Cross-Sectional Clinical Evaluation of Subantral Augmentation Using Nano Graft Composite: Implications for Implant Success

Abstract

Objectives: This study aims to evaluate the efficacy of hydroxyapatite-tricalcium phosphate (HAP-TCP) as a bone substitute in subantral augmentation for dental implants. Specifically, it investigates the effects of HAP-TCP on bone quality, density, and integration with implants over time. Methods: A prospective controlled longitudinal study was conducted on 22 patients (39–75 years of age) undergoing subantral augmentation and dental implantation. A total of 52 sites of augmented bone and 67 sites of native bone were analyzed using computed tomography (CT) to assess bone density in Hounsfield Units (HU), insertion torque measurements, and the Misch classification for bone quality. Augmented and native bone measurements were compared within each patient. Results: The augmented bone exhibited an average density of 1132.6 ± 334.9 HU, which is significantly higher (45.9%) than the average density of native bone at 519.3 ± 395.0 HU. Insertion torque values in the HAP-TCP augmented sites averaged 35 N·cm, showing a 71.4% increase compared to adjacent native bone sites (25 N·cm). The study found notable improvements in bone homogeneity and vascularization within the augmented zones. Conclusion: HAP-TCP demonstrates significant potential as a reliable and effective synthetic bone substitute for subantral augmentation in dental implants. It yields higher radiodensity and insertion torque than adjacent native bone, while mitigating complications associated with autogenous grafts. These observational findings support the potential clinical use of HAP-TCP for sinus augmentation.