Sinus floor elevation and immediate implant placement without grafting materials probably results in high implant survival rates and large bone gain

Abstract Background The volume of residual alveolar bone is critical to the survival of dental implants. When the volume of alveolar bone in the posterior maxillary region is less than 4 mm, maxillary sinus floor elevation (MSFE) with the lateral approach is an effective option. Traditionally, this standard approach is usually conducted at 4–6 months after tooth extraction (standard MSFE). However, defective dentition due to extraction can impair mastication during the period of bone remodeling, especially if the molars on both sides are severely compromised and must be extracted. MSFE before extraction (modified MSFE) can take full advantage of residual tooth strength. However, the effectiveness and practicability of the modified MSFE procedure remain unknown. Therefore, the aim of this study was to compare the clinical outcomes of modified vs. standard MSFE, in order to provide references to periodontists. Methods/design The study cohort included 25 adult patients (50 surgery sites) recruited from Peking University Hospital and School of Stomatology who met the inclusion criteria. The two sides of each patient will be randomly divided into two groups: a test group-modified MSFE or a control group-standard MSFE. The surgical duration and patient-reported outcomes (visual analog scale for discomfort) will be documented. Clinical indicators, including implant survival rates, mucosal conditions, and complications, will be recorded every 6 months during the 5-year follow-up period. The volume of the alveolar bone and marginal bone level will be assessed radiographically (cone-beam CT and periapical films) every 6 months. Histological analysis of biopsy samples retrieved from both sides will be performed to evaluate the biological features of the bone. Discussion The current study will explore the implant survival rates, safety, reliability, effectiveness, and practicability of the modified MSFE procedure. Moreover, the extent of osteogenesis on the sinus floor will also be assessed. The results of this trial will provide strategies for the modified MSFE procedure to achieve ideal clinical outcomes. Trial registration International Clinical Trials Registry Platform ChiCTR1900020648. Registered on 1 January 2019

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Assessment of the Simultaneous Use of Biomaterials in Transalveolar Sinus Floor Elevation: Prospective Randomized Clinical Trial in Humans

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17061888 ◽

2020 ◽

Vol 17 (6) ◽

pp. 1888 ◽

Cited By ~ 1

Author(s):

Adrián Maximiano Millán ◽

Rocío Bravo Álvarez ◽

Miguel Plana Montori ◽

María Guerrero González ◽

David Saura García-Martín ◽

...

Keyword(s):

Test Group ◽

Control Group ◽

Simultaneous Application ◽

Sinus Floor Elevation ◽

Implant Placement ◽

Randomized Clinical Study ◽

Additional Surgery ◽

Posterior Maxilla ◽

Sinus Floor ◽

Bone Gain

Implants inserted in the posterior maxilla frequently need additional surgery for successful bone augmentation. One of the most common procedures for this is transalveolar sinus floor elevation. There are different protocols for this procedure, and there is controversy over the simultaneous application of grafting material upon elevating. In this prospective randomized clinical study in humans, a total of 49 transalveolar sinus floor elevations were performed in 49 different patients, divided into a control group (without graft, 25 patients) and a test group (with graft, 24 patients). The analyzed variables were obtained through digital orthopantomography on day 0 (day of surgery) and 18 months after surgery. These measurements showed a tendency towards greater vertical bone gain in the test group, but this was not statistically significant. Therefore, considering that sinus elevation and implant placement without the application of grafts is a successful treatment with fewer complications, a critical assessment of the need for these biomaterials is necessary.

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Immediate implant placement combined with maxillary sinus floor elevation utilizing the transalveolar approach and nonsubmerged healing for failing teeth in the maxillary molar area: A randomized controlled trial clinical study with one‐year follow‐up

Clinical Implant Dentistry and Related Research ◽

10.1111/cid.12783 ◽

2019 ◽

Vol 21 (3) ◽

pp. 462-472 ◽

Cited By ~ 2

Author(s):

Hanqing Liu ◽

Renzhang Liu ◽

Mingzhen Wang ◽

Jianjun Yang

Keyword(s):

Controlled Trial ◽

Sinus Floor Elevation ◽

Implant Placement ◽

Maxillary Molar ◽

Maxillary Sinus Floor ◽

Immediate Implant ◽

Sinus Floor ◽

One Year ◽

Maxillary Sinus Floor Elevation

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Sinus Floor Elevation with Modified Crestal Approach and Single Loaded Short Implants: A Case Report with 4 Years of Follow-Up

Case Reports in Dentistry ◽

10.1155/2017/7829179 ◽

2017 ◽

Vol 2017 ◽

pp. 1-7

Author(s):

Michele Perelli ◽

Roberto Abundo ◽

Giuseppe Corrente ◽

Carlo Saccone ◽

Paolo G. Arduino

Keyword(s):

Surgical Techniques ◽

Sinus Floor Elevation ◽

Implant Placement ◽

Basal Bone ◽

Short Implants ◽

Sinus Floor ◽

Bone Gain ◽

Bone Height ◽

Functional Loading

Tooth extraction is usually followed by bone reduction. In the maxillary posterior region, this remodelling combined with sinus pneumatisation and periodontal defects may lead to a reduced basal bone height available for implant placement. Sinus floor elevation can be performed with different surgical techniques. Crestal approach has demonstrated to be effective, less invasive, and associated with a reduced morbidity. This article reports a modified sinus floor elevation by means of rotary, noncutting instruments, addition of xenograft, and 2 short-threaded implant placements. The aim of the study was to evaluate the implant’s success and intrasinus radiographical bone gain after 4 years of functional loading. The premolar implant site presented a starting basal bone height of 6 mm, while the molar site was of 2 mm. In the first surgical step, sinus floor elevation was performed mesially and the implant was inserted, and distally only sinus floor elevation was performed. After 6 months, the mesial implant was uncovered and the second implant was inserted; 4 months later, the second fixture was uncovered, and both fixtures were loaded with single provisional screw-retained crowns and later with single screw-retained porcelain fused to metal crowns. Implants integrated successfully, and crestal bone remodelling did not exceed the smooth collar. Bone gain was 3 mm for the mesial implant and more than 5 mm for the distal one.

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