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Purpose: The present study was performed to evaluate the 5-year status of immediately placed implants subjected to maxillary sinus elevation without grafting., Materials and Methods: Implants were placed in 2004 and 2005. A minimum of 3 mm of residual bone height (RBH) was required. All implants were placed with a sinus elevation performed through a lateral approach by the trap-door, open-window method without placement of any grafting material. Regular follow-up included oral hygiene instruction, periodontal charting, panoramic radiographs, and cone beam computed tomographic scans. The gained bone height (GBH) in the sinus, peri-implant sulcus depth, and marginal bone loss were analyzed statistically., Results: Forty-four patients (26 men, 18 women) with an average age of 58 years received 80 implants, which were followed for 5 years after prosthesis delivery. No patients developed sinusitis or other complications leading to implant loss. The average RBH was 5.06 ± 1.51 mm and the average intrasinus implant length was 7.77 ± 1.69 mm. Survival rates for the implants were 100% after 2 and 5 years. Average GBH was 7.24 ± 1.83 mm at 2 years (range, 3 to 12 mm) and 7.44 ± 1.94 mm at 5 years (P > .05). The average peri-implant sulcus depths were 2.5 ± 0.4 mm at 2 years and 3.1 ± 0.5 mm at 5 years (P < .05). The mean peri-implant marginal bone loss was 1.3 ± 0.3 mm at 2 years and 2.1 ± 0.5 mm at 5 years (P < .05)., Conclusions: New bone formation in the sinus was confirmed, and good survival of implants with maxillary sinus elevation by the lateral approach without grafting was observed after 5 years. Attention should be focused on oral hygiene maintenance to ensure peri-implant gingival health.

Barrier membranes are employed clinically to deflect the growth of gingival tissues away from root surface. They provide an isolated space over the regions with the defective tissues that allow the relatively slow growing periodontal ligament fibroblasts to be repopulated onto the root surface. Several makes of bioabsorbable membranes are now commercially available. In this study, we have employed chitosan as barrier membrane material and evaluated it for a guided tissue regeneration application. Three types of chitosan membranes: Chi-NaOH, Chi-Na(5)P(3)O(10), and Chi-Na(2)SO(3)(each was gelated by NaOH, crosslinked by Na(5)P(3)O(10) and Na(2)SO(3), respectively), were prepared to be evaluated by the following categories: the mechanical strength to create an effective space, the rapid rate to reach hydrolytic equilibrium in phosphate-buffered solution, and the ease of clinical manipulative operations. Consequently, standardized, transosseous and critical sized skull defects were made in adult rats and the defective regions were covered with the specifically prepared chitosan membranes. After 4 weeks of recovering, varying degrees of bone healing were observed beneath the chitosan membranes in comparison to the control group. The chitosan covered regions showed a clear boundary space between connective tissues and bony tissues. Apparently, this process resulted in a good cell occlusion and beneficial osteogenesis effect to the bone. As for the control group, the bone defect was filled with connective tissue, and a destruction of the integrity of newly formed bone was observed. Among the chitosan membranes tested in this study, Chi-NaOH membrane provided a higher percentage of new bone formation than those from the Chi-Na(5)P(3)O(10) and Chi-Na(2)SO(3) families., ((c) 2005 Wiley Periodicals, Inc.)