Crestal Approach for Maxillary Sinus Augmentation in Patients with ≤ 4 mm of Residual Alveolar Bone.
AUTHOR
-- BY Gonzalez S, Tuan MC, Ahn KM, Nowzari H.
Purpose: Less morbidity is the major advantage to a one-stage crestal approach to maxillary sinus elevation. However, the ability to ensure high primary implant stability in a severely atrophied ridge is of chief concern. The purpose of this study is to measure and compare the success rate of implants placed at the time of crestal approach sinus lift in patients with ≤ 4 mm of residual alveolar bone (RAB) and >4 mm of RAB.
Materials and methods: In this three-site
multicenter study, one hundred two patients, 53 males and 49 females, (23-89
years old; mean = 56.2) were evaluated. Three experienced surgeons (>15
years) performed the crestal approach sinus lift microsurgeries with simultaneous
implant placement. At baseline and at the follow-up appointments, calibrated
examiners measured radiographic interproximal bone level using ImageJ for
Windows after calibration of the radiographs. References for the bone level
measurements were the platform, first and second threads of the implants.
Statistical analyses, using STATA version 12, stratified patients according to
RAB height (group 1: RAB of ≤ 4 mm; n = 35 and group 2: RAB > 4 mm; n = 67),
age, gender, and treatment center.
Results: The success rate was 100% for group
1 and 98.51% for group 2 at 6 to 100 months post prosthetic loading (mean =
29.7 months). The peri-implant bone loss averaged 0.55 mm (interquartile range
[IQR] = 0.5 [0-1]) in group 1 and 0.07 mm (IQR = 0 [0-0]) in group 2. There was
no statistically significant difference between the two groups. Clinical outcomes
were independent of age, gender, and treatment center.
Conclusions: The RAB height did not increase crestal bone loss or reduce the success rate of the implants and associated prostheses. The crestal approach should be considered a viable technique for use in patients with residual bone height of ≤ 4 mm and merits further evaluation.
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