Implant survival rates after maxillary sinus augmentation. A systematic review

Department of Technologies for Health, Dental Clinic, IRCCS Galeazzi Institute, University of Milan, Milan, Italy.
European Journal Of Oral Sciences (Impact Factor: 1.49). 01/2009; 116(6):497-506. DOI: 10.1111/j.1600-0722.2008.00571.x
Source: PubMed


Implant therapy in the atrophic posterior maxilla becomes challenging in the presence of reduced maxillary bone height. Sinus augmentation can be performed for resolving this condition prior to implant placement. The aim of this article was therefore to evaluate implant survival rates in the grafted sinus taking into account the influence of the implant surface, graft material, and implant placement timing. A systematic review of the literature was performed. Articles retrieved from electronic databases were screened using specific inclusion criteria, and data extracted were divided according to: graft material (autogenous, non-autogenous, composite graft), implant surface (machined or textured), and implant placement (simultaneous with grafting or delayed). Fifty-nine articles were included. Survival rates for implants placed in grafts made of bone substitutes alone and grafts of composite material were slightly better than the survival rates for implants placed in 100% autogenous grafts. Over 90% of implants associated with non-autogenous grafts had a textured surface. Textured surfaces achieved better outcomes compared with machined surfaces, and this was independent of the graft material. Simultaneous and delayed procedures had similar outcomes. It may be concluded that bone substitutes can be successfully used for sinus augmentation, reducing donor-site morbidity. Long-term studies are needed to confirm the performance of non-autogenous grafts. The use of implants with a textured surface may improve the outcome in any graft type.

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Available from: Massimo Del Fabbro, Dec 18, 2013
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    • "Continuous advances in the field of implant dentistry have provided clinicians with various treatment options to facilitate the placement of dental implants in patients with deficiencies in bone volume in the posterior maxillae. Nowadays, one of the most common and predictable ways to compensate for inadequate vertical bone height is to elevate the sinus floor.1,2 Most of the time, this is done in combination with bone grafts and bone substitutes.3 "
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    ABSTRACT: Purpose This study was performed to determine the efficacy of observers' prediction for the need of bone grafting and presence of perioperative complications on the basis of cone-beam computed tomography (CBCT) and panoramic radiographic (PAN) planning as compared to the surgical outcome. Materials and Methods One hundred and eight partially edentulous patients with a need for implant rehabilitation were referred for preoperative imaging. Imaging consisted of PAN and CBCT images. Four observers carried out implant planning using PAN image datasets, and at least one month later, using CBCT image datasets. Based on their own planning, the observers assessed the need for bone graft augmentation as well as complication prediction. The implant length and diameter, the need for bone graft augmentation, and the occurrence of anatomical complications during planning and implant placement were statistically compared. Results In the 108 patients, 365 implants were installed. Receiver operating characteristic analyses of both PAN and CBCT preoperative planning showed that CBCT performed better than PAN-based planning with respect to the need for bone graft augmentation and perioperative complications. The sensitivity and the specificity of CBCT for implant complications were 96.5% and 90.5%, respectively, and for bone graft augmentation, they were 95.2% and 96.3%, respectively. Significant differences were found between PAN-based planning and the surgery of posterior implant lengths. Conclusion Our findings indicated that CBCT-based preoperative implant planning enabled treatment planning with a higher degree of prediction and agreement as compared to the surgical standard. In PAN-based surgery, the prediction of implant length was poor.
    Full-text · Article · Sep 2014 · Imaging Science in Dentistry
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    • "In the atrophic maxilla, even though sinus augmentation procedures were described as effective in creating conditions for implant placement [4] [5], the occurrence of several complications was reported in the literature [6]. "
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    ABSTRACT: Purpose. The aims of this study were to assess the treatment outcome of immediately loaded full-arch fixed bridges anchored to both tilted and axially placed implants in the edentulous maxilla and to evaluate the incidence of biological and prosthetic complications. Materials and Methods. Thirty-four patients (18 women and 16 men) were included in the study. Each patient received a maxillary full-arch fixed bridge supported by two axial implants and two distal tilted implants. A total of 136 implants were inserted. Loading was applied within 48 hours of surgery and definitive restorations were placed 4 to 6 months later. Patients were scheduled for followup at 6, 12, 18, and 24 months and annually up to 5 years. At each followup plaque level and bleeding scores were assessed and every complication was recorded. Results. The overall follow-up range was 12 to 73 months (mean 38.8 months). No implant failures were recorded to date, leading to a cumulative implant survival rate of 100%. Biological complications were recorded such as alveolar mucositis (11.8% patients), peri-implantitis (5.9% patients), and temporomandibular joint pain (5.9% patients). The most common prosthetic complications were the fracture or detachment of one or multiple acrylic teeth in both the temporary (20.6% patients) and definitive (17.7% patients) prosthesis and the minor acrylic fractures in the temporary (14.7% patients) and definitive (2.9% patients) prosthesis. Hygienic complications occurred in 38.2% patients. No patients' dissatisfactions were recorded. Conclusions. The high cumulative implant survival rate indicates that this technique could be considered a viable treatment option. An effective recall program is important to early intercept and correct prosthetic and biologic complications in order to avoid implant and prosthetic failures.
    Full-text · Article · Oct 2012 · International Journal of Dentistry
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    • "Maxillary sinus surgery can be defined as a routine and predictable procedure for the prosthetic rehabilitation in the atrophic maxilla [1] [2] [3] [4] [5] [6] [7]. "
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    ABSTRACT: Introduction. Maxillary sinus surgery is a reliable and predictable treatment option for the prosthetic rehabilitation of the atrophic maxilla. Nevertheless, these interventions are not riskless of postoperative complications with respect to implant positioning in pristine bone. Aim. The aim of this paper is to report the results of a clinical consensus of experts (periodontists, implantologists, maxillofacial surgeons, ENT, and microbiology specialists) on several clinical questions and to give clinical recommendations on how to prevent, diagnose, and treat postoperative infections. Materials and Methods. A panel of experts in different fields of dentistry and medicine, after having reviewed the available literature on the topic and taking into account their long-standing clinical experience, gave their response to a series of clinical questions and reached a consensus. Results and Conclusion. The incidence of postop infections is relatively low (2%–5.6%). A multidisciplinary approach is advisable. A list of clinical recommendation are given.
    Full-text · Article · Aug 2012 · International Journal of Dentistry
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