Assessment of the osteogenic effect after maxillary sinus floor elevation and simultaneous implantation with or without bone grafts by analyzing trabecular bone parameters: A retrospective study

Objective: The aim of this population-based retrospective study was to compare the osteogenic effect of newly formed bone after maxillary sinus floor elevation (MSFE) and simultaneous implantation with or without bone grafts by quantitatively analyzing trabecular bone parameters. Methodology: A total of 100 patients with missing posterior maxillary teeth who required MSFE and implantation were included in this study. Patients were divided into two groups: the non-graft group (n=50) and the graft group (n=50). Radiographic parameters were measured using cone beam computed tomography (CBCT), and the quality of newly formed bone was analyzed by assessing trabecular bone parameters using CTAn (CTAnalyzer, SkyScan, Antwerp, Belgium) software. Results: In the selected regions of interest, the non-graft group showed greater bone volume/total volume (BV/TV), bone surface/total volume (BS/TV), trabecular number (Tb. N), and trabecular thickness (Tb. Th) than the graft group (p<0.001). The non-graft group showed lower trabecular separation (Tb. Sp) than the graft group (p<0.001). The incidence of perforation and bleeding was higher in the graft group than in the non-graft group (p<0.001), but infection did not significantly differ between groups (p>0.05). Compared to the graft group, the non-graft group showed lower postoperative bone height, gained bone height and apical bone height (p<0.001). Conclusion: MSFE with and without bone grafts can significantly improve bone formation. In MSFE, the use of bone grafts hinders the formation of good quality bone, whereas the absence of bone grafts can generate good bone quality and limited bone mass.

本研究旨在通过定量分析骨小梁骨参数，比较上颌窦底提升（MSFE）后新形成的骨组织在同期植入带或不带骨移植材料中的成骨效果。研究方法：纳入100名需要MSFE和植入术的后牙缺失患者。将患者分为两组：无移植组（n=50）和移植组（n=50）。采用锥形束计算机断层扫描（CBCT）测量影像学参数，并利用CTAn（CTAnalyzer，SkyScan，安特卫普，比利时）软件分析新形成骨的质量。研究结果：在感兴趣的区域，无移植组在骨体积/总体积（BV/TV）、骨表面积/总体积（BS/TV）、骨小梁数量（Tb. N）和骨小梁厚度（Tb. Th）方面均优于移植组（p<0.001）。无移植组的骨小梁分离度（Tb. Sp）低于移植组（p<0.001）。移植组的穿孔和出血发生率高于无移植组（p<0.001），但感染发生率在两组间无显著差异（p>0.05）。与移植组相比，无移植组的术后骨高度、骨高度增益和尖部骨高度均较低（p<0.001）。结论：带或不带骨移植材料的MSFE均能显著促进骨形成。在MSFE过程中，使用骨移植材料会阻碍优质骨的形成，而无需骨移植则可能生成优质骨和有限的骨量。