Implant marginal bone loss in maxillary sinus grafts.
OBJECTIVE
The marginal bone loss (MBL) around implants placed in maxillary sinus grafts was evaluated.


METHODS
The study consisted of 70 patients who had undergone 81 sinus-graft procedures (total 212 screw-type implants). Complete radiographic records were available for 160 implants, which were used to calculate MBL (follow-up 6 to 56.5 months). Habits (smoking, bruxism), surgical phase parameters (preoperative residual bone, grafting material, implant characteristics, and complications), and prosthetic parameters (crown-implant ratio, marginal fit, and opposite-arch restoration) were recorded for each patient and statistically analyzed regarding MBL.


RESULTS
Cumulative survival and overall radiographic success rates were 95.5% and 83.7% for 4.5 years, respectively. Smoking, small implant surface area, and a delayed implantation approach were related to enhanced MBL, with mean MBL values of 0.24 mm/y (P < .011), 0.21 mm/y (P < .031), and 0.31 mm/y (P = .052), respectively. In residual bone of < or =4 mm, the relation to enhanced MBL was stronger (P < .018) for delayed implantation.


CONCLUSIONS
Survival and radiographic success rates compare well with other reports. However, most studies modify success criteria regarding MBL. Smoking may be a primary risk factor regarding implant success. Implants with greater surface area values could compensate for problematic bone characteristics (e.g., in grafted maxillary sinuses). The effect of delayed implantation on MBL was surprising and may prompt simultaneous implantation whenever primary stability can be achieved.


CONCLUSIONS
Smoking and implant surface area affected MBL in this patient population. Criteria for long-term implant success should be revised to a standard.
Herzberg
Ran
R
Department of Prosthodontics, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel.
Dolev
Eran
E
Schwartz-Arad
Devorah
D
D000328:Adult; D000368:Aged; D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging* / Q000209:etiology; D002012:Bruxism / Q000150:complications; D016009:Chi-Square Distribution; D003758:Dental Implantation, Endosseous / Q000009:adverse effects* / Q000379:methods; D015921:Dental Implants / Q000009:adverse effects*; D019232:Dental Restoration Failure; D005260:Female; D006801:Humans; D008297:Male; D008439:Maxillary Diseases / Q000000981:diagnostic imaging / Q000209:etiology; D008443:Maxillary Sinus / Q000601:surgery*; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D012907:Smoking / Q000009:adverse effects; D018709:Statistics, Nonparametric; D016019:Survival Analysis
D015921:Dental Implants