Keywords
Implant, Sinus floor elevation, Internal, Bone gain.
How to Cite
Rammelsberg , P. ., Pahle , J. ., Büsch , C. ., & Zenthöfer , A. . (2020). Long-term apical bone gain after installation of the implant combined with elevation of the sinus without a graft. Brazilian Journal of Implantology and Health Sciences, 2(8), 03–25. https://doi.org/10.36557/2674-8169.2020v2n8p03-25
Abstract
Background: Assess changes in apical bone height / bone gain for up to 8 years after implant placement combined with simultaneous elevation of the internal sinus from the sinus floor (ISFE) without the use of a graft.
Methods: 217 implants were placed in combination with ISFE without graft and successfully integrated into the posterior maxilla of 138 patients. Radiographs after surgery over an evaluation period of up to 8 years were analyzed. Changes in the apical and marginal bone height related to the implants were measured. Differences in bone height over the study period were assessed using the Wilcoxon test. To identify possible factors influencing apical bone gain and marginal bone loss, regressive linear regression selections and mixed linear regression models were performed.
Results: In the apical aspects of the implants, significant mean vertical bone gain of 2.4 mm (mesial) and 2.6 mm (distal) was observed after 6 months (p <0.05). Radiographic analysis produced an additional bone gain of up to approximately 3.5 mm during the study period. The small initial bone height was crossed with a more pronounced apical bone gain (p <0.05).
Conclusions: If the implants are placed in combination with the ISFE without a graft, a significant vertical bone gain can be expected, especially in the first postoperative year. Lower initial bone height is associated with a greater probability of greater bone gain.
References
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2. Tatum H. Maxillary and sinus implant reconstructions. Dent Clin N Am. 1986;30:207–229.
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8. Brägger U, Gerber C, Joss A, et al. Patterns of tissue remodeling after placement of ITI dental implants using an osteotome technique: a longitudinal radiographic case cohort study. Clin Oral Implants Res. 2004;15:158–166. doi: 10.1111/j.1600-0501.2004.00988.x.
9. Maiorana C, Sigurta D, Mirandola A, et al. Elevation with alloplasts or xenogenic materials and implants: an up-to-4-year clinical and radiologic follow-up. Int J Oral Maxillofac Implants. 2006;21:426–432
10. Esposito M, Grusovin MG, Rees J, et al. Effectiveness of sinus lift procedures for dental implant rehabilitation: a Cochrane systematic review. Eur J Oral Implantol. 2010;3:167–184.
11. Lundgren S, Andersson S, Guliani F. Bone reformation with sinus membrane elevation: a new surgical technique for maxillary sinus floor augmentation. Clin Implant Dent Relat Res. 2004;6:165–173. doi: 10.1111/j.1708-8208.2004.tb00224.x.
12. Leblebicioglu B, Ersanli S, Karabuda C, et al. Radiographic evaluation of dental implants placed using an osteotome technique. J Periodontol. 2005;76:385–390. doi: 10.1902/jop.2005.76.3.385.
13. Silva L, de Lima VN, Faverani LP, et al. Maxillary sinus lift surgery—with or without graft material? A systematic review. Int J Oral Maxillofac Surg. 2016;45:1570–1576. doi: 10.1016/j.ijom.2016.09.023.
14. Si MS, Zhuang LF, Gu YX, et al. Osteotome sinus floor elevation with or without grafting: a 3-year randomized controlled clinical trial. J Clin Periodontol. 2013;40:396–403. doi: 10.1111/jcpe.12066.
15. Nedir R, Nurdin N, Vazquez L, et al. Osteotome sinus floor elevation without grafting: a 10-year prospective study. Clin Implant Dent Relat Res. 2016;18:609–617. doi: 10.1111/cid.12331.
16. Rammelsberg P, Mahabadi J, Eiffler C, et al. Radiographic monitoring of changes in bone height after implant placement in combination with an internal sinus lift without graft material. Clin Implant Dent Relat Res. 2015;17:267–274. doi: 10.1111/cid.12138.
17. Rammelsberg P, Kilian S, Büsch C, Kappel S. The effect of transcrestal sinus-floor elevation without graft on the long-term prognosis of maxillary implants. J Clin Periodontol. 2020;47:640–648. doi: 10.1111/jcpe.13278.
18. Duan DH, Fu JH, Yi Q, Koob A, et al. Graft-free maxillary sinus floor elevation: a systematic review and meta-analysis. J Periodontol. 2017;88:550–564. doi: 10.1902/jop.2017.160665.
19. Moraschini V, Uzeda MG, Sartoretto SC, et al. Maxillary sinus floor elevation with simultaneous implant placement without grafting materials: a systematic review and meta-analysis. Int J Oral Maxillofac Surg. 2017;46:636–647. doi: 10.1016/j.ijom.2017.01.021.
20. Nasr S, Slot DE, Bahaa S, et al. Dental implants combined with sinus augmentation: what is the merit of bone grafting? A systematic review. J Craniomaxillofac Surg. 2016;44:1607–1617. doi: 10.1016/j.jcms.2016.06.022.
21. Cortellini P, Tonetti LNP, et al. The simplified papilla preservation flap in the regenerative treatment of deep intrabony defects: clinical outcomes and postoperative morbidity. J Periodontol. 2001;72:1702–1712. doi: 10.1902/jop.2001.72.12.1702
22. Jimbo R, Albrektsson T. Long-term clinical success of minimally and moderately rough oral implants: a review of 71 studies with 5 years or more of follow-up. Implant Dent. 2015;24:62–69. doi: 10.1097/ID.0000000000000205.
23. Perez-Martinez S, Martorell-Calatayud L, Penarrocha-Oltra D, et al. Indirect sinus lift without bone graft material: systematic review and meta-analysis. J Clin Exp Dent. 2015;7:316–319. doi: 10.4317/jced.51716.
24. Markovic A, Misic T, Calvo-Guirado JL, et al. Two-center prospective, randomized, clinical, and radiographic study comparing osteotome sinus floor elevation with or without bone graft and simultaneous implant placement. Clin Implant Dent Relat Res. 2016;18:873–882. doi: 10.1111/cid.12373.
25. Kusiak JF, Zins JE, Whitaker LA. The early revascularization of membranous bone. Plast Reconstr Surg. 1985;76:510–516. doi: 10.1097/00006534-198510000-00003.
26. Browaeys H, Bouvry P, De Bruyn H. A literature review on biomaterials in sinus augmentation procedures. Clin Implant Dent Relat Res. 2007;9:166–177. doi: 10.1111/j.1708-8208.2007.00050.x.
27. Özkan Y, Akoğlu B, Kulak-Özkan Y. Maxillary sinus floor augmentation using bovine bone grafts with simultaneous implant placement: a 5-year prospective follow-up study. Implant Dent. 2011;20:455–459. doi: 10.1097/ID.0b013e3182386cbc.
28. Balleri P, Veltri M, Nuti N, et al. Implant placement in combination with sinus membrane elevation without biomaterials: a 1-year study on 15 patients. Clin Implant Dent Relat Res. 2012;14:682–689. doi: 10.1111/j.1708-8208.2010.00318.x29. Thor A, Sennerby L, Hirsch JM, Rasmusson L. Bone formation at the maxillary sinus floor following simultaneous elevation of the mucosal lining and implant installation without graft material: an evaluation of 20 patients treated with 44 Astra tech implants. Int J Oral Maxillofac Surg. 2007;65:64–72. doi: 10.1016/j.joms.2006.10.047.
30. Shlomi B, Horowitz I, Kahn A, et al. The effect of sinus membrane perforation and repair with Lambone on the outcome of maxillary sinus floor augmentation: a radiographic assessment. Int J Oral Maxillofac Implants. 2004;19:559–562.
31. Ragucci GM, Elnayef B, Suárez-López Del Amo F, Wang HL, Hernández-Alfaro F, Gargallo-Albiol J. Influence of exposing dental implants into the sinus cavity on survival and complications rate: a systematic review. Int J Implant Dent. 2019;5:6. doi: 10.1186/s40729-019-0157-7.
32. Jiam NT, Goldberg AN, Murr AH, Pletcher SD. Surgical treatment of chronic rhinosinusitis after sinus lift. Am J Rhinol Allergy. 2017;31:271–275. doi: 10.2500/ajra.2017.31.4451.
33. Thoma DS, Zeltner M, Hüsler J, et al. EAO supplement working group 4 – EAO CC 2015 short implants versus sinus lifting with longer implants to restore the posterior maxilla: a systematic review. Clin Oral Implants Res. 2015;26:154–169. doi: 10.1111/clr.12615.
34. BACELAR, Suzane Medeiros de Araújo, and Ulisses Gomes GUIMARÃES NETO. "Sinus lift: Realização e técnicas cirúrgicas." Brazilian Journal of Implantology and Health Sciences 1.5 (2019): 119-146.
35. Coelho, PARAGUASSU Éber, et al. "Installation of Implants in the Atrophic Maxilla without the use of Bone Grafting-Systematic Review." International Journal of Advanced Engineering Research and Science 6.5 (2019).
36. Rammelsberg P, Lorenzo-Bermejo J, Kappel S. Effect of prosthetic restoration on implant survival and success. Clin Oral Implants Res. 2017;28:1296–1302. doi: 10.1111/clr.12974.
37. Rammelsberg P, Pahle J, Büsch C, Zenthöfer A. Long-term apical bone gain after implant placement combined with internal sinus-floor elevation without graft. BMC Oral Health. 2020 Jul;20(1):197
2. Tatum H. Maxillary and sinus implant reconstructions. Dent Clin N Am. 1986;30:207–229.
3. Van den Bergh JPA, ten Bruggenkate M, Disch FJM, et al. Anatomical aspects of sinus floor elevations. Clin Oral Implants Res. 2000;11:256–265. doi: 10.1034/j.1600-0501.2000.011003256.x.
4. Summers RB. The osteotome technique: part 3 - less invasive methods of elevating the sinus floor. Compendium. 1994;15:702–704.
5. Zitzmann NU, Schärer P. Sinus elevation procedures in the resorbed maxilla. Comparison of the crestal and lateral approaches. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998;85:8–17. doi: 10.1016/S1079-2104(98)90391-2.
6. Tan WC, Lang NP, Zwahlen M, et al. A systematic review of the success of sinus floor elevation and survival of implants inserted in combination with sinus floor elevation. Part II: Transalveolar technique. J Clin Periodontol. 2008;35:241–254. doi: 10.1111/j.1600-051X.2008.01273.x.
7. Hallman M, Hedin M, Sennerby L, et al. A prospective 1-year clinical and radiographic study of implants placed after maxillary sinus floor augmentation with bovine hydroxy apatite and autogenous bone. J Oral Maxillofac Surg. 2002;60:277–284. doi: 10.1053/joms.2002.30576.
8. Brägger U, Gerber C, Joss A, et al. Patterns of tissue remodeling after placement of ITI dental implants using an osteotome technique: a longitudinal radiographic case cohort study. Clin Oral Implants Res. 2004;15:158–166. doi: 10.1111/j.1600-0501.2004.00988.x.
9. Maiorana C, Sigurta D, Mirandola A, et al. Elevation with alloplasts or xenogenic materials and implants: an up-to-4-year clinical and radiologic follow-up. Int J Oral Maxillofac Implants. 2006;21:426–432
10. Esposito M, Grusovin MG, Rees J, et al. Effectiveness of sinus lift procedures for dental implant rehabilitation: a Cochrane systematic review. Eur J Oral Implantol. 2010;3:167–184.
11. Lundgren S, Andersson S, Guliani F. Bone reformation with sinus membrane elevation: a new surgical technique for maxillary sinus floor augmentation. Clin Implant Dent Relat Res. 2004;6:165–173. doi: 10.1111/j.1708-8208.2004.tb00224.x.
12. Leblebicioglu B, Ersanli S, Karabuda C, et al. Radiographic evaluation of dental implants placed using an osteotome technique. J Periodontol. 2005;76:385–390. doi: 10.1902/jop.2005.76.3.385.
13. Silva L, de Lima VN, Faverani LP, et al. Maxillary sinus lift surgery—with or without graft material? A systematic review. Int J Oral Maxillofac Surg. 2016;45:1570–1576. doi: 10.1016/j.ijom.2016.09.023.
14. Si MS, Zhuang LF, Gu YX, et al. Osteotome sinus floor elevation with or without grafting: a 3-year randomized controlled clinical trial. J Clin Periodontol. 2013;40:396–403. doi: 10.1111/jcpe.12066.
15. Nedir R, Nurdin N, Vazquez L, et al. Osteotome sinus floor elevation without grafting: a 10-year prospective study. Clin Implant Dent Relat Res. 2016;18:609–617. doi: 10.1111/cid.12331.
16. Rammelsberg P, Mahabadi J, Eiffler C, et al. Radiographic monitoring of changes in bone height after implant placement in combination with an internal sinus lift without graft material. Clin Implant Dent Relat Res. 2015;17:267–274. doi: 10.1111/cid.12138.
17. Rammelsberg P, Kilian S, Büsch C, Kappel S. The effect of transcrestal sinus-floor elevation without graft on the long-term prognosis of maxillary implants. J Clin Periodontol. 2020;47:640–648. doi: 10.1111/jcpe.13278.
18. Duan DH, Fu JH, Yi Q, Koob A, et al. Graft-free maxillary sinus floor elevation: a systematic review and meta-analysis. J Periodontol. 2017;88:550–564. doi: 10.1902/jop.2017.160665.
19. Moraschini V, Uzeda MG, Sartoretto SC, et al. Maxillary sinus floor elevation with simultaneous implant placement without grafting materials: a systematic review and meta-analysis. Int J Oral Maxillofac Surg. 2017;46:636–647. doi: 10.1016/j.ijom.2017.01.021.
20. Nasr S, Slot DE, Bahaa S, et al. Dental implants combined with sinus augmentation: what is the merit of bone grafting? A systematic review. J Craniomaxillofac Surg. 2016;44:1607–1617. doi: 10.1016/j.jcms.2016.06.022.
21. Cortellini P, Tonetti LNP, et al. The simplified papilla preservation flap in the regenerative treatment of deep intrabony defects: clinical outcomes and postoperative morbidity. J Periodontol. 2001;72:1702–1712. doi: 10.1902/jop.2001.72.12.1702
22. Jimbo R, Albrektsson T. Long-term clinical success of minimally and moderately rough oral implants: a review of 71 studies with 5 years or more of follow-up. Implant Dent. 2015;24:62–69. doi: 10.1097/ID.0000000000000205.
23. Perez-Martinez S, Martorell-Calatayud L, Penarrocha-Oltra D, et al. Indirect sinus lift without bone graft material: systematic review and meta-analysis. J Clin Exp Dent. 2015;7:316–319. doi: 10.4317/jced.51716.
24. Markovic A, Misic T, Calvo-Guirado JL, et al. Two-center prospective, randomized, clinical, and radiographic study comparing osteotome sinus floor elevation with or without bone graft and simultaneous implant placement. Clin Implant Dent Relat Res. 2016;18:873–882. doi: 10.1111/cid.12373.
25. Kusiak JF, Zins JE, Whitaker LA. The early revascularization of membranous bone. Plast Reconstr Surg. 1985;76:510–516. doi: 10.1097/00006534-198510000-00003.
26. Browaeys H, Bouvry P, De Bruyn H. A literature review on biomaterials in sinus augmentation procedures. Clin Implant Dent Relat Res. 2007;9:166–177. doi: 10.1111/j.1708-8208.2007.00050.x.
27. Özkan Y, Akoğlu B, Kulak-Özkan Y. Maxillary sinus floor augmentation using bovine bone grafts with simultaneous implant placement: a 5-year prospective follow-up study. Implant Dent. 2011;20:455–459. doi: 10.1097/ID.0b013e3182386cbc.
28. Balleri P, Veltri M, Nuti N, et al. Implant placement in combination with sinus membrane elevation without biomaterials: a 1-year study on 15 patients. Clin Implant Dent Relat Res. 2012;14:682–689. doi: 10.1111/j.1708-8208.2010.00318.x29. Thor A, Sennerby L, Hirsch JM, Rasmusson L. Bone formation at the maxillary sinus floor following simultaneous elevation of the mucosal lining and implant installation without graft material: an evaluation of 20 patients treated with 44 Astra tech implants. Int J Oral Maxillofac Surg. 2007;65:64–72. doi: 10.1016/j.joms.2006.10.047.
30. Shlomi B, Horowitz I, Kahn A, et al. The effect of sinus membrane perforation and repair with Lambone on the outcome of maxillary sinus floor augmentation: a radiographic assessment. Int J Oral Maxillofac Implants. 2004;19:559–562.
31. Ragucci GM, Elnayef B, Suárez-López Del Amo F, Wang HL, Hernández-Alfaro F, Gargallo-Albiol J. Influence of exposing dental implants into the sinus cavity on survival and complications rate: a systematic review. Int J Implant Dent. 2019;5:6. doi: 10.1186/s40729-019-0157-7.
32. Jiam NT, Goldberg AN, Murr AH, Pletcher SD. Surgical treatment of chronic rhinosinusitis after sinus lift. Am J Rhinol Allergy. 2017;31:271–275. doi: 10.2500/ajra.2017.31.4451.
33. Thoma DS, Zeltner M, Hüsler J, et al. EAO supplement working group 4 – EAO CC 2015 short implants versus sinus lifting with longer implants to restore the posterior maxilla: a systematic review. Clin Oral Implants Res. 2015;26:154–169. doi: 10.1111/clr.12615.
34. BACELAR, Suzane Medeiros de Araújo, and Ulisses Gomes GUIMARÃES NETO. "Sinus lift: Realização e técnicas cirúrgicas." Brazilian Journal of Implantology and Health Sciences 1.5 (2019): 119-146.
35. Coelho, PARAGUASSU Éber, et al. "Installation of Implants in the Atrophic Maxilla without the use of Bone Grafting-Systematic Review." International Journal of Advanced Engineering Research and Science 6.5 (2019).
36. Rammelsberg P, Lorenzo-Bermejo J, Kappel S. Effect of prosthetic restoration on implant survival and success. Clin Oral Implants Res. 2017;28:1296–1302. doi: 10.1111/clr.12974.
37. Rammelsberg P, Pahle J, Büsch C, Zenthöfer A. Long-term apical bone gain after implant placement combined with internal sinus-floor elevation without graft. BMC Oral Health. 2020 Jul;20(1):197
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2020 Peter Rammelsberg , Julia Pahle , Christopher Büsch , Andreas Zenthöfer
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