A narrative review of the survival of dental implants placed simultaneously with lateral sinus floor elevations without the use of graft materials

P Kenyon,N West,N Claydon

doi:10.1111/ors.12541

Abstract

AbstractThis review aims to critically appraise the available evidence for the survival of implants placed simultaneously with sinus floor elevation without the use of grafting materials. The atrophic maxillary sinus may be restored with implants using a variety methods and adjunctive grafting techniques. The placement of implants in the atrophic maxillary sinus with and without bone grafting was reviewed in a systematic manner by considering the evidence presented in clinical studies. The initial search yielded 983 titles. Following title‐based, abstract‐based and full‐text evaluation 12 studies were identified, reporting on 1353 implants. Analysis identified a 98.38% survival rate at the point of uncovering. A further 0.3% of remaining implants were lost after 12 months and another 0.01% after 24 months. Beyond this point there were no further reported implant failures. Data were comparable for both grafted and ungrafted sinuses, with implants in ungrafted sinuses appearing to have a marginally higher success rate (98.11% vs. 97.87%).This review of implant data studies confirms that placing dental implants into maxillary sinuses with a graftless approach yields comparable implant survival to those cases that are grafted. This suggests that there is scope to simplify treatment protocols, decrease the risk of infection while maintaining treatment success and increase patient acceptance of sinus lift procedures.

Highlights

Changing patient expectations are driving the increasing requirement for the rehabilitation of the atrophic posterior maxilla with dental implants
This review identified randomised controlled trials, case–control and cohort studies as well as case series that assessed implant survival after simultaneous implant placement and sinus floor elevation via a lateral approach, with or without augmentation materials
The rationale behind the undertaking of any sort of sinus floor elevation is that the residual bone height is deemed inadequate to provide stability for the long-term success of a dental implant supporting a functional prosthesis

Summary

Introduction

Changing patient expectations are driving the increasing requirement for the rehabilitation of the atrophic posterior maxilla with dental implants. It was noted incidentally that the creation of a void below the Schneiderian membrane could lead to spontaneous bone formation[6], encouraging clinicians to develop techniques where the apices of implants alone are used to support the elevated membrane to allow the formation of a blood clot that differentiates into mature bone[7]. This has several potential advantages including improved patient acceptance with reduced use of graft material, the reduced need for the introduction of foreign body grafting materials into the sinus which may reduce the risk of infection, reduced cost and treatment time. The aim of this narrative review is to summarise and critically appraise the clinical evidence for implants placed simultaneously into elevated

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Conclusion