Short implants placed with or without grafting into atrophic sinuses: the 5-year results of a prospective randomized controlled study.
OBJECTIVE
Over 5 years, (i) to evaluate the clinical efficiency of 8-mm implants placed with osteotome sinus floor elevation (OSFE) in extremely atrophic maxillae and (ii) to compare bone levels around implants placed with and without grafting.


METHODS
TE®SLActive®implants (Institut Straumann AG, Basel, Switzerland) were placed in sites with a residual bone height (RBH) of ≤4 mm. Before surgery, sinuses were randomized to receive anorganic bovine bone (control) or no graft (test). After 10 weeks of healing, implants were functionally loaded with single crowns. Bone levels were measured from standardized peri-apical radiographs.


RESULTS
Thirty-seven (17 test, 20 control) implants were placed in 12 patients (RBH: 2.4 ± 0.9 mm). Two early and one late failures occurred. The success rate was 91.9% (94.1% test, 90.0% control). All implants gained endo-sinus bone (3.8 ± 1.0 mm test, 4.8 ± 1.2 mm control; P = 0.004). Mean crestal bone loss (CBL) was 0.6 ± 1.1 mm, without a significant difference between the groups (P = 0.527). Mean bone gain and CBL did not change significantly between 1 and 5 years (P = 0.249 and P = 0.293, respectively).


CONCLUSIONS
Atrophic posterior maxillae can be predictably rehabilitated using OSFE with a simultaneous implant placement. The new bone formed around implants after 1 year was stable after 5 years, irrespective of the presence or the absence of graft. Grafting was unnecessary to achieve an average bone augmentation of 3.8 mm, but more bone was gained with grafting.
Ardentis Clinique Dentaire Vevey, Swiss Dental Clinics Group, Vevey, Switzerland.
Rabah
R
Nedir
Ardentis Clinique Dentaire Vevey, Swiss Dental Clinics Group, Vevey, Switzerland.
Nathalie
N
Nurdin
Ardentis Clinique Dentaire Geneva, Swiss Dental Clinics Group, Geneva, Switzerland.
Semaan
S
Abi Najm
Ardentis Clinique Dentaire Lausanne, Swiss Dental Clinics Group, Lausanne, Switzerland.
Marc
M
El Hage
Ardentis Clinique Dentaire Lausanne, Swiss Dental Clinics Group, Lausanne, Switzerland.
Mark
M
Bischof
D001284:Atrophy; D003442:Crowns; D003758:Dental Implantation, Endosseous / Q000379:methods*; D019250:Dental Implants, Single-Tooth; D017267:Dental Prosthesis Design; D005260:Female; D006801:Humans; D008297:Male; D008437:Maxilla / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D008903:Minerals / Q000627:therapeutic use; D011446:Prospective Studies; D059546:Sinus Floor Augmentation / Q000379:methods*; D016896:Treatment Outcome
C077540:Bio-Oss; D008903:Minerals
atrophic maxilla; bone gain; bone graft; bone regeneration; crestal bone loss; dental implants; internal sinus lift; no grafting; osteotome sinus floor elevation; posterior maxilla; prospective randomized clinical trial; sinus lift