Treatment outcomes of implants performed after regenerative treatment of absorbed alveolar bone due to the severe periodontal disease and endoscopic surgery for maxillary sinus lift without bone grafts

摘要

OBJECTIVE: We have developed a regenerative medicine therapy for the alveolar bone and endoscopic surgery for maxillary sinus lift without bone grafts, in patients experiencing severe periodontal disease with significant absorption of the maxillary alveolar bone, in which more than 10 mm of bone thickness in the maxillary bone was attained, with satisfactory results. The objective of this study was to examine the treatment outcomes of implants that were performed after these therapies. PARTICIPANTS AND METHODS: The participants were 36 patients with severe periodontal disease, who cannot be cured with any other treatments except the extirpation of all teeth. The 36 patients are all patients who underwent regenerative treatment of the alveolar bone through tooth replantation and transplantation of the iliac cancellous bone (the bone marrow) as well as endoscopic surgery for maxillary sinus lift from May 2003 to July 2007 in our clinic. A total of 120 implants were placed in these patients when the replanted teeth fell out because of root resorption, and the success rate was examined. RESULTS: The success rates of the implants were 16 of 33 (48%) in the group when surveyed less than 2 years after the surgery and 84 of 87 (96.5%) in the group when surveyed more than 2 years after the surgery. A statistically significant difference was found between the 2 groups (Chi-squared test, P < 0.001). CONCLUSIONS AND CONSIDERATIONS: It was believed that it takes approximately 2 years for the bones in the maxillary sinus floor, augmented through endoscopic surgery for maxillary sinus lift, to attain the thickness and hardness required for implant placement. Therefore, although the implant treatment should be performed later than 2 years after surgery, chewing is possible during this period, with the replanted teeth that were used for regenerative treatment of the alveolar bone. It is believed that this is an extremely effective treatment method to improve the patients' quality of life.