Material de injerto en elevación de seno de acceso lateral: ¿es necesario? Parte II

Resumen

Introduction: dental extractions produce a resorption of the alveolar process, horizontally and vertically in addition to pneumatization of the sinus. These bone changes in the posterior area of the maxilla can compromise implant placement. The conventional or lateral access technique is still the most used technique to perform maxillary sinus elevations. These elevations are performed without bone grafts and with different graft biomaterials where there is some discussion whether or not it is necessary to place a graft. Objective: Analyze and compare bone gain in graft and non-graft lateral access sinus lifts. Material and method: An electronic search was carried out to update the subject in three databases and a series of related books. Results: A gain of 4.0-6.14 mm is obtained when no graft material is used and between 3.11-13.1 mm when biomaterials are used. Studies show a marginal bone loss between 1.01-1.9 mm when no graft material is used and 2.3 mm on average when biomaterials are used. Lateral access sinus elevation technique without the use of biomaterial has high survival rates but survival rates are slightly higher when biomaterials are used. Rate of complications is low for both techniques, the most frequent being the perforation of Schneider’s membrane, which doesn’t seem to be an impediment to the placement of implants. Conclusion: conventional lift technique with filling obtains greater bone gain, but greater marginal bone loss and presents a high implant survival rate compared to the technique that doesn’t use graft material, so each case must be individualized to decide if it’s necessary or not the use of a bone substitute.