Influence of maxillary antrolith on the clinical outcome of implants placed simultaneously with osteotome sinus floor elevation: A retrospective radiographic study

• Published in: Clinical implant dentistry and related research 2021-12, Vol.23 (6), p.833-841
• Main Authors: Chen, Hsuan‐Hung, Yi, Chieh‐An, Chen, Ya‐Chi, Tsai, Chia‐Chin, Lin, Po‐Yen, Huang, Her‐Hsiung
• Format: Article
• Language: English
• Subjects: Aged; Biomedical materials; Bone grafts; Bone implants; Computed tomography; cone‐beam CT; Confidence intervals; Dental Implantation, Endosseous - adverse effects; Dental Implants - adverse effects; Dental materials; Dental prosthetics; Dentistry; Elevation; Endodontics; Female; Humans; implantology; Maxilla; Maxilla - diagnostic imaging; Maxilla - surgery; maxillary sinus; Maxillary Sinus - diagnostic imaging; Maxillary Sinus - surgery; Membranes; Middle Aged; nasal mucosa; Patients; radiographs; retrospective; Retrospective Studies; Root canals; sinus augmentation; Sinus Floor Augmentation - adverse effects; sinus floor elevation; Sinuses; Surgery; Surgical implants; Thickness; Transplants & implants; Treatment Outcome
• ISSN: 1523-0899; 1708-8208
• DOI: 10.1111/cid.13043

Background Large antroliths and those located adjacent to the sinus floor can affect clinical interventions and increase the difficulty of implant placement performed simultaneously with osteotome sinus floor elevation surgery. Purpose This retrospective study investigated the clinical outcomes of implants placed simultaneously with osteotome sinus floor elevation subjacent to maxillary antroliths. Material and methods Twenty implants inserted subjacent to or intruding into the antrolith after sinus floor elevation were evaluated in 18 patients. Cone‐beam computed tomography (CBCT) was used to measure antrolith size and membrane thickness at sites of osteotome sinus floor elevation. Periapical radiographs were used to assess the height of grafted bone. Generalized estimating equation (GEE) analysis was performed to correlate the occurrence of antroliths with patient background characteristics and dental outcomes, based on a sample population of 239, among whom 33 presented antroliths. Results The 20 implants remained clinically stable over a mean follow‐up period of 42.4 months. The mean thickness of the sinus membrane at osteotome sites was 5.4 ± 3.3 mm. None of the cases presented sinus membrane perforation or sinus symptoms following osteotome intervention. The mean gain in the height of grafted sinus bone was 4.0 ± 1.4 mm at the last follow‐up. The occurrence of antroliths was higher among females and the elderly (>49 years old). The multivariable GEE analysis showed that the adjusted odds ratio for the occurrence of antroliths with root canal fillings was significantly lower than those without root canal fillings (odds ratio = 0.33; 95% confidence interval = 0.11–0.96). Conclusion Our findings indicate that osteotome sinus floor elevation is a surgical procedure with a risk