Socket Preservation in the Posterior Maxilla : A Retrospective Pilot Study 1 March 2014

Authors: Hadi Antoun, Sylvie Pereira, Bouchra Sojod
Journal and references : Academy of Osseo Integration-Washington Seattle mars 2014

Maxillary sinus pneumatization is one of the main problems associated with posterior tooth extraction in the upper arch. In some cases it could be necessary to consider regenerative procedures simultaneous to extraction to prevent three-dimensional bone loss.

Sharan’s classification

In 2008 Sharan et al. proposed a classification for teeth to be extracted according to the topographic relationship between its root and the maxillary sinus floor.

To assess if socket grafting in the posterior maxilla could reduce the need for sinus augmentation
To verify if the relationship between the extracted teeth roots and the inferior wall of the sinus played a role in the alveolar ridge preservation.

Thirty-eight patients with 48 teeth for extraction were included. The distribution of teeth according to the Sharan’s classification is shown in table 1.

A socket grafting technique has been applied to all the extraction sockets.

In Thirty-one sockets the bone graft has been associated with a collagen sponge and in 17 sockets it has been associated with a collagen matrix.

After 6 months of healing, all patients underwent a CBCT and the need for sinus floor elevation before implant placement was evaluated depending on residual bone volume (Table 2).

Sinus augmentation and Sharan’s classification

The number of sockets needing a sinus lift was 14%, 31%, 50%, 70% and 80% for the respective 0, 1, 2, 3, and 4 Sharan’s classification.

Within the limitations of this retrospective pilot clinical study, we concluded that:

Socket grafting increases the probability of maintaining the alveolar ridge and/or preventing sinus pneumatization following tooth extraction;
The association of mucograft might enhance ridge preservation;
The need for sinus lift seems to be considerably larger in cases of extractions of teeth enveloped by a superiorly curving sinus floor.

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