Bone grafting of the floor of the maxillary sinus for the placement of endosseous implants

This study describes and evaluates a technique to augment the floor of the maxillary sinus and to widen the alveolar crest of the atrophic posterior maxilla with autogenous bone. The subjects were 43 patients whose maxillary alveolar crest was not high enough to permit reliable placement of endosseous implants in the posterior maxilla. Large autogenous cancellous bone grafts (n=37) or smaller grafts from the mandibular symphyseal area (n=5) or the maxillary tuberosity (n=1) were harvested. The operations were done in either one stage (n=20 patients, 36 sinuses) or two (bone grafting followed by placement of implants, n=23, 45 sinuses). In 28 cases the sinus membrane was perforated with no subsequent problems. Nine of the 171 Branemark implants that were inserted were lost during follow-up (mean 26 months, range 8-62 months). Augmentation of the maxillary sinus with autogenous bone is a reliable way of achieving placement of an implant.