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Osteotome sinus floor elevation without grafting material: a 1‐year prospective pilot study with ITI implants
Author(s) -
Nedir Rabah,
Bischof Mark,
Vazquez Lydia,
SzmuklerMoncler Serge,
Bernard JeanPierre
Publication year - 2006
Publication title -
clinical oral implants research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.407
H-Index - 161
eISSN - 1600-0501
pISSN - 0905-7161
DOI - 10.1111/j.1600-0501.2006.01264.x
Subject(s) - osteotome , medicine , dentistry , abutment , sinus (botany) , implant , bone grafting , maxillary sinus , prosthesis , osseointegration , orthodontics , surgery , osteotomy , civil engineering , botany , engineering , biology , genus
Objective: The aim of the present pilot study was to evaluate: (1) the predictability of an osteotome sinus floor elevation procedure with ITI‐SLA implants without placing a bone grafting material, and (2) the possibility to gain bone height without filling the created space with a bone grafting material. Material and methods: Seventeen patients received 25 implants protruding in the sinus. Most implants (21/25) were 10 mm long, eight were inserted in type 2 bone, 12 in type 3 and five in type 4 bone. At implant placement, the mean residual bone height (RBH) under the maxillary sinus was 5.4±2.3 mm; it was 5.7±2.6 mm on the mesial side and 5.1±1.9 mm on the distal side. Nineteen implants had less than 6 mm of bone on at least one side and six implants had less than 6 mm on both sides. A healing period of 3–4 months was allowed before abutment tightening at 35 Ncm. The percentage of stable implants at abutment tightening and at the 1‐year control was calculated. The endo‐sinus bone gain and the crestal bone loss (CBL) at the mesial and distal sides were measured. Results: Abutments were tightened after 3.1±0.4 months. All implants but one (96%) resisted the applied 35 Ncm torque. At the 1‐year control, all implants were clinically stable and supported the definitive prosthesis. All showed endo‐sinus bone gain; the mean gain was 2.5±1.2 mm. The mean CBL was 1.2±0.7 mm. Endo‐sinus bone gain and RBH showed a strong negative correlation ( r =−0.78 on the mesial side and −0.80 on the distal side). A good correlation ( r =0.73) was found between implant penetration in the sinus and endo‐sinus bone gain. Conclusion: Elevation of the sinus membrane alone without addition of bone grafting material can lead to bone formation beyond the original limits of the sinus floor. Despite a limited RBH at implant placement, a healing period of 3 months was sufficient to resist a torque of 35 N cm and to lead to a predictable implant function at the 1‐year control.