Comparing Operators and Imaging Techniques When Performing Trans-Crestal Sinus Augmentation: A Pilot Study
The aim of this article was to compare baseline residual ridge height using Cone-beam Computed Tomography (CBCT) and panoramic radiographs. A secondary aim was to examine the magnitude of vertical bone gain 6 months after trans-crestal sinus augmentation and compare it between operators. Thirty patients, who underwent trans-crestal sinus augmentation simultaneously with dental implant placement, were included in this retrospective analysis. Surgeries were done by 2 experienced surgeons (EM and EG) using the same surgical protocol and materials. Preoperative residual ridge height was measured on panoramic and CBCT images. The final bone height and the magnitude of the vertical augmentation were measured on panoramic X ray taken 6 months after surgery. Mean residual ridge height measured preoperatively using CBCT was 6.07 ± 1.38 mm, whereas these same measurements on the panoramic radiographs yielded similar results (6.08 ± 1.43 mm), which were statistically insignificant (P = .535). Postoperative healing was uneventful in all cases. All 30 implants were successfully osseointegrated at 6 months. The mean overall final bone height was 12.87 ± 1.39 mm (12.61 ± 1.21 and 13.39 ± 1.63 mm for operators EM and EG, respectively; P = .19). Likewise, mean postoperative bone height gain was 6.78 ± 1.57 mm, which was 6.68 ± 1.32 and 6.99 ± 2.06 mm for operators EM and EG, respectively (P = .66). A moderate positive correlation was found between residual bone height and final bone height (r = 0.43, P = .002). A moderate negative correlation was found between residual bone height and augmented bone height (r = −0.53, P = .002). Sinus augmentation performed trans-crestally produce consistent results with minimal interoperator differences between experienced clinicians. Both CBCT and panoramic radiographs produced similar assessment of the preoperative residual bone height.
(a) Calibration was done (on the postoperative panoramic) according to the implant's known dimension and radiographic measurement. The distance of neighboring tooth to the implant served to locate this same site on the preoperative panoramic. (b) The residual alveolar ridge height was measured in the preoperative panoramic X ray using the above coordinate; this was further adjusted according to the implants dimension that was previously inserted in positions 30 and 31. (c) The residual alveolar ridge height was also measured in the CBCT at the same site as in the panoramic X ray. These measurements (in red) were calibrated according to original DICOM dimension (in yellow).
Moderate positive correlation was found between the RBH before sinus augmentation and the final BH after the augmentation (r = 0.43, P = .002).
Moderate negative correlation between the RBH before sinus augmentation and the gained augmented bone height postoperatively (r = −0.53, P = .002).
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