Evaluation of Maxillary Sinus Floor Augmentation on Digital Panoramic Radiographs with an Image Manipulation Programme after Simultaneous or Staged Dental Implant Insertion

Abstract

Sinus floor augmentation is an effective method to regain bone height for the successful insertion of dental implants into the posterior maxilla. The aim of the study was to evaluate the behaviour of augmentation material following simultaneous or staged dental implant insertion, as visible on digital panoramic radiographs using the GNU Image Manipulation Program (GIMP). We evaluated one-stage (group 1) or two-stage (group 2) maxillary sinus floor augmentation procedures in 19 patients, using a high temperature-treated bovine porous hydroxyapatite material. Digital panoramic radiographic measurements were captured pre-operatively in both groups, pre-implant insertion in group 2, and immediately postoperatively and 6 months postoperatively in both groups. Forty parallelwalled bone-level implants were placed in a one-stage (n=18) or two-stage (n=22) protocol, with a mean residual bone height of 4.9±1.8 mm and survival rate of 100%. Mean bone height increased by 8.6±1.6 mm immediately post-implantation and by 7.9±1.7 mm after 6 months. Mean distal and mesial bone losses after abutment connection were 0.42±0.24 mm and 0.34±0.27 mm, respectively. No significant intergroup or intragroup differences between simultaneous and staged dental implant procedures were found. Our results show that the histogram tool in GIMP is useful for documentation of the area of the augmentation material used in maxillary sinus floor augmentation.