Association of transalveolar sinus floor elevation, platelet rich plasma, and short implants for the treatment of atrophied posterior maxilla

Objectives: Assess the efficiency of transalveolar sinus floor augmentation in association with platelet rich plasma and short implants for the treatment of atrophied edentulous maxilla with a residual bone height (RBH) <5 mm. Materials and methods: Atrophied posterior maxilla was treated with transalveolar sinus floor augmentation performed with conventional bone drills and autologous platelet concentrate. The space created below the Schneiderian membrane was filled with platelet rich plasma alone or in combination with a bone graft and followed by the insertion of short implants. Surgical complications, implant survival, and marginal bone loss were evaluated during the follow-up period. Results: Forty-eight patients (average age: 55.98 +/- 8.71 years) with 61 short implants were treated in this study. Schneiderian membrane perforation occurred in one maxillary sinus, and the initial RBH of 4.15 +/- 0.53 mm was increased to 8.86 +/- 1.60 mm. There was no significant difference between the grafting materials with respect to the gained bone height. The mean follow-up time of the implants was 10.81 +/- 5.87 months (range: 2-28 months) since loading. The average bone loss was 0.59 +/- 0.12 mm (loading time <6 months), 0.62 +/- 0.16 mm (loading time between 6 and 12 months), and 1.00 +/- 0.45 mm (loading time higher than 12 months). The use of wide implants was the only parameter that decreases significantly the marginal bone loss. Two implant failures occurred before loading, and the cumulative implant survival rate was 96.7%. Conclusions: The proposed treatment protocol for transalveolar sinus floor augmentation could be efficient in the treatment of severe atrophy in the maxilla.