

Clin Oral Implants Res. 2016 Mar;27(3):348-53. doi: 10.1111/clr.12551. Epub 2015 Feb 3.

Abstract

Objectives: The purpose of this study was to confirm volume stability of biphasic calcium phosphate (BCP) through the changes of grafted volume over the time by 3D CT analyzing software program.

Patients and methods: Fifteen patients, 16 sinuses who were scheduled a staged implantation through sinus floor elevation (SFE)-lateral window technique from 2009 to 2011 were included in the study. Of the 15 patients, eight were male and seven were female (mean age 50.1). For sinus floor augmentation, BCP with local blood was packed loosely into the maxillary sinus and the grafted site was covered with a collagen membrane. For the evaluation of volume change, 3D CBCT scans were taken five times at pre-operatively (To), post-op 1 week (T1), 1 month (T2), 3 months (T3), and 6 months (T4). 3D image processing software (OnDemand3DTM software) was used for this study. The time sequential change was statistically evaluated.

Result: 84.32% grafted BCP is maintained until post-op 6 month (T4), and the average volume loss is 207.7 mm(3) (about 0.21 cc). Statistically, a significant volume change (decreasing) was observed in three groups (T2-T1, T3-T2, T4-T3).

Conclusion: Biphasic calcium phosphate, as a synthetic material, has high volume stability and is a predictable graft material for the successful SFE. Although some limitations of the 3D analyzing software program, it is a fast, simple, relatively accurate and promising approach to quantifying long-term changes in the grafted area.

Keywords: 3D computed tomography; sinus floor elevation; volumetric stability.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Bone Substitutes / therapeutic use*
  • Calcium Phosphates / therapeutic use*
  • Collagen
  • Cone-Beam Computed Tomography*
  • Durapatite / therapeutic use*
  • Female
  • Humans
  • Imaging, Three-Dimensional*
  • Male
  • Membranes, Artificial
  • Middle Aged
  • Prospective Studies
  • Radiographic Image Interpretation, Computer-Assisted*
  • Sinus Floor Augmentation / methods*
  • Treatment Outcome

Substances

  • Bone Substitutes
  • Calcium Phosphates
  • Membranes, Artificial
  • beta-tricalcium phosphate
  • Collagen
  • Durapatite