Osteotome sinus floor elevation without grafting material: Results of a 2-year prospective study

Abstract

Objectives: The aim of this prospective clinical trial was to evaluate the success implant rates during 24 months using OSFE procedure without grafting materials. Study design: 42 adult patients (22 female, 15 male) were selected according to Nedir et al´s inclusion criteria of which 5 patients were excluded, due to periapical pathology in adjacent teeth (n=3) and treatment with bisphosphonates (n=2). 37 patients aged 31-68 years were selected. Smokers were divided in two groups depending on the number of cigarettes consumed per day (a) 0-10, (b) 11-20. One patient was excluded because he was lost to follow-up at 24 months A total of 36 threaded implants were placed, ∅4,1mm Straumann® (Straumann AG, Waldenburg, Switzerland) and ∅3,5mm Klockner® (Klockner Implant System, Barcelona, Spain). The most used implant diameter was 4,1 mm (n=29), followed by 3,5 mm (n=7), and length used was 10 mm (n=32) and 8 mm (n=4). Initial RBH ranged from 4 mm to 9 mm. All statistical data were processed using the program R 3.0.2 for windows. Results: A total of 36 threaded implants were placed. Residual bone height (RBH) at implant placement averaged 7,4 ± 0,4 mm. Mean bone gain was 1,8 ± 0,3 mm. Four implants showed a bone gain exceeding 3 mm. Mean implant protrusion length into the sinus amounted to 2.1 ± 0,3 mm. Regarding the relationship between smoking and periodontal probes, no statistically significant differences were found (P=0,25), neither in relation to the number of threads that the implants showed (P=0,29) or bone gain (P=0,79). After 24 months the implant success rate was 91,6%. Conclusions: Implant rehabilitation of edentulous atrophied posterior maxilla can be safely performed and simplified using the OSFE technique without grafting with reliable long-term results. Key words:Crestal bone loss, dental implants, internal sinus lift, no grafting, osteotome sinus elevation, grafting, sinus floor elevation.

Levels of smoking and dental implants failure: A systematic review and meta‐analysis

“…In one article, information on implant failure in smoker subgroups was extracted from the chart (van Steenberghe et al, ). Finally, 23 publications, including one clinical trial (Agliardi, Clericò, Ciancio, & Massironi, ), 6 prospective studies (Brizuela, Martín, Fernández, Larrazábal, & Anta, ; Cercadillo‐Ibarguren, Sánchez‐Torres, Figueiredo, & Valmaseda‐Castellón, ; Franceschetti et al, ; Gherlone et al, ; Hinze, Thalmair, Bolz, & Wachtel, ; Strietzel & Reichart, ) and 16 retrospective studies (Alsaadi et al, ; Alsaadi, Quirynen, Komarek, & van Steenberghe, ; Arora et al, ; Balderas Tamez, Neri Zilli, Fandiño, & Guizar, ; Bornstein, Halbritter, Harnisch, Weber, & Buser, ; Correia, Gouveia, Felino, Costa, & Almeida, ; Guido Mangano & Ghertasi Oskouei, ; Habsha, ; Kan, Rungcharassaeng, Lozada, & Goodacre, ; Nitzan, Mamlider, Levin, & Schwartz‐Arad, ; Noguerol, Munoz, Mesa, de Dios Luna, & O'Valle, ; Peñarrocha, Guarinos, Sanchis, & Balaguer, ; Sanchez‐Perez, Moya‐Villaescusa, & Caffesse, ; van Steenberghe et al, ; Testori, Weinstein, Taschieri, & Del Fabbro, ; Twito & Sade, ) were included in this systematic review and meta‐analysis (31,129 implants).…”

Improvements in the Crestal Osteotome Approach Have Decreased the Need for the Lateral Window Approach to Augment the Maxilla

“…Six references (16,17,(19)(20)(21)(22) reported bone gains ranging from 1.8 to 5.7 mm using a crestal approach with no graft placement. Deviations in reporting and data collection prevent a meaningful statistical analysis other than noting the consistency of results.…”

“…Maintenance of the space created after membrane elevation may be important for bone formation to occur (15)(16)(17)(18)(19)(20). The decision to use an osteotome method via the crestal approach allows elevation of the membrane with or without graft placement, which can result in adequate bone function for long-term implant success (7).…”

“…The bone gain from using the osteotome technique from the crestal approach ranges from 4 to 6 mm, with or without grafting (16,17,(19)(20)(21)(22)(23)(24)(25)(26). Different grafting materials did not seem to affect implant success rates (7,24).…”

Electromyographic assessment of masticatory muscles activity in patients with severe alveolar bone atrophy with implant-supported fixed dental prostheses

“…Prosthetic treatment of patients with severely atrophic posterior maxillae is extremely difficult, requiring provision of additional bone augmentation. Though the outcome of conventional osteotome sinus floor elevation (OSFE) is difficult to predict [1].…”