Authors
Nedir R., Nurdin N., Abi Najm S., El Hage M., Bischof M.
Title
Short implants placed with or without grafting into atrophic sinuses. The 5-year results of a prospective randomized controlled study.
Journal
Clinical Oral Implants Research 28(7), 877-886, 2017
Abstract
ABSTRACT Objectives: Over five years, the aims were: (1) to evaluate the clinical efficiency of 8-mm implants placed with osteotome sinus floor elevation (OSFE) in extremely atrophic maxillae, and (2) to compare bone levels around implants placed with and without grafting. Materials and Methods: TE® SLActive® implants (Institut Straumann AG, Basel, Switzerland) were placed in sites with a residual bone height (RBH) of ≤4 mm. Before surgery, sinuses were randomized to receive either anorganic bovine bone (control) or no graft (test). After 10 weeks of healing, implants were functionally loaded with single crowns. Bone levels were measured using standardized periapical radiographs. Results: Thirty-seven implants (17 test, 20 control) were placed in 12 patients (RBH: 2.4 ± 0.9 mm). Two early failures and one late failure occurred. The success rate was 91.9% (94.1% test, 90.0% control). All implants showed endo-sinus bone gain (3.8 ± 1.0 mm test; 4.8 ± 1.2 mm control; p = 0.004). Mean crestal bone loss (CBL) was 0.6 ± 1.1 mm, with no significant difference between groups (p = 0.527). Mean bone gain and CBL did not change significantly between one and five years (p = 0.249 and p = 0.293, respectively). Conclusions: Atrophic posterior maxillae can be predictably rehabilitated using OSFE with simultaneous implant placement. The new bone formed around implants after one year remained stable after five years, regardless of the use of grafting material. Grafting was not necessary to achieve an average bone augmentation of 3.8 mm, although greater bone gain was observed when grafting was used.
Keywords
Key words atrophic maxilla, bone gain, bone graft, bone regeneration, crestal bone loss, dental implants, internal sinus lift, no grafting, osteotome sinus floor elevation, posterior maxilla, prospective randomized clinical trial, sinus-lift
