title: Placement of tapered implants using an osteotome sinus floor elevation technique without bone grafting: 1-year results.
abstract: OBJECTIVE
  Achieving implant primary stability in poor-density bone is difficult when the available bone height is less than 6 mm. This study assesses the 1-year clinical performance of tapered implants in sites of reduced height in combination with osteotome sinus floor elevation without bone grafting material.
  
  
  METHODS
  An osteotome sinus floor elevation procedure without grafting material was performed in the atrophic posterior maxilla. Tapered implants were placed in maxillary sites with residual bone height of 1 to 6 mm. Implant primary stability was assessed by finger pressure exerted on the implant. Bone gain in the elevated sinus and crestal bone loss were evaluated at 1 year via radiographs.
  
  
  RESULTS
  Fifty-four tapered implants were placed in 32 patients and were loaded after a mean of 4.2 +/- 1.6 months. The mean maxillary residual bone height was 3.8 +/- 1.2 mm. All implants achieved primary stability, and all were successfully loaded. At the 1-year radiographic control, the mean bone gain within the sinus was 2.5 +/- 1.7 mm and the mean crestal bone loss was 0.2 +/- 0.8 mm.
  
  
  CONCLUSIONS
  In the atrophic posterior maxilla, primary stability can readily be achieved with tapered implants, even when the mean residual bone height is 3.8 mm. Despite limited bone support and lack of grafting material, all loaded implants were clinically stable, and crestal bone loss was limited. A net bone gain of 2.3 +/- 1.8 mm was observed. Survival and success rates were 100% and 94.4%, respectively. Elevation of the sinus membrane without the addition of bone grafting material led to bone formation beyond the original limit of the sinus floor.
authors.affiliation: Department of Stomatology and Oral Surgery, School of Dental Medicine, University of Geneva, Switzeland. rabah.nedir@swissdentalclinics.ch
authors.forename: Rabah
authors.initials: R
authors.lastname: Nedir
authors.forename: Nathalie
authors.initials: N
authors.lastname: Nurdin
authors.forename: Serge
authors.initials: S
authors.lastname: Szmukler-Moncler
authors.forename: Mark
authors.initials: M
authors.lastname: Bischof
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging / Q000209:etiology; D001284:Atrophy; D015519:Bone Density / Q000502:physiology; D000044:Dental Abutments; D015921:Dental Implants; D017267:Dental Prosthesis Design; D005500:Follow-Up Studies; D006801:Humans; D008437:Maxilla / Q000000981:diagnostic imaging / Q000601:surgery*; D008443:Maxillary Sinus / Q000601:surgery*; D008875:Middle Aged; D009092:Mucous Membrane / Q000473:pathology; D016348:Osseointegration / Q000502:physiology; D010012:Osteogenesis / Q000502:physiology; D010027:Osteotomy / Q000295:instrumentation* / Q000379:methods; D011183:Postoperative Complications; D011859:Radiography; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015921:Dental Implants