title: Osteotome sinus floor elevation with and without grafting material in the severely atrophic maxilla. A 1-year prospective randomized controlled study.
abstract: OBJECTIVE
  (1) To measure and compare endo-sinus bone levels around implants randomly placed with an osteotome sinus floor elevation (OSFE) procedure in grafted (control) and non-grafted (test) sinuses, (2) to evaluate the OSFE efficacy with short, tapered, and chemically modified hydrophilic surfaced implants in extremely atrophic maxillae, (3) to show that fused corticals may constitute a complication risk.
  
  
  METHODS
  The TE(®) SLActive 8 mm-long implants (Straumann AG) were placed using an OSFE procedure in 4 mm or less of bone height. Healing time before prosthetic rehabilitation was 10 weeks. One year after implant placement, bone levels were measured on standardized periapical radiographs.
  
  
  RESULTS
  Thirty-seven (17 tests, 20 controls) implants were placed in 12 patients with a mean maxillary residual bone height (RBH) of 2.4 ± 0.9 mm. Before loading, two control implants failed (RBH 1.4 and 1.2 mm); two others rotated at loading (one test, RBH 0.9 mm; one control, RBH 1.5 mm) but were uneventfully loaded after three additional months of healing. These adverse events and complications occurred when implants were placed in merged corticals. Endo-sinus bone gain was 3.9 ± 1.0 and 5.0 ± 1.3 mm for the test and control groups (P = 0.003). The 1-year success rate was 100% and 90%, respectively (P = 0.49).
  
  
  CONCLUSIONS
  Although more bone is gained when grafting material is used, this may not be required to promote endo-sinus bone gain. The OSFE procedure with or without grafting material could be efficient when the RBH is ≤ 4 mm. However, when both corticals merged, the risk of complication could increase.
authors.affiliation: Ardentis Clinique Dentaire Vevey, Swiss Dental Clinics Group, Vevey, Switzerland; Department of Stomatology and Oral Surgery, School of Dental Medicine, University of Geneva, Geneva, Switzerland.
authors.forename: Rabah
authors.initials: R
authors.lastname: Nedir
authors.forename: Nathalie
authors.initials: N
authors.lastname: Nurdin
authors.forename: Paul
authors.initials: P
authors.lastname: Khoury
authors.forename: Thomas
authors.initials: T
authors.lastname: Perneger
authors.forename: Marc El
authors.initials: ME
authors.lastname: Hage
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Bernard
authors.forename: Mark
authors.initials: M
authors.lastname: Bischof
mesh_terms: D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D016025:Bone Transplantation; D003758:Dental Implantation, Endosseous / Q000379:methods*; D015921:Dental Implants; D017267:Dental Prosthesis Design; D019232:Dental Restoration Failure; D005260:Female; D006801:Humans; D008297:Male; D008437:Maxilla / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D008903:Minerals / Q000494:pharmacology; D010027:Osteotomy / Q000379:methods*; D011859:Radiography; D013524:Surgical Flaps; D016896:Treatment Outcome
chemical_list: C077540:Bio-Oss; D015921:Dental Implants; D008903:Minerals