Osteotome-mediated sinus floor elevation: a clinical report.
OBJECTIVE
It was the aim of the present study to clinically evaluate the success of osteotome-mediated sinus floor elevation (OMSFE) using autogenous and xenogenic bone and a variety of screw-type implants.


METHODS
From August 1995 to February 2003, 276 OMSFE procedures with simultaneous implant placement were completed in 167 patients.


RESULTS
The mean residual bone height (RBH) of the alveolar ridge was 7.1 mm (range 3 to 10 mm). The mean increase in height of the implant sites using osteotome techniques was 3.8 mm (range 2 to 7 mm). Of the 276 implants placed, 240 had been loaded for an average of 27.9 months (range 1 to 84 months). There were a total of 18 failures: Ten implants failed to integrate, 3 implants were lost within the first 18 months of loading, 1 implant fractured after 3 years in function, and 4 implants demonstrated excessive bone loss. The overall survival rate was 93.5%. When only sites with an RBH of 4 mm or less were considered, the survival rate dropped to 73.3%. Small tears in the schneiderian membrane were clinically assessed at 13 sites, for a detectable perforation rate of 4.7%.


CONCLUSIONS
The primary determinant in implant survival with OMSFE procedures was the height of the residual alveolar ridge. Implant design, graft material, and the method of sinus floor infracture (direct or bone-cushioned) exerted minimal influence on survival outcome; however, factors such as edentulism, osteoporosis, and an overdenture prosthesis were shown to negatively influence postloading survival of implants placed in areas of limited RBH.


CONCLUSIONS
OMSFE procedures can be used predictably for implant placement at sites with moderate vertical deficiencies in the posterior maxilla.
Toffler
Michael
M
Department of Periodontology, Veterans Administration Medical Center, New York, NY, USA. mtoffler@optonline.net
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016301:Alveolar Bone Loss / Q000145:classification; D000539:Alveolar Process / Q000473:pathology; D000540:Alveolar Ridge Augmentation / Q000295:instrumentation* / Q000379:methods; D016025:Bone Transplantation; D015921:Dental Implants; D019232:Dental Restoration Failure; D003828:Denture, Overlay; D005260:Female; D006801:Humans; D008297:Male; D008437:Maxilla / Q000601:surgery*; D008443:Maxillary Sinus / Q000601:surgery*; D008875:Middle Aged; D009092:Mucous Membrane / Q000293:injuries; D016348:Osseointegration; D010024:Osteoporosis / Q000150:complications; D010027:Osteotomy / Q000295:instrumentation*; D016019:Survival Analysis; D014182:Transplantation, Autologous; D014183:Transplantation, Heterologous; D016896:Treatment Outcome
D015921:Dental Implants