IM0110

I 31 user report _ bone augmentation I implants1_2010 stitches. A post-operative radiograph was taken 7 days after surgery (Fig. 17). The distance between the sinus floor and the implant apex was measured on the radiograph. The results are shown in Table 2. The patients were recalled after one year to take a radiograph of the treated sites (Figs. 15 & 18). _Sinus lift with simultaneous implanta- tion—Bone gain measurement Six months after surgery, the sites were re- opened to install the healing abutments. Radi- ographs were taken to measure the bone gain. Table 2 shows the values measured post-opera- tively and one year later. Wealreadyobservedthattheprocessofresorp- tion of the cement coupled with new bone growth can be conveniently followed up radiographically (Gehrke 2009). One year after functional restora- tion we could see that the level of newly formed bonewasmaintained,withoutlossaroundtheapi- cal portion of the implants. This is a very positive finding because the loss of bone at the apical level after loading the implants is a common phenome- non when this type of sinus grafting is performed. _Discussion Several types of biomaterials and different techniqueshavebeenproposedfortherecoveryof bone tissue lost after tooth extraction or loss. The results obtained with the PD VitalOs cement show that this material is suitable and very efficient as a bone substitute. This is exemplified here through the presentation of a few cases, representative of the results generally obtained with this material. The way of delivering the product into the site greatly simplifies its placement: a dual syringe with a mixing tip. Since the product is initially in a pasty form it fills out the site to treat very uni- formely and prevents the ingrowth of soft tissues once it has hardened. The sites presented here are situations which offer stability to the cement due to the geometry of the defects. For these reasons, the product is used without membrane. However, a particular attention must be paid to achieving primary stability: if the product is not tightly an- choredontothebonewallsorontoanimplantsur- face, then the blood pressure is able to expel part oralloftheinjectedvolume.Toavoidthissituation, it is very important to control bleeding and to choose site geometries that offer stability to the cement. In our practice we observed the replacement of the cement by bone is generally fast, even though it depends much on the injected volume. This is a veryinterestingfeaturebecausepatientschoosing the immediate implantation treatment are willing to have the missing element replaced as quickly as possible. The same way, in the case of the maxillary sinus grafting, the cement promotes accelerated bone formation, enabling earlier placement of the restoration._ Tab. 2_Bone height measurement (sinus lift cases).Case Initial ridge height Post-operative distance between original sinus floor and implant apex Bone height between ridge and new sinus floor after one year 1 3 mm 9 mm 10 mm 2 4 mm 8 mm 9,5 mm Dr Sérgio Alexandre Gehrke BioFace Institut Dr.Bozano,571 Santa Maria – RS,Brazil E-mail: Sergio.gehrke@terra.com.br 1 MD,DDS,TutorofPeriodon- tologyandImplantologyat UniversityofPerugia _contact implants Fig. 16 Fig. 17 Fig. 18