{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T07:42:15Z","timestamp":1785224535277,"version":"3.55.0"},"reference-count":29,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2012,8,15]],"date-time":"2012-08-15T00:00:00Z","timestamp":1344988800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clin Implant Dent Rel Res"],"published-print":{"date-parts":[[2014,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Insufficient bone height in the posterior maxilla is caused by bone atrophy after tooth extraction and continued pneumatization of the maxillary sinus. To allow for implant placement in this area, external sinus\u2010floor elevations are performed. For this indication, the application of various bone graft materials can be a reliable alternative to autologous bone.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>The aim of this study was to analyze a nanoporous bone graft material under the condition of early implant treatment in sinus floor elevations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>Sixty\u2010six patients received 94 individual external sinus\u2010floor elevations as a precondition for implant surgery. As grafting material, a synthetic, nanoporous bone graft material consisting of a mixture of nano\u2010hydroxyapatite and nano\u2010\u03b2\u2010tricalciumphosphate crystals, combined with blood from the defect side, was used. Depending on the remaining vertical bone height, implant placement was performed either simultaneously with bone augmentation or consecutively in a delayed approach. After a 4\u2010month healing period, the patients received 218 implants and were followed up clinically, radiographically, and histologically. To quantify the bone situation at implant placement, immunohistochemical analysis using tenascin\u2010<jats:styled-content style=\"fixed-case\">C<\/jats:styled-content> was performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We achieved an average vertical bone increase of 8.28\u2009mm (<jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>, 2.59) for the one\u2010stage approach and 10.99\u2009mm (<jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>, 1.73) for the two\u2010stage approach after sinus\u2010floor elevation. The augmented areas showed mean resorption rates of 10.32% (one stage) and 10.82% (two stages) of vertical graft during the observation period. Immunohistochemical analysis after 4 months of healing showed high tenascin activity, indicating bone growth. Good primary stability was achieved during implant placement. Mean peri\u2010implant marginal bone loss was 0.45\u2009mm (<jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>, 0.31).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>After a mean observation time of 21.45 months, the biomaterial showed good osseointegration and bone stability radiographically. Adding to this the positive histological and immunohistochemical findings, we conclude that, after a relatively short 4\u2010month healing period, the biomaterial showed predictable results.<\/jats:p><\/jats:sec>","DOI":"10.1111\/j.1708-8208.2012.00484.x","type":"journal-article","created":{"date-parts":[[2012,8,15]],"date-time":"2012-08-15T16:05:47Z","timestamp":1345046747000},"page":"365-373","source":"Crossref","is-referenced-by-count":12,"title":["Maxillary Sinus\u2010Floor Elevation with Nanoporous Biphasic Bone Graft Material for Early Implant Placement"],"prefix":"10.1111","volume":"16","author":[{"given":"Christian","family":"Mertens","sequence":"first","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery University Hospital Heidelberg  Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Wiens","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery University Hospital 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