Artemchuk A. Yu., Osmanov B. Kh., Chepurnyi Yu. V.

A DIFFERENTIATED PROTOCOL FOR SUBANTRAL AUGMENTATION AND DENTAL IMPLANT PLACEMENT IN PATIENTS WITH MAXILLARY SINUS FLOOR DEFECTS: RESULTS OF A PROSPECTIVE COHORT STUDY

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About the author:

Artemchuk A. Yu., Osmanov B. Kh., Chepurnyi Yu. V.

Heading:

DENTISTRY

Type of article:

Scientific article

Annotation:

Restoration of dentition defects in the distal regions of the maxilla is often complicated by a deficiency of alveolar bone and the presence of defects of the maxillary sinus floor, which reduces the predictability of implantation and requires an individualized treatment strategy. The aim of the study was to increase the efficiency and predictability of subantral augmentation (SA) and dental implantation in maxillary sinus floor defects (MSFD) through the imple mentation of a differentiated treatment protocol and the assessment of complications and factors associated with failure. A prospective cohort study of 31 patients was conducted during 202-2025. The treatment protocol included stratification according to the type of defect and the expected implant position, with emphasis on restoring the cortical continuity of the alveolar ridge. Statistical analysis was performed using Pearson’s χ² test with EZR/R and MedStat software; p<0.05 was considered statistically significant. The most common etiology was tooth extraction (58.0%); trauma accounted for 35.4% and was associated with treatment failure (p=0.0067). The overall success rate of SA was 80.6%; membrane perforation occurred in 6.45% of cases; infectious complications were observed in 25.8%, and sinusitis in 22.6%. Implantation was performed in 80.6% of patients; a total of 52 implants were placed, with a disintegration rate of 7.7%, while repeat implantation was successful. Infectious complications and sinusitis were statistically associated with SA failure. In defect types I-III, a 100% success rate was achieved, whereas type IV defects demonstrated a 40% success rate and more frequently required additional surgical interventions. The differentiated treatment protocol for MSFD ensures high success rates of SA and dental implantation. Patients with traumatic etiology and type IV defects require a more staged reconstructive treatment strategy.

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Bibliography:

1. Pjetursson BE, Tan WC, Zwahlen M, Lang NP. Success of sinus floor elevation and survival of implants inserted in combination with sinus floor elevation: systematic review. J Clin Periodontol. 2008;35(8):216-240. DOI: 10.1111/j.1600-051X.2008.01272.x.
2. Carreño Carreño J, Aguilar-Salvatierra A, Gómez-Moreno G, García Carreño EM, Menéndez López-Mateos ML, Perrotti V, et al. Update of Surgical Techniques for Maxillary Sinus Augmentation: A Systematic Literature Review. Implant Dent. 2016;25(6):839-844. DOI: 10.1097/ ID.00000000000 00467.
3. Stacchi C, Bernardello F, Spinato S, Mura R, Perelli M, Lombardi T, et al. Intraoperative complications and early implant failure after transcrestal sinus floor elevation with residual bone height ≤5 mm: A retrospective multicenter study. Clin Oral Implants Res. 2022;33(8):783 791. DOI: 10.1111/clr.13959.
4. Artemchuk A, Osmanov B, Chepurnyi Y. Maxillary sinus floor defects: A key challenge in posterior maxillary implant planning. Journal of Oral Medicine and Oral Surgery. 2025;31(4):32. DOI: 10.1051/mbcb/2025035.
5. Jensen OT, Shulman LB, Block MS, Iacono VJ. Report of the Sinus Consensus Conference of 1996. Int J Oral Maxillofac Implants. 1998;13:11-45.
6. Zita Gomes R, de Vasconcelos MR, Lopes Guerra IM, de Almeida RAB, de Campos Felino AC. Implant Stability in the Posterior Maxilla: A Controlled Clinical Trial. Biomed Res Int. 2017;2017:6825213. DOI: 10.1155/2017/6825213.
7. Al-Juboori H, Petronis Z, Razukevicius D. Interrelation between cortical bone thickness and primary/secondary implant stability: systematic review. J Oral Maxillofac Res. 2024;15(4):e2. DOI: 10.5037/jomr.2024.15402.
8. Miyamoto I, Tsuboi Y, Wada E, Suwa H, Iizuka T. Influence of cortical bone thickness and implant length on implant stability at the time of surgery-clinical, prospective, biomechanical, and imaging study. Bone. 2005;37(6):776-80. DOI: 10.1016/j.bone.2005.06.019.
9. Tanaka K, Sailer I, Iwama R, Yamauchi K, Nogami S, Yoda N, et al. Relationship between cortical bone thickness and implant stability at the time of surgery and secondary stability after osseointegration measured using resonance frequency analysis. J Periodontal Implant Sci. 2018;48(6):360-372. DOI: 10.5051/jpis.2018.48.6.360.
10. Vallecillo-Rivas M, Reyes-Botella C, Vallecillo C, Lisbona-González MJ, Vallecillo-Capilla M, Olmedo-Gaya MV. Comparison of Implant Stability between Regenerated and Non-Regenerated Bone. A Prospective Cohort Study. J Clin Med. 2021;10(15):3220. DOI: 10.3390/ jcm10153220.
11. Di Stefano DA, Arosio P, Capparè P, Barbon S, Gherlone EF. Stability of Dental Implants and Thickness of Cortical Bone: Clinical Research and Future Perspectives. A Systematic Review. Materials (Basel). 2021;14(23):7183. DOI: 10.3390/ma14237183.
12. Brugnami F, Caleffi C. Prosthetically driven implant placement. How to achieve the appropriate implant site development. Keio J Med. 2005;54(4):172-8. DOI: 10.2302/kjm.54.172.
13. Kim M, Lee JH, Kim HS, Lee SY. Primary stability of implants in bovine bone defect models. Sci Rep. 2025;15(1):10237. DOI: 10.1038/ s41598-025-95318-x.
14. Yim HJ, Lim HC, Hong JY, Shin SI, Chung JH, Herr Y, et al. Primary stability of implants with peri-implant bone defects of various widths: an in vitro investigation. J Periodontal Implant Sci. 2019;49(1):39-46. DOI: 10.5051/jpis.2019.49.1.39.
15. Barros LA, da Silva CF, Camargos GV, Marcantonio E Jr, de Oliveira GJ, Barros-Filho LA. In vitro evaluation of the influence of bone cortical thickness on the primary stability of conventional- and short-sized implants. J Clin Exp Dent. 2022;14(2):e138-e143. DOI: 10.4317/ jced.58886.
16. Chiapasco M, Zaniboni M. Failures in jaw reconstructive surgery with autogenous onlay bone grafts for pre-implant purposes: incidence, prevention and management of complications. Oral Maxillofac Surg Clin North Am. 2011;23(1):1-15. DOI: 10.1016/j.coms.2010.10.009.
17. Osmanov B, Shepelja A, Chepurnyi Y, Kopchak A, Snäll J. Conditions of Iliac Bone Graft Application in Mandibular Defects Replacement: A Retrospective Study of 11-years’ Experience. Rev Esp Cir Oral Maxilofac 2023;45(3):98-106. DOI: 10.20986/recom.2023.1489/2023.
18. Gadre PK, Ramanojam S, Patankar A, Gadre KS. Nonvascularized bone grafting for mandibular reconstruction: myth or reality? J Craniofac Surg. 2011;22(5):1727-35. DOI: 10.1097/SCS.0b013 e31822e633b.

Publication of the article:

«Bulletin of problems biology and medicine», 2026 Issue 1, 180, 587-597 pages, index UDC 616.314-089.843.29+616.716.1-089.844

DOI:

10.29254/2077-4214-2026-1-180-587-597