Tissue Level Changes after Maxillary Sinus Floor Elevation with Three Types of Calcium Phosphate Ceramics: A Radiological Study with a 5-Year Follow-Up

Wilhelmus F Bouwman; Nathalie Bravenboer; Christiaan M Ten Bruggenkate; Francis A Eijsackers; Najada Stringa; Engelbert A J M Schulten

doi:10.3390/ma14061471

Tissue Level Changes after Maxillary Sinus Floor Elevation with Three Types of Calcium Phosphate Ceramics: A Radiological Study with a 5-Year Follow-Up

Materials (Basel). 2021 Mar 17;14(6):1471. doi: 10.3390/ma14061471.

Authors

Wilhelmus F Bouwman^{1

2}, Nathalie Bravenboer³, Christiaan M Ten Bruggenkate^{1

4}, Francis A Eijsackers^{4

5}, Najada Stringa⁶, Engelbert A J M Schulten¹

Affiliations

¹ Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam Movement Sciences, Amsterdam UMC and Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
² Department of Oral and Maxillofacial Surgery, The Tergooi Hospital, Rijksstraatweg 1, 1261 AN Blaricum, The Netherlands.
³ Department of Clinical Chemistry, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
⁴ Department of Oral and Maxillofacial Surgery, Alrijne Hospital, Simon Smitweg 1, 2353 GA Leiderdorp, The Netherlands.
⁵ Francis4YourPractice, Julius Caesarlaan 180, 2314 BS Leiden, The Netherlands.
⁶ Department of Epidemiology and Data Science, Amsterdam UMC-VUmc, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands.

Abstract

This study evaluates the radiological changes in tissue height after maxillary sinus floor elevation (MSFE) using three types of calcium phosphate ceramics over a period of up to 5 years after dental implant placement. In 163 patients, MSFE was performed. Three groups of patients were distinguished and treated based on the type of calcium phosphate ceramic used and radiologically evaluated: 40 patients with β-tricalcium phosphate (β-TCP), 76 patients with biphasic calcium phosphate (BCP) 20% hydroxyapatite (HA)-80% β-TCP, and 47 patients with BCP 60% HA-40% β-TCP. Radiological measurements were performed on panoramic radiographs at several time points up to 5 years after dental implant placement. After MSFE, a slow decrease in tissue height measured over time was seen in all three study groups. Resorption of the grafted bone substitutes was more prominent in β-TCP than in BCP ceramics with an HA component (60/40 and 20/80). Loss of tissue height after 5 years was lowest in BCP 60/40 and highest in β-TCP. This radiological study shows a predictable and comparable behavior of the slow decrease in tissue height over time for all three types of calcium phosphate ceramics used in MSFE. The fraction of HA in calcium phosphate ceramics and dental implant loading seems to be beneficial for tissue height maintenance after MSFE.

Keywords: beta-tricalcium phosphate; biphasic calcium phosphate; bone substitute; calcium phosphate ceramic; radiological measurements; sinus augmentation; sinus floor elevation.