A 10-Year Follow-Up Study on the Success Rate of Maxillary Sinus Floor Augmentation and Implant Placement in Relation to Strontium Ranelate

Background: Maxillary sinus floor augmentation (MSFA) is frequently required for implant placement in the atrophic posterior maxilla. However, limited bone quality and volume can compromise long-term success. Strontium ranelate (SrR), a dual-acting bone agent, stimulates osteoblasts while inhibiting osteoclasts, potentially improving bone density and osseointegration in grafted sites. Objective: This 10-year preliminary split-mouth study evaluated the long-term effects of SrR on bone density, volume, and implant success following MSFA. Methods: Six patients underwent bilateral MSFA using a lateral window approach. One side received systemic SrR (2 g/day for 6 months) after grafting, while the contralateral side served as a control. CBCT and DEXA analyses were performed to assess bone density and volume. Bone biopsies were examined histologically and by microindentation. Data were analyzed using paired t-tests or Wilcoxon signed-rank tests, depending on distribution, with significance at p < 0.05. Results: After 10 years, SrR-treated sites demonstrated a mean 22.9% increase in bone density versus 12.5% in untreated controls. Although both groups experienced minor reductions in bone volume (SrR: −13.3%; control: −12.8%), SrR samples exhibited greater mineralization, hardness, and lamellar bone maturity. Conclusions: SrR improved bone density and mechanical properties but not long-term volume preservation. Given the small sample size (n = 6) and absence of implant stability and patient-reported outcomes, these results should be interpreted with caution. Future large-scale clinical trials incorporating survival, ISQ, and quality-of-life data are warranted.