Randomized controlled multicentre study comparing short dental implants (6 mm) versus longer dental implants (11–15 mm) in combination with sinus floor elevation procedures. Part 1: demographics and patient‐reported outcomes at 1 year of loading

Abstract

AIM To test whether or not the use of short dental implants (6 mm) results in an implant survival rate similar to long implants (11-15 mm) in combination with sinus grafting. METHODS This multicentre study enrolled 101 patients with a posterior maxillary bone height of 5-7 mm. Patients randomly received short implants (6 mm) (group short) or long implants (11-15 mm) with sinus grafting (group graft). Six months later, implants were loaded with single crowns and patients re-examined at 1 year of loading. Outcomes included treatment time, price calculations, safety, patient-reported outcome measures (OHIP-49 = Oral Health Impact Profile) and implant survival. Statistical analysis was performed using a non-parametric approach. RESULTS In 101 patients, 137 implants were placed. Mean surgical time was 52.6 min. (group short) and 74.6 min. (group graft). Mean costs amounted to 941EUR (group short) and 1946EUR (group graft). Mean severity scores between suture removal and baseline revealed a statistically significant decrease for most OHIP dimensions in group graft only. At 1 year, 97 patients with 132 implants were re-examined. The implant survival rate was 100%. CONCLUSIONS Both treatment modalities can be considered suitable for implant therapy in the atrophied posterior maxilla. Short implants may be more favourable regarding short-term patient morbidity, treatment time and price. DOI: https://doi.org/10.1111/jcpe.12323Posted at the Zurich Open Repository and Archive, University of Zurich ZORA URL: https://doi.org/10.5167/uzh-107953 Accepted Version Originally published at: Thoma, Daniel S; Haas, Robert; Tutak, Marcin; Garcia, Abel; Schincaglia, Gian Pietro; Hämmerle, Christoph H F (2015). Randomized controlled multicentre study comparing short dental implants (6 mm) versus longer dental implants (11-15 mm) in combination with sinus floor elevation procedures. CLINICAL RELEVANCEScientific rationale for the study: implant therapy in the posterior maxilla with a limited ridge height presents challenges to the clinician. At present, a sinus floor elevation procedure to increase the ridge height in combination with the placement of long dental implants is considered the gold standard. In order to overcome limitations and disadvantages associated with this procedure, the use of shorter dental implants has been proposed to avoid extensive bone augmentation surgeriesPrincipal findings: Both treatment options, sinus floor elevation with long implants and short implants rendered similar outcomes at 1 year of function with respect to implant survival rates. Treatment costs, surgical time and physical disability at the day of suture removal were lower for the group with short dental implants. Practical implications:Within the limitations of this study both treatment options can be recommended for the severely atrophied posterior maxilla. 4ABSTRACT Aim: to test whether or not the use of short dental implants (6mm) results in an implant survival rate similar to long implants (11-15mm) in combination with sinus grafti...

Short dental implants as compared to maxillary sinus augmentation procedure for the rehabilitation of edentulous posterior maxilla: Three‐year results of a randomized clinical study

“…39 The sample size of the present investigation, with 52 patients and 122 implants, is wider than other prospective studies, except for the study by Thoma and colleagues that was a multicenter study involving 4 centres. 17 Findings coming from recent systematic reviews and meta-analyses were in line with our results describing a high prosthesis and implant survival rates for both procedures with no significant differences. [14][15][16] Analysis of pooled data of a systematic review conducted by Thoma and colleagues for EAO working group, 14 documented a 99.5% survival rate for standard implants in augmented sinus and 99.0% for SIs during for a follow-up of 16-18 months, 7,10-12,17 while for shorter follow-up (8-9 months) a 100% survival rate for standard implants and 98.2% for SIs was documented.…”

“…Similar high implant survival rates were also documented in other RCTs with the same study design as the present study, but a shorter follow-up. [5][6][7][8][10][11][12]17 Only 2 other published randomized studies reported results after a similar or longer follow-up period, that is 3 years 38 and 5 years. 39 The sample size of the present investigation, with 52 patients and 122 implants, is wider than other prospective studies, except for the study by Thoma and colleagues that was a multicenter study involving 4 centres.…”

“…[12][13][14][15][16] In addition, no statistical differences were reported for marginal bone loss. [13][14][15] However, SA is a more complex therapeutic option than SIs, generally associated to a higher total treatment time and cost, 17 a greater postoperative morbidity, and also a higher risks of complications. 1,14,16 The use of platelet concentrates in oral surgery may represent a valuable tool due to the action of growth factors and various proactive components released from platelet granules upon activation.…”

Implant stability in the posterior maxilla: a controlled clinical trial

“…Among these regenerative techniques, maxillary sinus augmentation [3][4][5][6][7], guided bone regeneration (GBR) [8], and split-crest techniques [9] are the most commonly used procedures to restore the ideal anatomical bone conditions and to allow simultaneous and/or subsequent placement of dental implants.…”

Projection d’implant dans le sinus maxillaire : gestion d’un cas et revue de la littérature

“…Les possibilités de traitements disponibles en fonction du volume osseux résiduel sont bien documentées pour la zone sous-sinusienne. Les techniques de surélévation par voie crestale utilisant des ostéotomes, le comblement de sinus par abord latéral ou même l'association de ces différentes techniques [14][15][16][17] Enfin, comme dans le cas présenté ici, les conséquences de l'inflammation liée à la présence du corps étranger intrasinusien associées à celles de l'intervention nécessaire pour le retirer, peuvent aggraver l'insuffisance de volume osseux résiduel et compromettre le projet prothétique initialement prévu. Il apparaît dès lors nécessaire d'informer clairement le patient en préalable à toute pose d'implant sous-sinusien des éventuelles complications peropératoires et postopératoires, afin d'éclairer sa décision quant aux différentes alternatives thérapeutiques.…”