Synergy between 3D Models and Tissue Engineering to Optimize Sinus Lift, Implant Placement and Immediate Loading in Partially Edentulous Patients

Tissue engineering is a clinical approach toward the development of dynamic molecular delivery that can restore and improve regeneration. The 3D models and regenerative principles applied during implant guided dental surgery open new approaches for tissue constructs favoring sinus lift and implant placement. Purpose: The aim of the present clinical study was to determine evidence that synergy between 3D models and bone regeneration utilizing autologous fibroblast growth factor (FGF) and growth factors matrices mixed with demineralized freezedried bone allograft (DFDBA) particles optimize tissue engineering for immediate dental implant placement and loading during sinus lift procedure. Materials and methods: Twelve endo-osseous implants were placed into residual crestal bone (5.0 ± 0.15 mm). A minimal invasive osteotome Summer’s technique was performed in combination with autologous FGF matrices mixed with FDBA particles. Soft tissue height and width were measured at baseline, 1, 3 and 6 months. Engineered bone surrounding implants was analyzed through 3D metric models for volume and contact interface from baseline to 6 months. Results: Healing was uneventful. The surgical guide and the osteotome technique significantly contribute to the initial implant stability. Gingival soft tissue improves in color and contour. Soft tissue height and width both increased from baseline to 6 months. At 1 month, soft tissue height (STH) increase was 2.55 ± 0.30 mm (CI 95%—p = 0.001), and soft tissue width (STW) gain was 1.50 ± 0.50 mm (p = 0.001—CI 95%). At 3 months, STH increased to 3.12 ± 0.50 mm and STW gain was 2.40 ± 0.40 mm (p = 0.001—CI 95%). At 6 months, these values remained stable. Implant sites receiving autologous FGF matrices mixed with DFDBA exhibited a BV gain of 0.47 ± 0.10 cm3—bone fill averaging 100% at 6 months (p = 0.001). Conclusion: The osteotome Summer`s technique was a predictable technique to increase bone volume. Autologous FGF matrices mixed with DFDBA favors 3D scaffold enhancing bioguided soft tissue gain and bone engineering at implant interface. Sinus membrane perforations were favorable controlled. Guided dental surgery and three-dimensional metric applications improve surgical placement, mechanical support, clinical performance and patient cost/benefit satisfaction. Further studies with a larger sample are needed to enhance the statistical significance of our clinical findings.