Hamlet, Stephen, Ivanovski, Saso, Hutmacher, Dietmar, Arora, Himanshu, Alayan, Jamil, Hamlet, Stephen, Ivanovski, Saso, Hutmacher, Dietmar, Arora, Himanshu, and Alayan, Jamil
Full Text, Thesis (PhD Doctorate), Doctor of Philosophy (PhD), School of Dentistry&Oral Hlth, Griffith Health, Maxillary sinus pneumatization is a frequently encountered problem in the dental implant rehabilitation of the posterior maxilla. Maxillary sinus augmentation (MSA) using a lateral wall approach is a well-established and commonly utilized surgical technique for overcoming this bone deficiency and allowing implant placement. MSA is still in the refinement process with a large degree of variation in all aspects of the technique including; the surgical protocol, the anatomical site, the choice of material, the site of autogenous bone harvesting, the timing of implant surgery and the use of barrier membranes. Generally, however, prospective controlled clinical trials critically assessing these domains remain rare, especially studies applying well defined success criteria for implant supported restorations placed in sites of MSA. The maxillary sinus grafting procedure is invasive and surgically demanding, but appears to have limited interference with maxillary sinus physiology when performed well. In addition, reported surgical complications are generally well tolerated and followed by normal recovery in the vast majority of cases. Most of this data however is derived from medium to low level evidence (clinical case series, retrospective analyses). Patients undergoing this procedure also expect to be counselled about their expectations regarding pain and the impact of this procedure on their daily life in the post-operative period. Such information is not available. There is also limited long term outcome data on implants placed in MSA. Historically, autogenous bone grafts have been considered the gold standard due to their inherent osteoinductivity. Their significant limitations in MSA however has driven intense research into various bone substitutes. Anorganic bovine bone mineral (ABBM) is a very well documented xenograft in MSA when used alone or as a composite graft with autogenous bone (AB) (ABBM + AB). More recently, collagen stabilized ABBM using 10% porcine type