Introdução:Quando a altura do osso alveolar residual é insuficiente na região posterior da maxila, a elevação do assoalho do seio maxilar visando a viabilizar a instalação de implantes dentários é um procedimento indicado. O enxerto autógeno (EA) de regiões intra ou extraorais é considerado o padrão ouro para esse procedimento. Novas opções de substitutos ósseos vêm surgindo, como o Straumann(r) BoneCeramic (BC) - 60% constituído de hidroxiapatita e 40% de β tricálcio fosfato, 100% sintético -, sendo o material utilizado no presente trabalho.Objetivo: Avaliar e comparar histologicamente o comportamento deste substituto ósseo com o enxerto ósseo autógeno.Material e método:Dez pacientes saudáveis e parcialmente desdentados na região posterior da maxila foram submetidos à elevação do assoalho do seio maxilar previamente à instalação de implantes dentários osseointegráveis, sendo, destes, cinco com EA e cinco com BC. Após seis meses do tempo de integração do enxerto ósseo, as amostras foram coletadas por uma trefina e coradas em hematoxilina e eosina para microscopia.Resultado:Todos os implantes osseointegráveis apresentaram boa estabilidade primária. A análise histológica demonstrou tecido ósseo neoformado viável em quatro das cinco amostras do BC, além de um íntimo contato do tecido ósseo mineralizado recém-formado com as partículas do BC. Em uma amostra do BC, não foi observada formação de osso viável. O tecido ósseo formado a partir do EA e do BC apresentou uma característica histológica similar.Conclusão:O BC se mostrou um material adequado para a elevação do assoalho do seio maxilar previamente à instalação de implantes dentários osseointegráveis.

Introduction:Sinus lift to permit insertion of implants when alveolar residual bone height is insufficient may be considered an effective procedure. The use of autogenous bone from intraoral or extraoral sources is considered as the gold standard for this procedure. New options of bone substitutes have been emphasizing, such as Straumann(r) BoneCeramic (BC), consisting of 60% of hydroxyapatite and 40% of calcium phosphate, 100% synthetic material that was used in this work.Objective:This investigation was designed to evaluate and compare the behavior of a fully synthetic biphasic calcium phosphate (BCP) 60% hydroxyapatite and 40% of β-tricalcium phosphate (Straumann(r) Bone-Ceramic) to the autogenous bone graft (ABG) in maxillary sinus floor elevation procedure prior to installation dental implants.Material and method:Ten healthy patients who were partially edentulous in the posterior maxilla were included in this study and submitted to a unilateral maxillary sinus floor elevation procedure, with grafting using either ABG (control group; 5 patients) or BCP (test group; 5 patients). After 6 months of healing implant sites were created and biopsies taken for histological analyses.Result:A primary stability was achieved with all dental implants after the biopsies. Histological investigation showed a viable new bone tissue formed in 4 of 5 BCP specimens. Also, showed close contact between new bone and BCP particles, in 4 of 5 specimens. In 1 of 5 BCP specimens no viable bone tissue was found. Both ABG and BCP produced similar amounts of newly formed bone, with similar histologic appearance.Conclusion:The results indicate that BCP is a suitable material for sinus augmentation for the placement of dental implants.

The aim was to investigate the impact of cone-beam computed tomography (CBCT) on implant planning and on prediction of final implant size. Consecutive patients referred for implant treatment were submitted to clinical examination, panoramic (PAN) radiography and a CBCT exam. Initial planning of implant length and width was assessed based on clinical and PAN exams, and final planning, on CBCT exam to complement diagnosis. The actual dimensions of the implants placed during surgery were compared with those obtained during initial and final planning, using the McNemmar test (p < 0.05). The final sample comprised 95 implants in 27 patients, distributed over the maxilla and mandible. Agreement in implant length was 50.5% between initial and final planning, and correct prediction of the actual implant length was 40.0% and 69.5%, using PAN and CBCT exams, respectively. Agreement in implant width assessment ranged from 69.5% to 73.7%. A paired comparison of the frequency of changes between initial or final planning and implant placement (McNemmar test) showed greater frequency of changes in initial planning for implant length (p < 0.001), but not for implant width (p = 0.850). The frequency of changes was not influenced by implant location at any stage of implant planning (chi-square test, p > 0.05). It was concluded that CBCT improves the ability of predicting the actual implant length and reduces inaccuracy in surgical dental implant planning.