All ETDs from UAB

Advisory Committee Chair

Micheal S Reddy

Advisory Committee Members

Nico Geurs

Mia Geisinger

Jack Lemons

Amjad Javed

Document Type

Thesis

Date of Award

2012

Degree Name by School

Master of Science in Dentistry (MScD) School of Dentistry

Abstract

Insufficient bone height is a common obstacle to placing dental implants in the posterior maxilla. Sinus lift procedures using various grafting materials have been shown to be a highly predictable way to increase bone height in the posterior maxilla (Jensen 1998). Given the wide range of materials that have proven successful in augmenting the sinus, the argument could be made that the presence of graft is not critical. Instead, the creation and maintenance of space, provided by two implants, along with the osteoinductive properties of the membrane, the periosteum, and growth factors provided by a blood clot are the only requirements for bone formation in the maxillary sinus. The purpose of this "proof of principle" study is to demonstrate that elevation of the sinus, using the patient's venous coagulum alone, results in clinical, radiologic and histologic evidence of vital bone formation. A total of 5 sinus elevations with simultaneous placement of 2 dental implants were performed with venous blood coagulum as the sole filling biomaterial. After 8-9 months of healing, a postoperative cone-beam computed tomography(CBCT) was taken and the implants were uncovered. During the uncovery procedures, core bone sample were taken from the lateral wall of the maxilla. The cores underwent micro-computed tomography(CT), histologic and histomorphometric analyses. Comparisons of pre-operative and post-operative alveolar crest height were made using cone-beam CT to determine the gain of bone height. Criteria for inclusion were: edentulism in the posterior maxilla, less than 10mm alveolar height beneath the maxillary sinus, greater than 18 years of age and systemically healthy. Gain in height was observed in all 5 sites ranging from 4.37mm to 10.01mm. Histological evaluation showed new bone formation in 4 of the 4 biopsies obtained. Based on the results of this study, it appears that bone graft materials in the sub-sinus cavity are not required for bone formation. Instead, stabilization of a blood clot under the sinus membrane appears to be the fundamental healing mechanism, allowing for bone formation after sinus elevation procedures.

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Dentistry Commons

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