title: Simultaneous dental implant placement and endoscope-guided internal sinus floor elevation: 2-year post-loading outcomes.
abstract: OBJECTIVE
  To determine whether endoscope-guided sinus elevation procedures can be consistently used to create sufficient bone support for stable implant placement and long-term implant success.
  
  
  METHODS
  Sixty-two implants were surgically placed into 30 patients (14 men and 16 women) following internal sinus elevation without the use of graft material. Panoramic radiographs were made pre-, post-operative and after 24 months in order to evaluate the peri-implant bone and maxillary sinuses. Resonance frequency analysis (RFA) was used to evaluate implant stability immediately upon placement and just before prosthesis delivery.
  
  
  RESULTS
  The average pre-operative height of the maxillary alveolar bone was 8.4+/-2.2 mm at the premolar and 7.3+/-3.1 mm at the molar regions. The average bone gain was 3.5+/-1.8 and 4.5+/-1.9 mm in the premolar and molar sites, respectively. Clinical parameters and the RFA (4 and 12 weeks post-operative) outcomes show sufficient stability (ISQ=60) of the inserted implants. Three implants failed during the healing period of 12 weeks. The overall implant success rate was 94%. After loading, no further implant failure was observed. The overall success rate after beginning of implant loading was 100%.
  
  
  CONCLUSIONS
  Sinus floor elevation is a well-established procedure for augmentation of the atrophic maxillary posterior region. The minimally invasive internal sinus floor elevation procedure visually guided by an endoscope helped to prevent, diagnose and manage complications such as sinus membrane perforation. The clinical outcomes of this study show that endoscope-controlled internal sinus floor elevation combined with implant placement results in low intra operative trauma, good implant stability upon placement, low incidence of post-operative symptoms and high success rates after 24 months of loading.
authors.affiliation: Clinic for Special Medicine/Department of Orofacial Surgery, University Hospital Stavanger, Stavanger, Norway. SCPE@sus.no
authors.forename: Peter
authors.initials: P
authors.lastname: Schleier
authors.forename: Gerrit
authors.initials: G
authors.lastname: Bierfreund
authors.forename: Stefan
authors.initials: S
authors.lastname: Schultze-Mosgau
authors.forename: Franziska
authors.initials: F
authors.lastname: Moldenhauer
authors.forename: Harald
authors.initials: H
authors.lastname: Küpper
authors.forename: Martin
authors.initials: M
authors.lastname: Freilich
mesh_terms: D000328:Adult; D000368:Aged; D003758:Dental Implantation, Endosseous / Q000379:methods*; D017268:Dental Prosthesis Retention; D019094:Dental Prosthesis, Implant-Supported; D019723:Endoscopes; D005260:Female; D006801:Humans; D008297:Male; D008443:Maxillary Sinus / Q000601:surgery*; D008875:Middle Aged; D013516:Oral Surgical Procedures, Preprosthetic / Q000295:instrumentation* / Q000379:methods; D011862:Radiography, Panoramic; D012189:Retrospective Studies; D013997:Time Factors; D014732:Vibration