Evaluation of maxillary sinus floor augmentation using a mixture of hyaluronic acid and bovine bone graft with simultaneous dental implants installation

Abstract Purpose This study aimed to evaluate the efficacy of using hyalouronic acid (HA) with bovine bone for maxillary sinus floor augmentation with simultaneous implant installation. Patients and methods This study was implemented on 10 cases with atrophic edentulous posterior maxillary regions. All the cases underwent sinus floor elevation and augmentation with simultaneous implant installation. This was done in two stages, Stage I: lateral antrostomy was made by piezoelectric device, osteotomy of implant site by densah kit, augmentation of the sinus with a mixture of bovine bone with HA gel and then implant installation, finally coverage the lateral window with HA gel, Stage II: surgical exposure of the implant top surface and insertion of the implant healing abutment at 6 months after stage I surgery. After soft tissue healing around the abutment, all cases were referred to fixed prosthodontics department in Faculty of Dentistry. Tanta University for fixed prosthesis construction. Results Regarding panoramic radiography and cone-beam computed tomography analysis immediate and after 6 months of alveolar bone height and density showing significant implant osseointegration with increase in both height and density of alveolar bone. Resonance frequency analysis show significant increase in implant stability from stage I (primary stability) to stage II (secondary stability). Conclusion The mixture of HA gel with bovine bone, gaining the advantage of osteoconductive potential of bovine bone with the anti-inflammatory, pro angiogenic properties of HA. Immediate implant installation after sinus floor augmentation is a promising surgical protocol that can reduce the number of the surgeries and reduce the treatment time.