Oral and maxillofacial surgery
Comparison of clinical outcomes of sinus bone graft with simultaneous implant placement: 4-month and 6-month final prosthetic loading

https://doi.org/10.1016/j.tripleo.2010.04.011Get rights and content

Objectives

The aim of this study was to compare the survival rate and surrounding tissue condition of sinus bone grafts with simultaneous implant placement between 4-month and 6-month occlusal loading after implantation.

Study design

Twenty-seven patients (61 implants) who were treated with sinus bone grafts (sinus lateral approach) and simultaneous Osstem GS II implant placement from July 2007 to June 2008 were included in this study. Of these patients, 14 (31 implants) were in the 4-month loading group, and 13 (30 implants) were in the 6-month loading group. We investigated the implantation type (submerged or nonsubmerged), sinus membrane perforation, type of prosthesis, opposed tooth type, primary and secondary stability of implants, and crestal bone loss around implant and surrounding tissue conditions.

Results

The amounts of crestal bone-loss at the final recall time (12.56 ± 5.95 mo after loading) of the 4-month and 6-month loading groups were 0.19 ± 0.33 mm and 0.39 ± 0.86 mm, respectively. However, the difference between groups was not statistically significant (P = .211). The width of keratinized mucosa, gingival index, plaque index, and pocket depth of the 4-month and 6-month loading groups were 2.50 ± 1.69 mm and 1.73 ± 1.40 mm (P = .081), 0.72 ± 0.83 and 0.59 ± 0.69 (P = .671), 1.11 ± 0.96 and 0.76 ± 0.79 (P = .226), 3.56 ± 0.98 mm and 3.65 ± 1.06 mm (P = .758), respectively. The primary stabilities of implants in the 4-month and 6-month loading groups were 61.96 ± 12.84 and 56.06 ± 15.55 (P = .120), and the secondary stabilities were 71.85 ± 6.80 and 66.51 ± 11.28 (P = .026), respectively. The secondary stability of the 4-month group was significantly higher than that of the 6-month group. There was no statistical difference (P > .05) between the 4-month and 6-month loading groups regarding the implantation type (submerged or nonsubmerged), sinus membrane perforation, type of prosthesis, or opposed tooth type. In the 4-month and 6-month groups, all of the implants survived until the final recall time.

Conclusions

For the cases in which the residual bone was >3 mm and primary implant stability could be obtained, we conclude that loading is possible 4 months after the sinus bone graft and simultaneous implant placement.

Section snippets

Materials and Methods

This study was conducted prospectively on the patients who underwent sinus bone grafts using a lateral approach and simultaneous implant placements performed by a single oral and maxillofacial surgeon from July 2007 to June 2008. The approval from the Institutional Review Board at Seoul National University Bundang Hospital (B-0810-062-010, Seoul, Korea) was obtained before the onset of study. The subjects were male and female patients in whom the residual bone height to the maxillary sinus

Results

One implant from the 6-month group involving a simultaneous bone graft in the maxillary sinus and implant placement failed; therefore, the implant was removed and immediately replaced with a wide implant. Including the one repositioned implant, all implants survived to the last follow-up observation time.

The cases from each group with perforation in the maxillary sinus membrane are shown in Table I, and a statistically significant difference between the 2 groups was not detected (P = .216

Discussion

Maxillary sinus bone grafts and implant placements have been classified as simultaneous or delayed placement, and the benefits of the 2 types of placements are controversial among investigators. Greatly different success rates have been reported for this procedure, and therefore the procedure should be performed according to the treatment concept of surgeons and after sufficient consultation with patients. It has been reported that good results could be obtained if the patients who could

Conclusion

Between the cases with 4-month and 6-month loading times after simultaneous maxillary sinus bone graft and implant placement, the short-term prognosis was not greatly different. If cases are chosen appropriately to achieve primary stability, even in the cases in which bone grafts and implant placements are performed simultaneously and loading is placed at the time point of 4 months after placement, good results can be obtained.

References (23)

  • O.T. Jensen

    The sinus bone graft

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